Today, April 28th, is Blog for Fair Pay Day. In recognition of this important day, our guest post by Lisa Codispoti, Senior Counsel for Health and Reproductive Rights, National Women’s Law Center, relates to health care and equal pay.

Between 2000 and 2006, health insurance premiums increased 87.5 percent—4 times more than wages. In addition to the burden of inflated health care costs, women are still paid only 78 cents for every dollar earned by men—with women of color earning even less. In a world where women are earning significantly less than men for comparable work, how can they also afford health care?

Pay inequity for women compounds the issues that already exist with our broken health care system. This is a system that makes unfair practices by insurance companies flourish, such as allowing health to be more expensive for women. For example, women pay higher premiums than men when they try to buy health insurance directly from an insurance company through the individual health insurance market (a practice known as gender rating.) Even worse is that many of these health plans do not cover maternity care or expect women to pay an additional fee (what is called a rider) to gain maternity coverage. Women are then left trying to stretch their already smaller paycheck for a much larger health care bill.

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On Wednesday, the FDA announced that the emergency contraceptive Plan B — also known as the “morning-after” pill and, more technically, levonorgestrel — will be made available without a prescription to women at least 17 years old, in compliance with a federal court order issued a month ago, as Sarah Rubenstein reported on the WSJ Health Blog:

Back in 2006, the FDA gave the go-ahead to over-the-counter sale of the emergency contraceptive, known as Plan B, for women 18 and older after three years of delays in which there were angry protests by pro-choice groups and alleged back-room arm-twisting by conservatives close to the Bush White House. But the FDA said then the drug would remain prescription-only for those 17 and younger.
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Last month, a federal judge ordered the FDA to allow sales of Plan B to women 17 years and older without a prescription, and slammed several current and former FDA officials for their handling of the matter, accusing them of using “political considerations, delays and implausible justifications” to hold up the nonprescription sales of the drug.

Christine P. Bump provided further details on the FDA Law Blog:

Plan B has been available by prescription since 1999. On August 24, 2006, FDA approved non-prescription use of Plan B for women 18 years and older. Women 17 years and younger, however, still needed a prescription to obtain the drug. FDA described its August 2006 decision as a conclusion reached through an “extensive process” of obtaining expert advice and public comment. The Agency stated that the non-prescription use of Plan B presented novel issues, and that FDA was committed to “a careful and rigorous scientific process,” although an advisory panel convened by FDA had recommended by a vote of 23-4 that Plan B be available over-the-counter without any age restrictions. Note that the effect of both the District Court’s decision and FDA’s notice would still require a prescription for girls under the age of 17, although the District Court remanded the matter back to FDA for the Agency to “reconsider its decisions regarding the Plan B switch to OTC use.”

Naturally there has been a great deal of discussion about this development and the overarching issue around the blogosphere since the FDA’s decision not to appeal the federal court order. On Donklephant, Alan Stewart Carl noted:

The change isn’t huge. The previous age for over-the-counter purchase was 18. But do not doubt that the Obama administration will not have the problems with this rule that the Bush administration had. Many abortion opponents consider the morning-after-pill to be no different than an abortion and Bush was sympathetic to those worries. Obama, on the other hand, is decidedly liberal on the abortion issue.
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Of course, much of the debate comes down to when you think life begins… I think, for most people, the issue is not so clear cut. My views on abortion are complex and too complicated to effectively describe in a blog post. But I will say that I support Plan B contraceptive. Mistakes happen, either out of foolish moments of passion or failure of other contraceptive devices. Plan B allows for otherwise responsible people to remain responsible and not have a child they don’t want or can’t care for. It’s not perfect. But doing nothing and waiting to see if pregnancy results creates even greater problems and deeper moral dilemmas. It’s easy to draw bright lines, but it’s not always what’s best for a responsible society.

At NC Policy Watch’s Progressive Pulse blog, Sean Kosofsky wrote:

The old arbitrarily drawn line was 18 even though there is no research or evidence showing why only adults should have access to the drug known as “Plan B.” Emergency contraception is a superdose of “the pill” and prevents a pregnancy, but cannot end a pregnancy.

… tens of thousands of young women may now be able to prevent unintended pregnancies more easily should they face an unintended sexual encounter, be the victim of rape, or if their first choice of contraception failed. NARAL Pro-Choice North Carolina has worked for years to ensure that every pharmacy in NC stock Plan B and that all emergency rooms have it available for rape victims. This move by the FDA is terrific progress.

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What Nurses Can Teach Senators About Medicare:

Medicare took center stage earlier this week at a roundtable hearing held by the Senate Finance Committee to discuss reforming America’s health care delivery system. Because care for chronically ill older adults accounts for a disproportionate share of health care spending, Senate members were seeking solutions that could demonstrate Medicare savings for this population.

Dr. Mary Naylor, the Marian S. Ware Professor in Gerontology at the University of Pennsylvania School of Nursing and director of NewCourtland Center for Transitions and Health testified at the hearing and recommended the establishment of a Medicare benefit covering a program of transitional care to help coordinate care from hospital to home in the management of chronic illness. Mary’s main point: “There is an opportunity to reform our health care system using a rich base of evidence that demonstrates that nurse-led, team-based, transitional care can improve the health outcomes of at risk chronically ill elders, reduce avoidable hospitalizations and decreased health care costs.”

I was glad to see there was a great deal of interest in the transitional care model. I think the Senators get it that a significant portion of the Medicare population is costing the system dearly and models like Mary’s are innovations that need to be considered.

I heard some serious tension between the ideas of being bold with the reorganization of health care while others were saying too much disruption would scare purchasers and patients away. I heard Senators and former CMS Director Mark McClellan as well as the Director of MEDPAC say there will be upfront costs to do things differently such as scaling up primary care services. There were more conservative Senators who didn’t want to hear this.

Senator Hatch wants to create a Commission of the Health Care Workforce in response to the call from several physician groups present that we have a shortage of primary care docs, general surgeons. Others added nurses and nurse practitioners. I didn’t hear much support for his idea. The additional bonuses for primary care docs led to the discussion about medical homes and the admission from the MEDPAC director that this isn’t just about a payment to docs but evidence based practice, health IT integrations, and so on. The importance of nurse case managers for medication management, care coordination and patient compliance was a theme especially from health systems CEOs. Good to hear.

What next? Mary Naylor recommends the following: (more…)

When a woman is born, she has all the eggs she’ll ever have. The older >she gets, the fewer eggs she has — and they go down in quality. As some docs explain, you don’t want to bake brownies with old eggs. But, last week, a report came out that Chinese scientists have been able to grow new eggs in mice.

If women could produce new eggs, then they wouldn’t have to hire egg donors, and they wouldn’t have to feel pressure from friends, family and gynos to have babies before they’re 35. The Washington Post reported that this is a step toward stopping the biological clock.

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As a relatively frequent contributor to Huffington Post, I was unprepared for the avalanche of comments that followed a blog I wrote about YouTube sensation Susan Boyle. As one of the first bloggers to write about her, I caught an earful from HuffPo readers across the globe. My characterization of her as “homely” raised the ire of dozens of people who declared her “beautiful, inside and out.” Several wanted to know why I found it necessary to point out that she was 47, and several others excoriated me for being both ageist and sexist and possibly even beautyist. This is all so very ironic given that I am older than Ms. Boyle and have never been able to get by on my looks.

A week later, having been interviewed by a London-based radio station that asked me, “What does America think of Susan Boyle?” I am appalled by the hypocrisy displayed by people here and in Europe. When I mentioned to a male friend that I had written about her, he asked, “Is she the one who looks like a man?” Believe me, I would have loved for his response to have been, “Oh yes, the adorable one who signs like an angel!” But what are the chances?

I would love for all people to be judged on the basis of their strength of character or kindness or talent. But even for Susan Boyle, that is a short-lived dream. Already stylists are lining up to pluck, curl, straighten, camouflage, colorize, and glamorize Ms. Boyle. Given the opportunity, producers would sign her up for Britain’s Biggest Loser followed by a stint on Style Her Famous. In a few weeks, our frumpy eccentric singing phenom would undoubtedly have her face lifted, her breasts reduced, her brows tattooed, her hair colored and her wardrobe replaced if TV execs had their way. Would she sing any better? No. But she would look more like the singing idols we are used to.

Yes, there’s been a global outcry to leave her how she is. So many “average” people have delighted in the possibility of someone who looks like them achieving fame and glory. But is there a sea change coming in how we perceive and treat those who fail to achieve the ideals of youth and beauty espoused by our media? Will we now see Susan Boyle clones on the covers of women’s magazines and starring in the latest TV sitcoms and cop shows? I am willing to bet not. Susan Boyle may emerge from all of this hoopla unchanged, but I’m afraid so will our views on women and beauty and age. Plastic surgeons can rest easy knowing that she’s an aberration – a sweet moment of relief for those of us who fail to meet unattainable standards – in the landscape of nipping, tucking, lifting and Botoxing that will endure long after Ms. Boyle’s day in the sun fades.

The following is a two part post (both parts are included so please read all the way through) that calls attention to an exciting and important new effort to engage everyone in health reform. Do you have a “2 minute rant” you’d like to share with the administration? If so, read on…

Introducing h20tv!
Indu Subaiya, MD, MBA
Co-founder, Health 2.0

Blame it on election fever or my move to the filmmaking capital of the world, LA, but I was recently inspired, along with my amazing conference teammates, to create and launch h20tv, a video channel for Health 2.0. It has been apparent for a while now that we’re hearing a lot more from the community than just feedback on new technologies and we wanted a way to surface that.
While technology is still what we live and breathe most days, what’s been interesting is people’s responses to how technology is actually changing healthcare experiences or enabling new visions for change on many levels. Our work with the Center for Information Therapy on a joint conference and on the first h20tv video project has already surfaced many lively debates.

We’re now a few years into this Health 2.0 thing if you will and it’s not speculative anymore. There’ve been successes and failures, hard data and experiences we can all learn from. In the present context of healthcare reform, sure, the papers and blogs have been full of the punditry exchanging blows…we wanted to capture more of the dinner table conversations. Because there are some really good ideas out there and they’re not all from experts. And who is an expert in healthcare anyway? For more about that sidebar, see Great Debate #5 at the upcoming conference agenda.

So what do you get when you ask people what their 2 minute rants to the new administration would be about healthcare – not their long manifestos, just their biggest, burning issues? It’s fascinating to see what bubbles to the top. My Co-founder Matthew Holt talks about the need for a common social insurance pool, Dr. Thomas Barber of Kaiser Permanente tells us how web tools have decreased his office visits by more than 20%, Julie Murchinson of the Health 2.0 Accelerator talks about the promise of personalized health care, Robin Strongin of Amplify Public Affairs advocates for the consideration of broader life circumstances when providing healthcare including education, transportation etc. and healthcare consumer Julian Robinson describes how challenging it is to find a doctor in a new city… and that’s coming from a web-savvy 23 year old.

We want lots more voices. And we’ll string along select snippets for a little trailer to show at the upcoming conference. No this isn’t going to have perfect production quality – you’ll have to go to expensive agencies for scripted messages and bad background music for that. This is pure user-generated brainpower, the way we love it, straight up and unfiltered.

We don’t have a special in with the new administration, but we know we are part of a growing and diverse community of people who think and care deeply about improving the healthcare system. So we figure the word will eventually float over to the white house over these wild web airwaves. And now, here’s Julie to say more about this project in the context of the accelerator and what she’s seeing on the ground for health 2.0 companies trying to innovate and integrate with the healthcare system.

We the people want more out of health
Julie V. Murchinson, MBA
Managing Director, Manatt Health Solutions
Executive Director, Health 2.0 Accelerator

We are at a turning point in how we the people take part in our healthcare. Just as Facebook and Twitter have allowed people to connect and delve more deeply into each other’s everyday life, h20tv is amassing the power of the people to begin to weave together a story of what we want, our ideas about how to make it happen and, in some cases, desperate pleas to change the status quo. What is most interesting, however, is that many of the videos spell out a fairly simple desire – the personalization of health care – to allow citizens to play a larger role in their care and to have care more customized for each person. Sure, there are still several million Americans who aren’t yet racing to get a seat at their care-team table, but for those who are…why is it so hard to do something so seemingly simple?

Why can’t we jump on our iPhone to track our stomach pain until we realize that its getting increasingly worse, then be able to access some clinical information about treatment options that helps us find a clinician online we can consult with, who recommends a specialist close to work so we don’t have to take more time off, who sees us that day because health IT has improved his/her patient through-put, who sends an e-script to the pharmacy for pick-up on the way home, which launches a medication schedule with reminders to our iPhone to make sure we take our meds on time and appropriately, as well as a health management portal that recommends a dietary plan and begins to help us self-test different diet, exercise and other daily living practices that may impact our condition until we narrow down the flare-up association and circle back around with our clinician to validate our findings? Whew…deep breath. Should this really be that hard to do? And I didn’t even mention the correlation between our genetic make-up and our symptoms, and how that impacts clinician direction, medication and our self-discovery efforts. Now you’re talking!

So, why doesn’t that happen today? Umm…let’s see…how long do you have to read this blog? Or personal relationship with our own healthcare is an unfortunately complicated one. At the Health 2.0 Accelerator, a nonprofit organization working with Health 2.0 companies and traditional health care organizations, we are beginning to chip away at this ideal by driving integration of technology and the consumer experience. From our perspective, we see consumers starting to seek comprehensive solutions, rather than fragmented tools and services, from this emerging movement referred to as “Health 2.0.” Health 2.0 companies are seeking ways to expand their offerings to consumers rapidly and cost effectively, while fortifying or evolving their business models. “Traditional” healthcare organizations are starting to explore new capabilities for patients to generate, analyze and consumer health information.

The great ideas in these videos are finding realistic test beds to see what works and, most importantly, what we the people need, want and will use to begin to take part in our healthcare…just for us…in the same independent, personalized way we have begun to do so in so many other parts of our lives.

The following is a guest post from Julia Loughran, a Digital Media and Gaming Solutions Expert with iConecto—Gaming4Health.
(Full Disclosure: Amplify Public Affairs is now the PR Strategic Partner for iConecto—Gaming4Health)

Yesterday, I had the opportunity to speak on Capitol Hill as part of a special event hosted by the same group that hosts this wonderful blog – Disruptive Women in Health Care, and its media partner The Hill. The topic was Health eGaming, Healthy Patients: Supporting Stimulus Goals Through Health eGaming. I was there to speak about the opportunities health eGames can bring to healthcare, both as forms of preventative care (e.g., exer-games that get people up and moving and games that promote healthy behaviors, like healthy eating and smoking cessation), as well as games that can help with acute and chronic disease management (e.g., asthma, cancer and diabetes).

The Honorable Nancy L. Johnson, Former Chair of the House Ways and Means Health Subcommittee opened the session, stressing that change was needed in health care and one of the main changes was the need to focus on the patient. “The real reason the patient is going to become the most important person in the healthcare system,” according to Johnson, is “you can’t do prevention without them.”

This point really resonated with me because it made me think about personal responsibility. When it comes right down to it, our health and the reform of our health behaviors rests in our own hands. We have the tools, the information, and now hundreds of health eGames that can help us live healthier and longer lives. Do we need to wait for the U.S. government to prescribe these games (which I understand will take years of slogging through regulatory barriers and miles of bureaucratic paperwork), or can we all just go out and start taking advantage of the great stuff already out there?

iConecto has done the leg work to capture a database of the nearly 600 health eGames and 500 plus mobile applications, many of which are featured and reviewed on our consumer portal Gaming4Health.com. So, if you want to be more active, why not try out some of the many titles designed for the Wii? We had Congressional Staffers at yesterday’s event that were breaking into a real sweat after just a few minutes jogging to a game on Active Life’s Outdoor Challenge. Exer-games like Outdoor Challenge, Wii Fit, and Dance, Dance Revolution are a much better way to spend an evening with your family instead of passively watching Dancing With the Stars on TV. But, if Dancing with the Stars is something you love, then why not do it yourself with the Wii version? And if it is your brain you want to exercise, there are many web sites filled with fun and interactive games that will give your gray matter a work out. Some of the popular brain fitness sites include Happy Neuron, Sharp Brains, and Lumosity.

Being healthy and having an active lifestyle isn’t as hard as it used to be. Today there are mobile and iPhone apps that will provide you with your own virtual fitness coach, or you can try yoga or track your steps, or if you are competitive, you can find online health and fitness competitions.

We all have the resources to be healthier, we just need to step up to the plate and take responsibility for leading healthier lives – and there is no reason why we can’t have a lot of fun while we shed a few pounds, eat better, and work our noggins. So, what are you waiting for? Get out and play a little. It will be fun and good for you!

View photos from this event on Facebook, or on Flickr, and see The Hill’s video coverage here, and The Washington Post’s coverage here.