Despite the shouts and insults at town council meetings, I remain hopeful about health reform. I have no choice. br As an obstetriciangynecologist, I have spent years learning to keep women healthy. Too often I find myself saying to patients with easily treatable disease that can not stop them who have no money to heal. Denying care to women and it tears me apart to see them suffer. That's why I became an ardent advocate of health reform. br I'm not talking about the retention of the latest, cuttingedge, medications or treatments exorbitant prices. No I have had patients whose health insurance does not cover basic health needs, such as Pap tests and prescriptions for birth control. And forget about having a baby many insurance policies do not cover prenatal care or delivery, or to treat pregnancy as a preexisting condition. br As a country, we must give women a better chance of staying healthy. Thanks to the reform of health, Washington could ensure reproductive health care accessible to every woman and child in the nation, no matter who your insurer. br I recently had a patient, Celia, who made too much money to qualify for Medicaid. Your employer does not offer insurance. She had fibroids, a common condition of the uterus. But because Celia could not afford to see a doctor, her fibroids grew uncontrollably to the point of interfering with their monthly cycles. She bled so hard that she suffered severe anemia. I had to send her to the emergency room, where he was hospitalized for a blood transfusion. Hemorrhage br Celia was an unnecessary risk to their health. Additionally, the hospital paid for his trip to the emergency room, the type of cost that makes health care more expensive for everyone. If she had health coverage, your fibroids could have been managed by a solution as simple as birth control pills, without affecting the number of his illness had on his family, coworkers, and everyone else who depends on it. br As a doctor, could have some satisfaction in helping to improve Celia not with Maureen, the mother of four who saw some years ago. Maureen Say your first pelvic exam ever. She was 29. I found a great growth in the cervix that is almost certainly cancer, but could do a biopsy or continue their treatment because they could not pay for it. br Maureen had no insurance and little money. Like many of my medical colleagues in situations like this, I tried desperately to find financing for it. I came with empty hands. I ended up with the feeling of having done something immoral telling Maureen about a potentially deadly medical problem that could not do anything. br To Celia, Maureen, and all other women, reproductive health is the foundation of their welfare. However, insurance companies treat reproductive health care as a luxury and load accordingly. Some make a woman to pay up to 45 percent higher than a man for an individual policy, just because it happens to be female. Health reform must address the health of women as a rule, not as an exception. We have to change American health insurance to cover the needs of women at prices they can afford. br As a nation, we can not dismiss Celia and Maureen situations as quot; mujer.quot problems; Women constitute half of our population. Their reproductive health can not be separated from their overall health and their impacts on the overall health of their families, their jobs, and our society as a whole. br Congress should pay attention to reproductive health at the heart of the reform. Women should have affordable access to pelvic exams, cancer screening and sexually transmitted diseases, contraception, prenatal care, treatment of miscarriage, maternity services and abortion services. Helping women stay healthy will help us all. br Will J. Parker, MD, MPH, is a board member of Physicians for Reproductive Choice and Health and an obstetriciangynecologist in Washington, DC br br
