[Congressional Record Volume 143, Number 9 (Wednesday, January 29, 1997)]
[Senate]
[Page S820]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         ADDITIONAL STATEMENTS

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            THE WOMEN'S HEALTH AND CANCER RIGHTS ACT OF 1997

 Ms. SNOWE. Mr. President, I am pleased to join my colleague 
from New York, Senator D'Amato, along with Senators Feinstein and 
Hollings, in introducing the Women's Health and Cancer Rights Act of 
1997. This bill provides key protections to women facing breast cancer, 
and to all Americans confronting a possible diagnosis of cancer.
  Breast cancer is currently one of the major public health crises 
facing this Nation. In 1997, 180,000 new cases of breast cancer will be 
diagnosed in this country, and more than 44,000 women will die from the 
disease. Breast cancer is the most common form of cancer and the second 
leading cause of cancer deaths among American women. In my home State 
of Maine, 900 to 1,000 women will be diagnosed with breast cancer this 
year.
  Consider for a moment what it must be like to face a cancer 
diagnosis. Then imagine what a woman with breast cancer goes through 
when she loses a breast to this disease. A mastectomy patient may 
endure great pain resulting from the surgery, and has a large wound 
with drainage tubes which must be properly cared for. She must also 
face the emotional pain of losing part or all of a breast, and may 
struggle with her fear of cancer and what lies ahead. Then try to 
imagine if she is released from the hospital within hours of surgery.
  That is what some health plans are doing today. Yes--some health care 
plans have issued guidelines requiring mastectomies to be performed on 
an outpatient basis. The New York Times recently reported that 
approximately 7 to 8 percent of all mastectomies are performed on an 
outpatient basis. Doctors may feel pressured by their health care plan 
to release patients before it is medically appropriate, as health care 
plans push doctors harder and harder to cut costs. Women who are 
released from the hospital too early following a mastectomy, 
lumpectomy, or lymph node dissection do not have time to recover from 
the surgery in a supervised setting, or have an adequate opportunity to 
learn how to properly care for their wound, much less begin to deal 
with their emotional and physical pain. And some problems or 
complications from the surgery may not arise within the first hours 
following the surgery.
  The Women's Health and Cancer Rights Act of 1997 will help ensure 
that women with breast cancer obtain medically appropriate care. This 
bill says that women who undergo a mastectomy, lumpectomy, or lymph 
node dissection can stay in the hospital as long as a doctor deems 
medically appropriate, in consultation with the patient. The bill does 
not mandate how long a patient should stay in the hospital, or 
prescribe an arbitrary time period. Instead, it encourages the highest 
standard of medical care by allowing a doctor to exercise his best 
medical judgment in determining how long a patient should remain in the 
hospital. The bill contains strong protections for doctors to ensure 
that they are not penalized by insurance companies for prescribing a 
given length of stay. The procedures could still be performed on an 
outpatient basis if deemed medically appropriate by the doctor, and 
agreed to by the patient.

  Second, the bill requires insurance companies to cover breast 
reconstruction following cancer surgery, as well as reconstructive 
surgery to make breasts symmetrical following cancer surgery. I am 
extremely pleased that this provision is based on the law in my own 
State of Maine. Currently, insurance companies treat reconstructive 
surgery following breast cancer differently than other types of 
reconstructive surgery. In fact, a recent survey found that 43 percent 
of the respondents had been denied coverage for follow-up 
reconstructive symmetry procedures. The availability of reconstructive 
surgery is important not only for those women who believe it is 
necessary to return their lives to normal following cancer surgery, but 
because studies show that the fear of losing a breast is a leading 
reason why women do not participate in early breast cancer detection 
programs. If women understand that breast reconstruction is widely 
available, more might participate in detection programs.
  Finally, this bill requires insurance companies to pay full coverage 
for secondary consultations whenever any cancer has been diagnosed by 
the patient's primary physician. It also requires a health plan to 
cover a second opinion even when the specialist finds the patient does 
not have cancer, and allows the patient to go outside an HMO for 
consultation by a specialist. This is designed to prevent all Americans 
from making inappropriate and uninformed decisions regarding medical 
treatment due to either a false-negative or a false-positive result.
  I urge all of my colleagues to join me in supporting and securing 
swift passage of the Women's Health and Cancer Rights Act of 
1997.

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