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Medicare is becoming increasingly conscious that sexuality and aging are not incompatible terms. Sexual issues are often ignored in older adults.

The Women’s Health Policy Report, a source for major women’s health stories covered in the media posted a link to a Medpage article in today’s Daily Update, “Medicare Considers Covering Testing for Sexually Transmitted Infections.”

The article addresses The Centers for Medicare and Medicaid Services (CMS) decision to consider paying for sexually transmitted disease (STD) testing for elderly and disabled Medicare beneficiaries. The CDC’s latest data reports a rise in sexually transmitted disease rates among the elderly. This increase in STDs may be related to an increase in the male population using drugs to treat erectile dysfunction.  There is also evidence that  the elderly are far less likely to use condoms and practice safe sex.  Medicare currently covers HIV testing. This review process will evaluate whether Medicare should include coverage for testing for Chlamydia, gonorrhea, hepatitis B, and syphilis, and to pay for counseling to prevent sexually transmitted diseases (STDs).

The media coverage of this topic is a smart reminder that ageism exists and public health issues rise when health care professionals fail to ask, or even consider, whether an older person is at risk for HIV or sexually transmitted diseases

 

 

Medicare is becoming increasingly conscious that sexuality

Jen Busse, RN, MPH, is an intern at the CHMP, and currently pursuing an MS in nursing as a Family Practice Nurse Practitioner at Columbia University.

Made in India at Roosevelt House

Made in India at Roosevelt House

Those who watched Made in India at CHMP’s Film and New Media Series event with their own preconceived notions regarding reproductive tourism were left with more questions than answers.  With the film, filmmakers Rebecca Haimowitz & Vaishali Sinha, expertly create a nuanced view that thoughtfully represents perspectives of both infertile couples and the reproductive tourism industry without vilifying either side.  In fact, the moviegoer finds themselves sympathetic to both sides in this story.  The film leaves one questioning the currently unregulated world of international surrogacy; its need for parameters to protect families seeking a surrogate mother, as well as for the surrogates, themselves.

Made in India is a documentary that transports the viewer into the world of surrogate “outsourcing” to India.  We are taken on the journey of a blue-collar American couple in their quest to have a biological child.  The viewer watches them struggle to articulate their case to an often-skeptical public in America.  We witness a strong bond between the would-be parents, as they trudge through hormone treatments, make the long trip back and forth to Mumbai, and finally, are nearly unable to take their children home with them.  We watch the trials of the surrogate, who later finds out she is pregnant with twins.  She struggles through relationships with her family and friends, and then sufferes a placental abruption, a medical emergency, early in her third trimester.

Following the film was a panel discussion moderated by CHMP’s Barbara Glickstein with the filmmakers and two experts in the field: Dr. Carole Vance and Daisy Deomampo.  The panel and audience discussed how the surrogate, who at first the audience believes is powerless, actually has a strong ability to negotiate her interests with respect to her husband, the medical tourism company, and the couple she provided a surrogacy for.  However, when it comes to the initial contract she had entered into, there existed no legal enforcement mechanism.

The film, however, does not portray the worst-case scenario in these situations, as Dr. Vance pointed out.  The filmmakers noted that a pregnancy is not guaranteed in these contracts and loss of a pregnancy is common.  The film chooses not to take the easy way out and does not latch on to an extreme of cases.  Consequently, it does not romanticize or disparage, but portrays the agency of the film’s subjects.  It paints a complex picture that is international surrogacy.  While the case shown in the film is not the worst, one is left to wonder what happens in such cases.  Rather than condemning the practice of reproductive tourism, the filmmakers highlighted the need for regulation of the industry.  The need for regulation is especially true, as shown in the final 5 minutes of the film, because this particular company has plans to expand to other developing countries.

While the biological parents and United States Department of State ultimately negotiate a way for the twins to leave India, the viewer is left with concern that this may not be the case in other situations.  Fear also remains of an industry unregulated, and therefore unable to protect the basic human rights of the surrogates, for whom offering surrogacy is an increasingly appealing way to provide for their families–especially when they are left with few other options.  Perhaps most importantly, the film raises the point of how policies, globally, will be required to keep up with growing and evolving international industry and technology.

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Jen Busse, RN, MPH, is an intern

Source: AOLNews.com

Source: AOLNews.com

A new chartpack by the Kaiser Commission on Medicaid and the Uninsured challenges prevailing perceptions that Medicaid is bankrupting states. The Top 5 Things to Know About Medicaid includes such points as: Medicaid spending has increased largely because of increased enrollment; it brings federal health care dollars into states; and it creates jobs. And, of course, it has reduced the numbers of uninsured and increased access to care. It will be expanded under the Affordable Care Act, but it will be incumbent on both the federal government and the states to reform payment and care delivery under Medicaid to emphasize care coordination, wellness, and chronic care management. Our current obsession with budget cuts is a short-term solution to our financial problems that could escalate health care costs in the long run if we continue to rely on emergency rooms as ‘safety nets’ for a growing number of uninsured.

Diana J. Mason, PhD, RN, FAAN, Rudin Professor of Nursing

[caption id="attachment_10485" align="alignleft" width="300"] Source: AOLNews.com[/caption] A new