[Congressional Record (Bound Edition), Volume 147 (2001), Part 4]
[Extensions of Remarks]
[Page 5799]
[From the U.S. Government Publishing Office, www.gpo.gov]



      WOMEN'S OBSTETRICIAN AND GYNECOLOGIST MEDICAL ACCESS NOW ACT

                                 ______
                                 

                            HON. SUSAN DAVIS

                             of california

                    in the house of representatives

                        Wednesday, April 4, 2001

  Mrs. DAVIS of California. Mr. Speaker, today I am introducing the 
Women's Obstetrician and Gynecologist Medical Access Now Act, the WOMAN 
Act. This bill will ensure that every woman has direct access to her 
ob-gyn.
  When I served in the California State Assembly, I heard from many 
women that they were being denied access or had to jump through 
numerous bureaucratic hoops to see their ob-gyn. Statistics show that 
if there are too many barriers between a woman and her doctor, she is 
much less likely to get the medical care she needs. This is simply 
unacceptable. A woman should not need a permission slip to see her 
doctor. Ob-gyns provide basic, critical health care for women. Women 
have different medical needs than men, and ob-gyns often have the most 
appropriate medical education and experience to address a woman's 
health care needs.
  It is not hard to see what a difference direct ob-gyn access makes in 
women's health care. Imagine a working woman in San Diego who has a 
urgent medical problem that requires an ob-gyn visit. She works forty-
five hours a week and has limited sick and vacation time. On Monday she 
calls from work to make an appointment with her primary care physician. 
If she is lucky, she gets an appointment for Tuesday morning and takes 
time off to go see her doctor. Her doctor agrees she should be seen by 
her ob-gyn and gives her a referral. Tuesday afternoon she returns to 
work and calls her ob-gyn. The doctor is in surgery on Wednesday, but 
they offer her an appointment on Friday morning. On Friday she takes 
another morning off work and finally gets the care she needs. This 
unnecessary referral process has resulted in her taking an extra 
morning off work and delayed her proper medical care by 5 days. The 
patient, employee, primary care physician, and health plan provider 
would have saved money and time if the patient had been able to go 
directly to her ob-gyn.
  A recent American College of Obstetricians and Gynecologists/
Princeton survey of ob-gyns showed that 60% of all ob-gyns in managed 
care reported that their patients are either limited or barred from 
seeing their ob-gyns without first getting permission from another 
physician. Nearly 75% also reported that their patients have to return 
to their primary care physician for permission before they can see 
their ob-gyn for necessary follow-up care. Equally astounding is that 
28% of the ob-gyns surveyed reported that even pregnant women must 
first receive another physician's permission before seeing an ob-gyn.
  After meeting with women, obstetricians and gynecologists, health 
plans, and providers in the State of California, I wrote a state law 
that gives women direct access to their ob-gyn. That law was a good 
first step; however, it still does not cover over 4.3 million 
Californians enrolled in self-insured, federally regulated health 
plans. Clearly, this problem is not unique to California. There are 
still eight states that do not guarantee a woman direct access to her 
ob-gyn. Equally important to remember is that even if a woman lives in 
a state with direct access protections, like California, she may not be 
able to see her ob-gyn without a referral if she is covered by a 
federally regulated ERISA health plan. This means that one in three 
insured families are not protected by state direct access to ob-gyn 
laws. The time has come to make direct access to an ob-gyn a national 
standard.
  I urge you, Mr. Speaker, and all of my colleagues to pass this 
critical legislation quickly into law.

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