[Congressional Record Volume 141, Number 43 (Wednesday, March 8, 1995)]
[Senate]
[Pages S3681-S3682]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


       SENATE RESOLUTION 85--RELATIVE TO HEALTH CARE LEGISLATION

  Mr. CHAFEE (for himself, Ms. Snowe, Mrs. Boxer, Mr. Bryan, Mr. 
Hollings, Mr. Thurmond, Mr. Lugar, Mrs. Hutchison, Mr. Warner, Mr. 
Akaka, Mrs. Murray, Ms. Moseley-Braun, Mr. Simon, Mr. Stevens, Mr. 
Murkowski, Mr. Kempthorne, Mr. Lott, Mr. Inouye, Mr. Hatfield, Mr. 
McCain, Mr. Jeffords, Mr. Cochran, Mr. Johnston, Mr. Burns, Mr. Baucus, 
Mr. Dodd, Mr. Kerrey, Mr. Dorgan, Mr. Bradley, Mr. Levin, Mr. Leahy, 
Mr. Brown, Mr. Domenici, Mr. Daschle, Mr. Sarbanes, Mrs. Feinstein, Mr. 
Grassley, Ms. Mikulski, Mr. Robb, and Mr. Craig) submitted the 
following resolution; which was referred to the Committee on Labor and 
Human Resources:
                               S. Res. 85

       Whereas women constitute more than 50 percent of the 
     population of the United States;
       Whereas, because women's health historically has received 
     little attention in terms of Federal funding and in terms of 
     research priorities, there should be an increased emphasis on 
     the needs and preferences of women in such areas;
       Whereas the Federal Government should increase its support 
     for women's health and can make a significant difference in 
     improving the status of women's health;
       Whereas increased funding for research is insignificant if 
     women's health care services are restricted;
       Whereas many women view their obstetrician-gynecologist as 
     their primary or sole physician;
       Whereas approximately 70 percent of women would be 
     unwilling to change their obstetrician-gynecologist to save 
     money;
        [[Page S3682]] Whereas an obstetrician-gynecologist 
     improves the access to health care of a woman by providing 
     primary and preventive health care throughout the woman's 
     lifetime, encompassing care of the whole patient in addition 
     to focusing on the processes of the female reproductive 
     system;
       Whereas preventive and primary care provided by an 
     obstetrician-gynecologist includes instruction in breast 
     self-examination, cervical cancer screening, health 
     education, instruction in health promotion, hypertension and 
     cardiovascular surveillance, osteoporosis counseling, 
     sexually transmitted diseases counseling, and identification 
     of victims of domestic violence;
       Whereas the most effective way to treat health problems is 
     to prevent such problems from occurring or to catch such 
     problems in the early stages, when such problems are most 
     treatable;
       Whereas 60 percent of all office visits to obstetrician-
     gynecologists are for preventive care;
       Whereas obstetrician-gynecologists refer their patients to 
     other physicians less frequently than other primary care 
     providers, thus avoiding costly and time-consuming referrals;
       Whereas more than two-thirds of all visits to obstetrician-
     gynecologists were by established patients of the physician 
     who were returning for care of a medical condition;
       Whereas obstetrician-gynecologists manage the health of 
     women beyond the reproductive system, and are uniquely 
     qualified on the basis of education and experience to provide 
     such health care services to women;
       Whereas obstetrician-gynecologists provide health care to 
     women with an awareness of the relationship of disease to 
     family history;
       Whereas over two-thirds of general family practice 
     physicians do not deliver newborns and will not be able to 
     address this need of women; and
       Whereas 80 percent of maternity care services in the United 
     States are provided by obstetrician-gynecologists: Now, 
     therefore, be it
       Resolved, That it is the sense of the Senate that--
       (1) obstetrician-gynecologists should be included as 
     primary care providers for women in Federal laws relating to 
     the provision of health care; and
       (2) legislative proposals that define primary care should 
     include primary care services performed by obstetrician-
     gynecologists in such definition.

 Mr. CHAFEE. Mr. President, today I join with my colleagues Senator 
Boxer and Senator Snowe, along with 37 other Senators in submitting a 
sense-of-the-Senate resolution that obstetrician-gynecologists [OB-
GYN's], should be recognized as primary care physicians under Federal 
health programs.
  This resolution is a very important first step in guaranteeing 
American women the access to quality medical care that they need in 
order to lead healthy and productive lives. Such a change in policy 
would give women greater access to the medical treatment they need, 
while eliminating much of the bureaucracy in our current health care 
system.
  American women use obstetrician-gynecologists more than any other 
type of physician. In 1987, more than 53 percent of women aged 15 and 
older, who visited an OB-GYN, did so to receive a general check-up. In 
1990, over 7 million women visited an OB-GYN for a general examination. 
When asked, the majority of these women stated that they regarded their 
OB-GYN as their primary care physician. In fact, receiving a general 
check-up was cited more frequently as a motivating factor for seeing an 
OB-GYN than for visiting either family physicians or internists.
  OB-GYN's provide a variety of services which are vital to women's 
health: screenings for breast, ovarian, and cervical cancer; counseling 
about sexually transmitted diseases, such as HIV; and identifications 
of domestic violence victims.
  One of the most important services that OB-GYN's provide is prenatal 
care. Lack of adequate prenatal care has serious ramifications on our 
society: mental retardation, deafness, blindness, autism, cerebral 
palsy, epilepsy, or chronic lung ailments, are just a few of the 
problems that affect children whose mothers did not receive adequate 
prenatal care. The Institute of Medicine, in its report, ``Preventing 
Low Birthweight,'' found that prenatal care is most effective in 
reducing the chance of low birthweight among high-risk women.
  Dr. Ruth Schwartz, clinical professor of obstetrics and gynecology at 
the University of Rochester School of Medicine and Dentistry, has 
stated that a woman with prenatal care is five times as likely to give 
birth to a living child than women who have no prenatal care. Although 
only 7 percent of live births were low-birth-weight babies, this number 
accounts for nearly 60 percent of all infant deaths.
  Infant mortality rates in this country should be a concern to all of 
us. We are the richest nation on the planet, the most industrialized 
country in the world, and yet we have one of the highest infant 
mortality rates in the industrialized world. As the preceding 
statistics attest, one way to defeat this statistic is to provide 
American women freer access to OB-GYN's.
  The majority of American women perceive their OB-GYN's as their 
primary care physicians. The challenges that we face with regard to 
battling infant mortality and ensuring health babies point us toward 
one direction: giving women direct access to OB-GYN's.
  Mr. President, I urge my colleagues to cosponsor this important 
resolution.


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