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Health Care Reform Debate Renews Focus On Insurance Coverage Of Abortion Care
The issue of whether government-subsidized health care programs should include coverage for abortion procedures is gaining attention as Congress continues drafting health care reform legislation, Time reports. Currently, the Hyde Amendment -- a legislative provision attached annually to major spending bills since 1976 -- prohibits states from using federal Medicaid funds to pay for abortion. All but 17 states have similar restrictions on their own funds. Although current versions of health reform legislation do not yet address the issue of abortion, congressional s involved in the process say that an explicit ban on abortion coverage could have "much further-reaching implications" than the Hyde Amendment. According to Time, the restrictions could deny abortion coverage to women whose private insurance plans currently cover the procedure. A 2002 Guttmacher Institute survey found that nearly 90% of private insurers cover abortion procedures. Under the legislation being worked on in three House committees, U.S. residents with incomes up to 400% of the poverty level -- about $88,000 annually for a family of four, or $43,000 for an individual -- would be eligible for government subsidies to help purchase coverage. However, antiabortion-rights lawmakers are pushing to prohibit those subsidies from being used to purchase health insurance policies that include abortion coverage, Time reports. Such restrictions would mean that women who currently have abortion coverage in their private plans would have to give up the benefit. According to Time, such a provision also "would raise all sorts of other questions if insurers were allowed to discriminate among their customers based on whether or not they are using federal dollars to pay for their policies."Pelosi Negotiating With House Dems Over ConcernsLast week, 19 House Democrats sent a letter to House Speaker Nancy Pelosi (D-Calif.) stating that they "cannot support any health care reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health insurance plan." They also said that abortion "must be addressed clearly in the bill text" of the legislation. The signers of the letter include Reps. Bart Stupak (Mich.) and Charlie Melancon (La.), both members of the House Energy and Commerce Committee, one of the three panels with jurisdiction over health care reform. According to Time, Pelosi"s office is attempting to address the concerns through negotiations.Poll Shows Support for Reproductive Health CoverageMeanwhile, abortion-rights advocates are "pushing back" against those seeking to specifically exclude abortion coverage in health care reform legislation, Time reports. The National Women"s Law Center on Monday released results of a nationwide poll of 1,000 likely voters showing that 71% of respondents favor including reproductive services like birth control and abortion in health care reform (Tumulty, Time, 7/8). The poll also found that 72% would oppose exclusion of abortion coverage from any national health care plan (Eaton, Plain Dealer, 7/7). In addition, 75% of respondents said that an independent commission, not Congress, should determine what medical services are included in the basic benefits offered under health reform. Congress also is weighing giving that power to HHS Secretary Kathleen Sebelius (Time, 7/8).Judy Waxman, NWLC vice president, said that 80% of employer-based insurance plans provide coverage for abortion services, adding that "people will be angry if they don"t get to keep what they already have" under any public insurance option (Cleveland Plain Dealer, 7/7). Waxman said Congress should "refrain from practicing medicine and instead let medical professionals determine what health care services will be included in a benefits package" (Time, 7/8).
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Study Shows Teen Contraception Use Declining, Level Of Sexual Activity Unchanged
After years of declining teenage pregnancy rates and improved teen contraception use during the 1990s and early 2000s, the trends appeared to have flattened or even reversed among some groups of teens in recent years, according to a study from Columbia University"s Mailman School of Public Health and the Guttmacher Institute, the Christian Science Monitor reports. Researchers found that from 2003 to 2007, teens" contraceptive use declined by 10%, while their level of sexual activity did not change. The decrease in contraceptive use was particularly prevalent among black teens. The figures take into account the rate of contraception use as well as the types of contraceptives used, as methods vary in effectiveness. Teen condom use leveled off and in some cases declined, according to the study. The study also reported that the teen birth rate increased by 5% from 2005 to 2007. According to the study"s authors, the findings suggest a link between declining teen contraception use and the rise in abstinence-only education during former President George W. Bush"s administration. President Obama"s fiscal year 2010 budget proposal calls for redirecting some abstinence-only funds toward increased comprehensive sex education, the Monitor reports. In addition to the effects of abstinence-only sex education, the decline in condom use also could be tied to lessening concern about sexually transmitted infections, including HIV/AIDS. A shift in the teen population to include a higher number of Hispanics -- who have the highest rates of teen pregnancy and birth -- also could contribute to the findings. Laura Lindberg, one of the study"s authors and a senior research associate at Guttmacher, said, "In the end, this story is really about the loss of momentum." She added that although the statistical changes are small, "they raise concern about what the next few years will bring in this country." Sarah Brown, director of the National Campaign To Prevent Teen and Unplanned Pregnancy, noted that the proportion of births to unmarried women, particularly among women ages 20 to 24, also is on the upswing (Feldmann, Christian Science Monitor, 6/18).
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Two Doctors Share Their Expectations For Health Reform
Two doctors with over 30 years of experience spoke with National Public Radio about how medicine has changed over their careers, and what they expect to see come out of the current health reform debate.
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Canada Joins International Effort To Provide Access To Health Research

Accelerating the development of discoveries and innovations and facilitating their adoption through free and open access to research findings. This is the aim of an important new initiative that will provide researchers and knowledge users free access to a vast digital archive of published health research at their desktop and connect them to an emerging international network of digital archives anchored in the United States. The Canadian Institutes of Health Research (CIHR), the National Research Council"s Canada Institute for Scientific and Technical Information (NRC-CISTI), and the US National Library of Medicine (NLM) have announced a three-way partnership to establish PubMed Central Canada (PMC Canada). PMC Canada will be a national digital repository of peer-reviewed health and life sciences literature, including research resulting from CIHR funding. This searchable Web-based repository will be permanent, stable and freely accessible. "PMC Canada is a powerful tool that will help researchers build upon one another"s work and speed up the discovery and innovation process to address important health challenges," says Dr. Ian Graham, Vice-President of Knowledge Translation at CIHR. "It will provide quick and easy access to a much broader audience, increasing the value and application of CIHR-funded research." PMC Canada supports CIHR"s recently announced Policy on Access to Research Outputs, under which grant recipients are required to ensure that their peer reviewed publications are freely accessible online within six months of publication. PMC Canada will include a manuscript submission system to enable CIHR-funded researchers to deposit articles that are accepted for publication by peer reviewed journals. PMC Canada builds on the successful PubMed Central (PMC) archive developed by the US National Library of Medicine and will join UK PubMed Central (UKPMC) as a member of the broader PMC International network. This network enables national versions of PMC to share content, and will make much of PubMed Central and UKPMC content accessible through PMC Canada. The network uses software developed by the National Center for Biotechnology Information (NCBI), the division of NLM that created and administers PMC. "We are pleased that Canada is joining the PMC International family, further strengthening this effort to share life sciences literature across the world," says NLM Director Donald A.B. Lindberg, M.D. "International collaboration and data sharing has proven to be a strong driver of scientific advance, with projects such as the GenBank international DNA sequence database propelling new discoveries at a rapid pace. The addition of Canada as a PMCI member should similarly aid the progress of science, while also enhancing public access to the results of research that affects health and health care." CIHR will supply the funds for PMC Canada and NRC-CISTI will contribute its technological expertise to build the infrastructure and manage the repository. "NRC is proud to be a partner in an initiative that will create a permanent archive for Canadian health research and increase access for all Canadians," says Dr. Pierre Coulombe, President, NRC. "This initiative is an important step forward in NRC-CISTI"s efforts to collaborate with others to provide Canadians with seamless and permanent access to scientific, technical and health information." The initial release of PMC Canada, to be available in fall 2009, will include a basic bilingual interface, a manuscript submission system for CIHR researchers and a bilingual help desk. An advisory committee of Canadian health researchers and other stakeholders will guide PMC Canada"s future development. The Canadian Institutes of Health Research


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