Women's health imperiled by budget plan

Phyllis Greenberger

is president and CEO of the Society for Women's Health Research

Whenever the 2008 presidential candidates discuss health care, prevention always comes up. Of course, White House hopefuls are not alone in touting prevention. Efforts are already under way within the federal government to boost prevention.

The federal government spends millions of dollars on nationwide public-education campaigns that tell people how to prevent disease, because officials know effective prevention cuts future health-care costs for everyone.

Despite these efforts and the supportive rhetoric for prevention that reverberates throughout Washington, funding for key prevention services is in peril.

Congress will soon decide whether to cut $20 billion in Medicare funding that is designated for medical imaging services. This includes ultrasound, X-rays, CT scans, MRI, and other cutting-edge technologies that have revolutionized health care in recent decades. They are critical to our efforts to prevent disease or detect it early.

These cuts would be on top of $13 billion that has already been slashed by the 2005 Deficit Reduction Act, which took effect this year.

How important is imaging? The New England Journal of Medicine calls it one of the top 11 innovations of the last 1,000 years.

Advances in imaging have enhanced every aspect of women's health care. For instance, timely mammography screening of women over age 40 could prevent 15 to 30 percent of all deaths from breast cancer. Noninvasive bone scans can head off many of the 1.5 million fractures that occur every year because of osteoporosis.

These days, you rarely hear the term "exploratory surgery." That is because noninvasive medical imaging technologies can pinpoint problems quickly, precisely, with less pain and usually for less money. Consider uterine fibroid embolization. Guided by imaging, a woman can avoid a hysterectomy, cutting her recovery time from six weeks to just one.

So why is funding for these tests on the chopping block? Congress wants to contain rising health- care costs, and many believe that cutting Medicare reimbursements for imaging at non-hospital facilities is a good step in that direction.

This approach will have a disproportionately negative effect on millions of Americans who rely on public transportation or live in a rural area and do not have affordable or easy access to hospitals. Women with limited financial resources who already suffer from inadequate health services will have to forego imaging tests because they cannot afford out-of-pocket costs.

The problem is compounded when you realize that Medicaid and most private carriers of health insurance follow the lead of Medicare. The result would be a domino effect, reducing access to imaging services across the board.

Even though an immediate cost savings would be realized through these cuts, long-term health-care costs would soar because of undetected diseases, more invasive surgeries, longer hospital stays and longer recovery times.

Access to modern diagnostic and imaging tools is an issue of critical importance to women's health care that goes beyond general prevention efforts. For decades, the research and medical communities failed to adequately address the areas of health, such as heart disease and cancer, in which there are biological differences between women and men. The nuances of disease were not understood and women were treated based on studies of men. It was the era of one-size-fits-all medicine. Thankfully, questions about sex differences in health are now being addressed. New and emerging technologies are closing the gaps in clinical care.

Women have been waiting a long time to receive the right information and the right care in both hospitals and physicians' offices. Now is not the time to make it more difficult for women to get the care they deserve.