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Preventive care must remain a priority


The current administration’s proposed repeal and replacement of the Affordable Care Act is on the minds of a lot of women in Orange County.

Politics aside, every day in my office patients ask me questions about what the future holds for women with breast cancer and those who are undergoing screenings for early detection.

I can understand their worry, which unfortunately is piled upon their anxieties about their battle with breast cancer.

While many in my profession have debated the merits of the ACA and its changes to how we as physicians and surgeons practice medicine, most doctors do believe the law improved health care for women, particularly in providing incentives for preventive screenings. The law made it affordable for Orange County women (and men) to get preventive tests, such as mammography or colonoscopies.

On Monday, the administration released its proposed new health bill that would replace President Obama’s Affordable Care Act. At this point, few details have been released so it’s hard to know if the ACA’s preventive-health related items will remain intact or be repealed. I am hoping that many of the positive provisions in the ACA remain intact, particularly as we have seen good outcomes for women’s health, such as:

  • A rise in mammography screenings. A study from University Hospitals Cleveland Medical Center found that at least for mammography, eliminating out-of-pocket expenses has greatly increased the population of people who are getting screened.
  • Two years following the introduction of the ACA, the mammography rate increased among Medicare beneficiaries across all economic classes, according to the study, which was published in the American Cancer Society’s Cancer Journal.
  • While the study showed that mammography rates increased across the board, the most important aspect of the study showed that low-income women got screenings too, improving access for a hard-to-reach and engage population.

Right now, under the ACA, mammography is lumped into preventive care and not subject to co-pays. These routine tests don’t prevent breast cancer but can help detect it sooner when it’s more treatable. I believe that some women will skip their mammogram if they have to pay out of pocket, particularly those living in underserved communities of Orange County.

The ACA also provides support for breast feeding and working mothers. Some provisions allow for breast pumps and professional lactation services. Studies have shown that breastfeeding lowers moms’ lifetime risks of breast cancer.

More worrisome to many breast cancer patients was the potential repeal of ACA regulation that covered pre-existing conditions. Before the ACA, you could be denied health care coverage because you had a pre-existing condition like breast cancer. I am pleased to see that in the proposed new replacement bill announced Monday this provision remains intact. Quite simply, it saves lives.

I anticipate reviewing this administration’s replacement bill for the fine details. I hope that preventive care — given its value in the health care system and its importance for women in particular — remains a top priority for all of our legislators regardless of party affiliation. In the battle against breast cancer, which will claim about 40,000 daughters, moms and grandmothers this year in the United States, there should be no party lines. We have the most advanced technology and tools to find it early; let’s not leave them unused.

Michele Carpenter, MD, is an Orange County breast cancer surgeon and is current chief of staff of St. Joseph Hospital, Orange.

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Categories: Cancer,News,News Alert