New York State just did an awesome thing — a really awesome, totally progressive thing. Governor Cuomo announced that gender reassignment surgery has to be covered by health insurance throughout the entire state.

We recently got wind of this stellar news last week when @NYTimesHealth tweeted the following:

Insurers in New York Must Cover Gender Reassignment Surgery, Cuomo Says http://nyti.ms/1skxKUG

According to Kaiser Health News, the announcement was made last week via letter from Governor Cuomo to insurance agencies. The governor came to this conclusion because, “state law requires insurance coverage for the diagnosis and treatment of psychological disorders.” This covers people who have a “mismatch between their birth sex and their internal sense of gender.”

So, insurance coverage would naturally cover treatment for this condition, which is commonly called gender dysphoria.

Along with the surgery, health insurance companies also must cover hormone treatment, as well as the preparation it takes a person who is planning to have the surgery. It also must take into account recovery time.

New York is now one of about a handful of other states that have made similar rulings. These other states include California, Colorado, Connecticut, Illinois, Massachusetts, Oregon, Vermont, and also Washington, D.C., reports Medical Daily. The hope is that this type of coverage will soon become the norm and other states will follow in these progressive states’ footsteps. If a health insurance plan doesn’t cover this type of surgery, a person typically has to raise their own money, as the surgeries (and prep, recovery) are quite expensive.

Also of note: The NY Daily News reports that the number of companies that cover gender reassignment surgery has “more than doubled in the past year.”

Let’s hope these positive trends continue.

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Image: Ted Eytan

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Women rejoice for the Affordable Care Act.

When Obama’s Affordable Care Act passed in 2010, many of its provisions would not go into effect until 2012. At the time, 2012 seemed like it might as well be light-years away. Most insurance companies didn’t cover birth control, so most women paid out of pocket. $50 a month is a lot — and that’s if you’re lucky enough to be employed and insured.

But being a woman is no longer a pre-existing condition (we wish that were a joke, but it’s not). Many of the health care penalties that women had to pay are now gone. As of August 1, 2012, all birth control — IUDs, the pill, and so on — are all covered by insurance. That means that they’re free. No co-pays, no deductibles. Among the other fabulous new benefits covered are annual “well woman” checkups that include preconception care, counseling and support for breast-feeding, pap smears and support for domestic violence survivors.

As great as these new benefits sound, they do come with some caveats. Only women between the ages of 18 and 64 who are currently covered by private health insurance qualify for free birth control — and if their plans haven’t changed since March of 2010, when the act passed, then their current co-pays are grandfathered in. The uninsured will still have to pay for everything out of pocket, even though it is currently easier for young people and those with preexisting conditions to purchase insurance.

But by this time next year, most of these caveats will have expired and 47 million women will qualify for free birth control.

We like that.

Image: Ultraviolet.

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We all continue to be somewhat baffled over how often to get mammograms and whom to trust as the last word on this critical issue for women. Hey, we all want to grow up to be old women, right?

Weeks after the release of the report on new recommendations for mammograms by the 16-member U.S. Preventative Task Force, the firestorm rages on, even splitting parties as Republicans argue that the recommendations could be used to ration healthcare under reform legislation before Congress, a charge Democrats denied.

According to Reuters, Republican Representative Joe Barton suggested in a congressional hearing that under Democratic healthcare reform legislation passed by the House of Representatives, the task force could decide which preventive services, including mammograms, would be covered for many Americans.

“To have a task force make the recommendation that has been made, and to have in this bill the authority that’s given to various unelected bureaucrats to make healthcare decisions, including coverage frequency, in my opinion, is wrong,” Barton told the House Energy and Commerce Committee’s subcommittee on health.

The Senate is debating its version of healthcare reform legislation, seen as President Barack Obama’s top domestic priority, especially among American cancer doctors, who are outraged about the challenge to the accepted guidelines. It has touched off a heated debate among those doctors, as well as various groups.

The American Cancer Society, perhaps the most prominent of these groups, says it is sticking to the current recommendation to start annual mammogram screening at age 40 because the breast X-rays have been proven to save lives by spotting tumors early on when they are most easily treated.

Current standards say women 40 and older should get mammograms every year, while the revised recommendations suggest only we gals over 50 get screened, and that they do so every other year. Women over 74 can dispense with the test altogether, says our government.

An analysis by ABC News suggests money is the motivation. Professor Theodore Marmor, a health care policy specialist at Yale University, said cost-benefit analysis is routine in the health insurance biz.

“Although screening every woman between the ages of 40 and 50 would turn up some breast cancer”¦the question is what is the cost per diagnosis per relevant harm,” says Marmor.

“The question is going to be, between the ages of 40 and 50, what is the frequency with which you are going to find a true positive cancer finding, how many cases would we miss, how many of those cases would develop into cancer and what is it going to cost to treat them,” says Ian Duncan, president of Solucia, a company that provides actuarial health care analysis for insurers.

Duncan explains further that mammograms are actually a value-based benefit because they are preventative and only run about $125 per exam.

It’s  believed the new research doesn’t take into consideration the savings of newer technologies in screenings. ABC reports that digital mammograms are 1.5 to 4 times more expensive than conventional film-based mammograms, according to the National Cancer Institute, which also reported in 2005 that only 8 percent of the country’s breast imaging units provide the technique.

Either way, should we be thinking about money when it comes to prevention and saving lives?

“I definitely think this is the beginning of rationed care and I am very upset that women are the first to get slammed with this,” said Dr. Elizabeth Vliet, a women’s health care specialist based in Tucson, Ariz., and an opponent of health care reform. “I think that this change is designed to cut costs, not improve women’s health.”

Meantime, we women must decide for ourselves. What else is new?

Personally, at 51, I’m usually a year late in getting my own exam so I’m not overwhelmed by this debate. I don’t beat up on myself when I’m late but I know I cannot let it go too long. I know because of the number of women lost to this horrible disease, and the pink ribbons that symbolize we must keep asking the important questions and donating to our own cause when we can. I trust the pink panel more than the government panel. How ’bout you?

Image: About.com

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Kaiser Permanente is prescribing big doses of sustainability in the sixth season of its $50 million Thrive ad campaign.

Two new ads – Emerald Cities and Connected – reinforce the health care provider’s commitment to the planet by dramatically reducing paper use – no small task for an industry long married to countless charts and forms. For most of us, being ordered to “Fill this out” is as rote as, “Hop on the scale,” and just as painful.

The Emerald pitch describes how Kaiser is allowing patients access to their own medical data via Kaiser Permanente HealthConnect, the world’s largest civilian electronic health record.

Not just a handy core tool for patients, the online system is apparently saving thousands of trees annually. And, as of September 2009, Kaiser estimates its members completed six million doctor’s visits without using one gallon of gasoline. Guess they got the help they were seeking by going online.

“We will be entirely paperless by 2010 and these ads illustrate how we are doing our part in some way to help the environment,” I’m told by Lisa Ryan, Director of National Advertising at Kaiser. “Having a healthy environment creates a healthy community that helps individuals thrive.”

In these appealing ads, actress Allison Janney, the KP spokeswoman since 2004, drives home the point in her now familiar, smooth-as-a-surgical-glove delivery:

“By putting an end to paper medical records, we have ushered health into the digital age.”

To paraphrase the tagline: I think that I shall never see, a 62-page medical report as lovely as a tree.

“Our ode to trees talks to the fact that when you have online capabilities and a way to connect, it  does eliminate the need to drive to a facility or to an office visit,” says Ryan.

The Connected spot highlights the convenience of securely e-mailing your doctor, checking your medical records, reviewing test results and booking appointments online. This spares not just trees but the stress of being forced to listen to bad “music” after being placed on hold the second your doctor’s receptionist answer the line.

Kaiser clinicians are digitally connected to each other, which ultimately helps them stay connected to  members. The closing line of the ad summarizes, “At Kaiser Permanente, we believe that if knowledge is power, shared knowledge is even more powerful.”

Personally, I have struggled to attain the elusive power of shared knowledge while advocating for loved ones at hospitals where overworked, impatient doctors seemed agitated when pressed for too much info. Getting them to return phone calls was even harder. Then again, my family doesn’t use Kaiser. Maybe their doctors are more generous.

“Our primary care physicians are at center of who we are and we have great accessibility in person, on the phone and email,” says Ryan. “Ive had great experience with my own doc whom I have spoken to on the phone and through email. All of our new alternative ways to reach out and stay connected really help.”

I was glad to see the green connection extends to its Thrive website, which give readers tips on being “thriving communities” by buying locally-grown food, using fewer shopping bags, making their own cleaning supplies and avoiding exposure to chemicals in the home.

Ryan told me all of this effort, including the ad campaign, has been an extension of proven sustainability practices at Kaiser’s newly-built facilities, such as centers in Modesto and Santa Clara, using solar panels, pavement treatments to recycle run off water and friendly denim material in the walls as green insulation.

“The advertising is a great bridge between the sustainability message and the innovation of who we are,” Ryan  says. “It was a huge undertaking to go digital and to retrain the care staff, but it all speaks to our overall concern with the health of individuals and the community. ”

Prior to the green thrust, Kaiser treated us to daily ads on prevention, reminding our unhealthy nation that the more we exercise, eat well and get screened for diseases, the less we will have to spend on health care.

I think the ads resonate with the radio-listening masses facing poor health along with a poor health care system that has yet to be reformed.

With $50 million invested in the message, let’s hope Kaiser proves to be one of the needed cures.

Images: Kaiser Permanente, Wiki

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