Ratti’s on the Right Track

By Sandra Koch, MD, and Tim McFarren, MD

State Senator Julia Ratti has introduced Senate Bill 233;  when passed, this bill will ensure that the current health care coverage for Nevada’s women and their families continues regardless of changes in health care that may occur at the national level.  The bill includes provisions that will maintain the barrier-free access to preventative services, prenatal care, cancer screening, assistance with smoking cessation, screening for sexually transmitted diseases, vaccinations and contraception.

Barriers to obtain these services were lifted about 5 years ago.  We can see the impact these changes have had within our state both socially and economically.  We have known for decades that the cost of screening/ prevention is far less than the cost of treating the consequences.  When we look beyond cost to see the effect on families, the changes have had a profound impact that will be felt for generations.  Cancers detected before they invade, diseases treated before infertility sets in, pregnancies planned, smoking rates lowered, healthy babies born at term, mental health problems addressed and indicated vaccines given, lowering the spread of disease.

In our Carson City practice, when the cost barrier was removed, we saw a big increase in women seeking preventative care who hadn’t been seen in years.  A few, unfortunately, had already developed cancer and needed advanced treatment but with most we were able to recognize pre-cancerous changes and address other medical problems at minimal cost.  These visits also provide time to address cancer screening, wellness needs and pregnancy concerns.

Most women spend several decades trying to avoid pregnancy.  Removing barriers to effective affordable contraception leads to fewer unplanned pregnancies. Since the ACA was passed, Nevada has seen a 10 percent decrease in unintended pregnancies across all age and socioeconomic groups.  When pregnancies are planned there’s less risk for mothers and babies and lower costs for care.  Those of us in health care firmly believe that the decrease in unplanned pregnancies is due to removing barriers to effective, reliable and affordable contraception.

 Women who struggle financially are much more likely to be affected by unintended pregnancy.  Those with family incomes below the federal poverty level are 5 times more likely to have an unintended pregnancy.  These women are much more sensitive to barriers for services that allow them to prevent pregnancy and for this reason are less likely to use contraception.  When unplanned pregnancies result, there is great social and financial cost. Every dollar spent on contraception leads to a saving of seven dollars in public funds.  A very good investment!

This bill would add two new to options for contraception.  In addition to covering the pill, the ring, the shot, implants, intrauterine devices and tubal ligation; it would add vasectomy and the ability to obtain 12 months of the pill with one stop. No more monthly trips to the pharmacy to pick up the prescription.

There are many reasons why couples choose one contraceptive method over another.  Sometimes it is a personal preference and other times there are medical reasons why only a few methods may be used safely. This is why it’s important for couples to be able to obtain, without barriers, every method approved by the FDA.

We believe that with these resources, we will continue to see improvement in the overall health in our state and a decline in unplanned pregnancies.

The benefit to our society and our budget is tremendous.

SB233 deserves all of our support.

Dr. Sandra Koch has been practicing Obstetrics medicine at Carson Medical Group for 27 years. She moved with her husband and co-author, Dr. Timothy McFarren (also an OBGYN at Carson Medical Group), to Carson City in 1990 from the Central Valley of California to welcome a new lifestyle that included open space, lower population and easy access to recreation.