Carole Ann Moleti, CNM, FNP, MS, MPH

Shit Happens--An Update

2011-11-20T17:44:00.000-08:00

According to a note I got from Credo, the Delaware River Commission meeting for November 21 has been cancelled, signaling that the plans to allow hydrofracturing in the Delaware Basin did not have the support of President Obama and the Governors of New York, New Jersey, and Delaware.

Thank you to everyone who wrote, called, or clicked on the Credo button to send your public comments to the President and to your Governor. Surely our collective voices were heard, but as always, we must remain vigilant and guard the back door.

For more insight on the plight of Upstate New York residents in the wake of Hurricane Irene, please see my previous post. I still can't believe what I saw in those pictures, and similar scenes of devastation can be found in New Jersey and Pennsylvania.

The time for denial about the truth of climate change is over. It is time to stand up for the environment before things get any worse. Hopefully, it will not be too late to remediate the damage that has already been done.

On a more personal note, I am recovering well from my arm injury, enough to be able to make my acting debut on November 5 as Hannah Townsend Lawrence at the Bayside Historical Society's tour of Lawrence Cemetery. And on November 21, right after my lecture on OB/GYN emergencies for the Emergency Room Nurses Course at Montefiore, I'll be headed to Manhattan.

Fellow urban fantasy author April Gray and I will be chatting about the genre of urban fantasy and I'll be reading from my novel in progress Boulevard of Bad Spells and Broken Dreams at the Columbus Library. I will sign copies of anthologies containing excerpts of Someday for your holiday gifts.

Next week, I plan to muse about the Occupy Wall Street movement and another example of the government mishandling a situation by not responding to the concerns of We, the People.

Shit Happens

2011-10-15T18:36:00.000-07:00

I apologize in advance for the language, and the idioms you are about to endure, but I'm in a morose Brooklyn/Bronx mood these days. The frozen shoulder I woke up with on September 10 turned out to be tendonitis. I'm better since the steroid injection, but am still limited in my range of motion and how long I can type before the pain—from right thumb to my neck—roars back. Physical therapy is a slow process, with some good days interspersed with a few bad ones. Shit happens and, this too, shall pass.

Seems like nothing in comparison to the sights on a recent trip upstate to close our summer cottage: The devastation wrought by Hurricane Irene on the already depressed towns in the Catskills where floods wiped out whole towns, roads, bridges, and a lot of farmland and livestock. At one low lying intersection, at the bottom of a hill, next to a stream between Cobbleskill and Middleburg, remnants of hay bales dangled from treetops, where they were deposited by raging flood waters. I can only imagine what it was like since more than a month has already elapsed with most roads at least passable, but many homes and businesses damaged or in ruin and fields underwater.

This courageous homeowner, somewhere between Potter Hollow and Preston Hollow, has chosen to count his/her blessings and remain positive though the property is a total loss.

The Preston Hollow Little League field, home to a team that once made the Little League World Series, is a mudflat and the playground equipment a tangled ruin, testament to the power of floodwaters in one of those rare weather events that come along once in a lifetime—we hope.

Has over development, acid rain denunding the northern forests, and global warming caused major changes in the ecology, the environment, and weather patterns, which caused this area to suffer more damage from Irene's wind and rain than Coney Island, Brooklyn where the storm made landfall (another cosmic joke, though none of this is really funny)? Yes, I think so.

( Locust Point, Throggs Neck (Bronx) after tidal surge from Hurricane Irene. This area was under mandatory evacuations but obviously not everyone left. Thanks for the photo Karl, Jr.)

Which might mean that this sort of shit will happen more often in places that it has never happened and no one is prepared for or equipped to handle it. Like the Indian Point Nuclear Plant, Buchanan, New York, which is up for license renewal and advertising like hell, using a female engineer who sounds far too young and naïve (and brainwashed) to reassure me and others in the fall out zone (approximately the surrounding 250 miles, which is just about where Potter and Preston Hollow are) that the plant has been built to withstand hurricanes, floods, is protected from aerial terrorist attacks or airplane accidents at nearby airports, and is "perfectly safe."

I ain't buyin' it—though I'm from Da Bronx, not Brooklyn. Floodwaters with the power of those in the Catskills would surely create another Fukushima Daiitchi scenario and we ain't got the Fukushima Fifty kamikazes around here to go in to try and fix it. Hell, we can't even get home on Friday nights never mind evacuate the tri-state area about to experience nuclear meltdown. And in upstate New York, "you can't get there from here'" right now with many bridges still badly damaged.

Who knows what the proposed hydraulic fracturing (say it isn't so, Governor Cuomo) will do to the topography and environment, exposing this area and our watersheds to pollutants and further degredation and ecological and environmental systems? Big business has paid for a smooth talking, snake oil salesman to sell the idea, but the signs are all over the muddied lawns upstate, and I concur. "No fracking way!" "No drill, no spill!"

Fugetaboudit. Give up those gas guzzlin' cars, turn out the lights, reduce your own carbon footprint, and reuse and recycle. We can do without "alternative energy sources" which could kill us all either the quick and dirty way, or the slow and insidious evolutionary way.

Yeah, shit happens, and we're shoveling, pumping, and mopping enough of it in New Yawk these days.

Ten Years Later-Tread Lightly On Our Memories, The Pain Is Still Great

2011-09-11T09:14:00.000-07:00

I knew this weekend would be difficult and it is. I am physically sick today, and do not believe that my (minor) case of PTSD is not to blame for this otherwise unexplainable pain.

View my photo scrapbook: 9/11, Then and Now here

Please go to my other blog for my thoughts on the tenth anniversary of the 9/11/01 attacks

Here is a retrospective on The Twin Towers and The Lowly Parking Meter that I wrote last year.

And here is part of the 9/11/01 chapter of Someday I'm Going to Write a Book:

It was pleasantly busy. A few women in labor, triage was quiet. I got coffee

from the food cart, Starbucks, with a shot of French vanilla. I made sure to get skim milk because I treated myself to a scone. They have almost my whole day’s allotment of calories. That Starbucks has enough caffeine to jazz me up for 12 hours.
“Wow, you have to see this,” said Janine the unit clerk. “A plane just hit the World Trade Center.”
A few of us went into an empty patient room and saw live footage of the gaping hole and the smoke.
“Someone must have lost control of a small plane, there have been a few helicopter crashes recently,” I said. “I hope not too many people got hurt.”
No sooner were the words out of my mouth when we saw, live and in living color, the second plane crash into the south tower. Flames exploded, debris and what we now know were people were flying out. Even the news commentators were stunned, stumbling over their words like drunkards.
“Ohmigod!”
“What the hell just happened?”
“Someone just flew a second plane into the other tower!”
“Shit!”
“It’s terrorists!”
I don’t remember who said what. One hand over my mouth to hold back the vomit, I held onto the wall as I walked, my knees like rubber. External disaster codes were activated. Bells clanged and the operator called out instructions.
“THIS IS NOT A DRILL!”
“Blue team to basement.”
“Red team to lobby.”
“Green team to ER.”
Automatic fire doors slammed shut. Strobe lights flashed. Footsteps pounded in the hallways. Panic bars clicked on the doors as they smashed open against the walls then slammed shut. People ran around like an uncovered nest of roaches.
“The phones are down!”
“The pagers aren’t working!”
“Make sure all emergency equipment is plugged into red outlets in case we lose power!”
“My husband is in that building!” screamed someone, falling to her knees.
“My father is down there,” said Janine through tears, trying in vain to get a cell phone, any phone to work.
“Joann, let’s get you into the lounge. Turn the TV’s off in the patient’s rooms!” I tried to help her to her feet and ease her out of the hallway.
“A plane just went down near Philly. It was supposedly headed for the White House. There are 8 planes missing from the flight controllers, they are going to shoot them down, the US is under attack.” Josie read the CNN headlines to us but she spoke like she was the President.
Of course, when planning an attack the enemy knocks out communications first. The World Trade Center is very close to here. We have no phones…
The fear, not for myself, but for my country was so profound I was beginning to panic myself. Outbursts and screams from staff that had relatives in lower Manhattan reminded me that my job was to help others, not to dissolve under pressure.
Our Father, who art in heaven hallowed be thy name…
“Joann, just because he’s not answering his phone doesn’t mean anything, they aren’t working.”
Thy kingdom come, thy will be done, on earth as it is in heaven…
“Here have a drink of water.”
“Lisa, your husband works blocks away, I’m sure he’s fine.”
Give us this day our daily bread and forgive us our trespasses as we forgive those who trespass against us…
“I know Denise’s husband is a fireman, they know what they’re doing, in 1993 very few people got hurt.”
And lead us not into temptation, but deliver us from evil. For the kingdom, the power and the glory are yours now and forever, Amen.
“She wants to push? OK, I’m coming Josie.”
“Carole, the south tower just collapsed. It’s gone.” Josie whispered in my ear as she tied my surgical gown for me. The splash guard on her mask fogged up with her warm tears.
“Push mommy, the baby’s coming, don’t be afraid. Everything is alright, nothing bad is happening to you.”
Hail Mary, Full of Grace, the Lord is with thee, Blessed are you amongst women and blessed is the fruit of thy womb Jesus…
“You’re doing great, see the baby’s head? I know it feels terrible but really, nothing bad is happening. Just push.”
“One more push, you can do it, you’re strong. The baby’s almost here, soon you’ll be done. Great, here comes the baby! It’s a girl!”
I dried the baby and gave her to her mother. I helped her father cut the umbilical cord. They took pictures. I
delivered the placenta, did some suturing. Josie whispered to me as we cleaned up and got the baby to nurse.
“Carole, both towers are down.”
Holy Mary, mother of God, pray for us sinners, now and at the hour of our death, Amen.

Hurricane Irene is Just Another Memory--Which Conjures A Lot More

2011-08-28T13:58:00.000-07:00

The latest storm has come and gone, just like the other ones in my life, but the memories will be with me until the end. Having grown up on the Bronx waterfront, high water and high winds were something we dealt with all the time--as a family.

The storms that did the most damage were the ones we never expected--two of them were winter Noreasters with tidal surges augmented as the water flowed down the streets over the snow. But two hurricanes in particular, come to mind every time one takes aim at New York and I immediately go into prep mode.

In 1976, I was the only one home while the rest of the family vacationed in Cape May, New Jersey. I got up for work at 6:00 a.m. and heard the first warning that Hurricane Belle was on the way later that afternoon (weather forecasting was not as advanced as it is today). I called in 'sick' and got to work securing my Dad's Larsen Lapline, anchored behind the house in Long Island Sound, and 'evacuating' his pigeons from their waterside abode a block away to my cousin Dennis' coop.

Dennis helped me with that, as well as moving all the patio furniture and my Dad's ten thousand houseplants summering outside to safer haven. Then there was the matter of the shed-moving the lawnmower and other electrical equipment, all the bicycles and loose flower pots. And the cars, which needed to be moved about a half mile away, to higher ground. I had to walk back, twice. God, I wish I still had that picture my high school sweetheart (soon to be first husband) took of me, sitting in the dining room facing the sound, surrounded by the contents of the backyard and shed, holding an umbrella.

The family arrived home after a harrowing drive home from Cape May in evacuation traffic to find it all done, and honestly, I don't remember anything about the storm except that we came through it with minimal damage from the storm surge, even though the boat had dragged its anchors quite a distance and was beached about 50 feet from the bulkhead in our backyard.

In 1985, I was living a block away when Hurricane Gloria threatened, separated from but trying to reconcile with my first husband. Due to the strength of the storm, the shoreline, including my childhood home was under mandatory evacuation. My parents and younger sister went to stay with my grandmother--the first time they'd ever left for a storm--but I was not under the same advisory and stayed behind. The storm blew by in what seemed like a few minutes, and I waded around the corner through thigh high water to find water lapping at the back door of the house, but no major damage.

My ex stayed with me to help that time, and we celebrated with friends by going out for Mexican food with our good friends Jerry and Liz, at Don Emilio's in Larchmont. I'll never forget the plate glass window in the shop next door, still boarded up and spray painted in red "Gloria, Be Gentle."

I'd called in 'sick' that day too, and unfortunately the reconciliation with my ex was as short lived as Hurricane Gloria.

I was not scheduled on duty in either of my jobs for Hurricane Irene, but after my house was secured and I'd assured that my Mom, spending her first hurricane without my Dad, was tucked away and riding it out with a friend, contemplated calling to see if they needed me.

Nothing illustrates the schism between my professional and family life better. I learned, by being part of a family that stayed together and played together, that nothing else matters. But then again, the pull to help with disaster services both in the streets and in the hospitals is very strong. I feel guilty, for just a little while, that I'm not doing my part.

Maybe when the next hurricane threatens New York, things will be different and I'll ride it out with co-workers instead of cooking dinner, playing Zhu-Zhu pets with my daughter, and helping my (second) husband mop the basement and clean up the downed tree limbs. And I don't even feel guilty about it.

Moving Along and Getting Back in Business

2011-06-30T18:22:00.000-07:00

It's been just over a week since my father's funeral and I'm numb and in a fog after being up, up, up for so long. I lapse into these moments where I see or remember some moment I spent with Daddy and either burst into tears (very unlike me) or stare into space for an hour lost in thought.

Going to work for short shifts helps since I get to focus on something and my co-workers give me tea, cookies, and strategically distributed hugs. OMG, Madeleines are just what you need for sinful, buttery comfort.

I don't think those random things are psychosis--rather synchrony. Things happened (and still do) after my grandparents died. On the morning of the funeral, I suddenly remembered my Dad had given me a bracelet when I was little. I'd already found and put on a pair of earrings he'd bought me when I had this really short haircut in my tomboy days and he told me "please wear these so they know you're a girl."

My hands went right to the bracelet buried in my jewelry box. The engraving on the back was June 18, 1971. Forty years to the day before he died. He wanted me to wear it, and it still fits. Synchrony. Some comfort.

Enough, back to work. Thanks for all your kind words of support. I'm looking forward to covering labor and delivery at LIJ this weekend. It's been a long time since I caught a baby.

For more about what I've been up to, writing wise, including another successful pitch for Someday I'm Going to Write a Book, check out my creative writing blog. There is lots of other good news there as well.

The Most Difficult Deadline I've Ever Met

2011-06-23T12:36:00.000-07:00

Two seasons have passed since I last posted here, and June 21 was truly the longest day of the year for me as I spent it with my family at a wake for my father who died after a long illness on June 18. And that, my friends, is one of the things that has kept me from posting and updating this blog on a regular basis. I have a host of half written, and some entirely written posts on subjects like the Japanese earthquake, local and national politics, bad boy behavior from the likes of Dominque Strauss-Khan and Anthony Weiner and the attack on reproductive rights.

But alas, there are only so many hours in a day I needed to allocate to being with my Dad in his last days, taking care of my kids, supporting my mom and my sisters, and working with "my kids" in the high school health center in the Bronx. Which is the direction I want to take this post because we all experience the death of loved ones and the best way to commemorate them is to honor what they accomplished and the legacy they left behind.

Many excerpts of Someday I'm Going to Write a Book pay tribute to my great-grandmother Jennie Bruno, a lay midwife in the same neighborhoods in which I now practice. And to my grandfather, her son, Alexander "Al" Bruno, who knew the Bronx like the lifelines on his palm. Coincidentally, or synchronously, whichever you choose to believe, he worked for Montefiore Hospital in the engineering department and somehow, ahem, I wound up there as well.

I inherited a lot from my Dad, and absorbed his love for the Bronx, for nature, for animals (his first name was Francis after all), the outdoors, particularly the beach and ocean, and for activism and community service. While he always told me to stay out of the bad neighborhoods, and harm's way, I know he was proud of the fact I paid no attention to him and waded waist deep through the South Bronx, Harlem and Washington Heights during the worst of times: the 1970s and 1980s when a bankrupt NYC had just about given up on those areas, and on the entire boro of the Bronx it seemed. Okay, that's all in Someday but this is about Frank Moleti.

Here is an short piece I wrote for a local newspaper about my father. It was one of the hardest things I ever had to do: distill all his accomplishments, his personality, his passions into a few paragraphs. A feeble attempt but if the lines of mourners who came to pay their respects on Tuesday is any indication, I am not alone in my awe and admiration.

Councilman James Vacca kindly paid a visit and spoke about working with my father on Community Board #10 during those dark days in the Bronx. His tribute was a great comfort to my mother, an inspiration to everyone in the room, and I envisioned my Dad was looking down on the scene, nodding his head, with his typical closed lipped smile of self effacing satisfaction at a life well lived, a battle well fought, and legacy engraved on the hearts of almost everyone he met.

Francis A. Moleti, a longtime Bronx resident and community leader, died on June 18, 2011 from complications of lymphoma. He was 78.

Frank’s proudest accomplishments included his 1952-56 tour of duty with the United States Navy, serving as a machinist on the Battleship New Jersey during the Korean War. After returning stateside, he joined the Sheet Metal Workers International Association and was a foreman for Brook Sheet Metal, which handled many major New York City construction projects including the building of the Twin Towers of the World Trade Center .

He grew up in Castle Hill, lived for a while in Parkchester, then moved to Throggs Neck. He served several terms as president of the Locust Point Civic Association until retiring to Southampton in 1995. An entire generation of local kids will remember Frank for his tireless efforts to bring PAL activities to Throggs Neck, as well as the weekend marathon of Labor Day events sponsored by the LPCA including the costume parade, foot and swimming races, as well as popular adult activities such as dancing under stars, the married vs. single men’s softball game, and the pie eating/throwing contest.

An avid fisherman and sailor, Frank worked tirelessly to improve the water quality of Long Island Sound, as well as the quality of life for Northeast Bronx residents, by serving on Community Planning Board #10 under then District Manager James Vacca. His efforts were instrumental in the closing and remediation of toxic waste leaching from the Pelham Bay Landfill as well as dealing with traffic congestion, noise, and environmental pollution near the Throggs Neck Bridge .

He is survived by his wife of 55 years, Carole, three daughters, Carole Ann, Christine and Allison, and seven grandchildren. Donations in his memory can be made to The Connecticut Fund for the Environment-Save the Sound Project.

The Moleti, Virzi, Gentile, and Maiello families visit the Battleship New Jersey, Camden, 2002.

Why I Should Be The Next New York City Sanitation Commissioner

2011-01-07T15:46:00.000-08:00

I know. You're thinking "how could she be qualified for the job just because she throws out the garbage?" And I say to you "like Mayor Bloomberg and Cathy Black think she's the best candidate for the job of Schools Chancellor because she once attended school."

Actually, I could do that job, too. My three kids went through or are currently in a New York City public school, and I run a health center in a New York City public high school. I have put in real life classroom time. But I digress--she hasn't screwed up yet so her job isn't at risk.

So, how would a nurse practitioner and midwife run the NYC Sanitation Department? Why do I not aspire to replace the embattled chief of Emergency Medical Services since I am a health care provider and administrator, trained in provision of disaster services, and have ridden ambulances and done my share of night shifts in NYC public hospitals? Nope, don't want that job. I already have one that holds me responsible for acts of nature and other things totally out of my control.

The sanitation commish didn't see that his people got the streets cleared, and the OEM didn't issue snow emergency orders. How is it his fault the ambulances got stuck and the poor firefighters and EMTs couldn't schlep all their equipment through the drifts and carry the patients on stretchers to the nearest hospital?

You might not know I have a longstanding connection to garbage. My ex-husband's father worked for the Sanitation Department and kept us up to date on all the doings. Three of my neighbors were garbage men. The father of one of my college buddies was in charge of snow removal in the days when Mayor Koch ruled the roost and I heard, first hand, how he figured it all out when the legendary storms of yesteryear threatened.

I live within sniffing distance of the Pelham Bay Landfill, and my father was on the New York City Planning Board trying like hell to get it capped and closed before it leached any more toxins into Long Island Sound. I studied environmental sciences, including solid waste management, while doing my MPH. My then father-in-law was so thrilled that I was studying the Betz Avenue incinerator where he worked. To quote: "Ya see, that here Columbia University is sending their students to learn from me. Who says there's no future in garbage?"

I learned well, which is why I am such a rabid recycler and a member of organizations such as Save the Sound and The Nature Conservancy. I also learned a lot from the sanitation men in my life. They are a hard working bunch of people, albeit a trifle sexist and rough around the edges. But they handle garbage, which most of us really don't want to.

My current garbage men are a lot more dedicated than my current mail carrier, who tosses mail into the bushes when the steps are too icy. By the way, how come I only got two deliveries of mail between December 24 and December 31? What happened to "Neither rain nor sleet, nor snow nor dark of night...?" There I go again, off topic.

Poor John Doherty seems like one of the goodhearted sanitation man giants of my past, boasting on December 26 that his snow removal teams were the envy of those near and far. He steadfastly defended them even though the only plows I saw during the blizzard and weeklong aftermath were either double parked in front of restaurants or running up and down the streets with the plows up. Come to think of it, that could be one of those "men" things, like forgetting to put the seat down and swearing they wiped off the rim of the bowl.

I guess Mayor Bloomberg wasn't out in the storm while he continued with his snotty nosed bluster (ever heard of tissues and decongestant?), blaming us for shoveling snow into the streets (now really), abandoning cars in snowdrifts (because we had nothing better to do after we dutifully shoveled walks so the City didn't issue us summonses), and that we shouldn't call EMS unless it was a real emergency, not because we were sick, trapped, or freezing on a stranded NYC subway train without food, water or a bathroom.

Mother Nature cleared the snow by allowing temperatures to go above freezing. Most of it has melted--at least enough so that cars can park catty corner on top of the mounds, which are now mostly ripe, rotting holiday leftovers, gift wrap, boxes, and Christmas trees.

So, if I were Sanitation Commish here's what I would do:

Immediately reinstate alternate side of the street parking. Send a plow, with the blade LOWERED, to scrape away the icy remnants. Behind it should be a sweeper to collect the schnibles of garbage and recycling blown about in the wind. And behind that, a truck collecting garbage.

I would have to consult about the feasibility of the plow being down while the workers tossed garbage into the back of the same truck to maximize manpower and clean up a two week backlog. There might be technical issues that I, as a non garbage man, am not aware of. That's what my second in command, who should be a veteran sanitation worker who has made his way up the ranks, is for.

But the cynical administrator in me believes that the real rules against doing double duty aren't in place for worker safety or because of the limitations of the trucks themselves, but rather union rules which would insist on double time if the men were doing BOTH garbage collection and snow removal at the same time. Remember, my father-in law and neighbors were garbage men and shared a lot of insights.

Anyway, slapping myself back on track again, on the second round of alternate side of the street cleaning, all the snow will be gone and the recycling, including the Christmas trees, should be collected. In one week it will all be done and there will be no football games at Yankee Stadium and New Year's Eve Times Square Cleanup to distract attention from any other areas in The Bronx or Manhattan and the entire boros of Brooklyn, Queens and Staten Island.

But in the event we get another big snowstorm, any remaining garbage will be encased in ice and snow, thus minimizing the stench, rat and raccoon raids, and loose schnibles of paper, plastic and metal being bandied about by gale force winds. The Christmas trees can be propped upright in the drifts, indicating there is indeed garbage under there to be addressed, not some irreverent New Yorker's carelessly abandoned vehicle. A nice touch would be to hang birdfeeders from the branches for the poor pigeons and sparrows.

Plan B would be, after discussion with my second in command, to plow the garbage and snow at the same time and deploy manpower with shovels and brooms to deal with the remainder, before resuming Plan A. Having a background in environmental safety and infection control, I will insist my men be fitted with masks, gloves and the proper personal protective equipment, and get hazardous duty pay.

All hyperbole aside, I think that Mayor Bloomberg should, in the future, get out there with a shovel and ask "How am I doing?" like former Mayor Ed Koch did whenever the City was faced with a crisis. Instead of insisting that we're all just cry babies, using something besides his mouth would enlist all of New Yorkers in a united effort to take care of each other as well as clean up the City.

That would be a lot more effective than blaming the victims and demonizing his commissioners who had lapses in judgment or, like him, over exaggerated their omnipotence, were out of the City or out of touch with the National Weather Service, or caught off guard from all the holiday cheer.

Arrogance and apathy trickles down from above, which is why I really don't want the job. But thanks, anyway.

'Tis the Season for Compromise, And to Stand Up for Moral Choices

2010-12-25T18:23:00.000-08:00

'Tis the season for compromise. Or political oneupmanship. Or staging. No matter what you think, and what your beliefs, it's hard to deny the past year distinguishes itself as one of the most egregious examples of party politics and special interest pandering in recent memory.

I'm really happy Don't Ask Don't Tell has been repealed, but did we need a big ceremony to flaunt it? You'd think the Democrats learned some lessons after the circus performance when the Affordable Care Act (one of the biggest betrayals the President Obama has executed and thus imposed on his former loyal supporters and the American people) was signed. You remember, the Vice President's Big F-ing Deal.

Does the sludge trickle down from the President, who, along with the cabinet and advisers all share the same lack of focus and leadership and accountability? Or does the stench waft up from below, from a pit of legislators who have just spent too much time filling seats with lead bottoms and campaigning for their own re-elections?

All our elected officials allowed a deeply flawed health care reform bill to pass. No one without insurance due to job loss or other financial difficulties will see any relief until 2014 while health care insurers rig up new exchanges that meet their needs, not those of patients.

Second, instead of calling out Republican special interests in repealing tax cuts for the rich, those concessions were made to allow extension of unemployment benefits. How are those two issues linked, except in the world of politics?

At the eleventh hour, my two New York State Senators, Schumer and Gillebrand, who caved on the Affordable Care Act, stood up for the rights of first responders in desperate need of assistance due to life threatening illnesses they are suffering after doing their public and civic duty in the aftermath of 9/11. How can anyone who lived through that day, and the succeeding events deny the unprecedented sacrifice those men and women made, and deny them the needed medical care they deserve? Republicans, it seems, are not human. Or reneged on the vow to "Never Forget."

How does this game playing affect real people?

A 35 year old single mother and police officer confided with me December of 2001 how the horror of 9/11 had seriously affected her, physically and emotionally. "It's far from over," she whispered, sadness and fear in her eyes as well as her voice. In February of 2002, she was dead of a lung ailment no one yet understood, her ten year old son an orphan, in the care of an aunt, devastated.

Another police officer friend is battling lung disease, trying valiantly to stay on the job to support his wife and three kids. He's losing.

Women have already had their constitutional rights trampled by the express prohibition of abortion services in any exchange plan, a precedent likely to be adopted by all insurers.

Now, women are at risk of having their access to birth control severely limited clearly a measure that prevents the expense and possible adverse health effects of undesired pregnancy, taken away. A bunch of celibate old men on the Conference of Catholic Bishops has expressed their opinion, yet have not weighed in on treatment for erectile dysfunction. This is blatant sexism, blatant disregard for our Constitutional Rights, and Separation of Church and State.

To see how absolutely devoid of reason the Bishops are, consider that one believes a hospital's decision to allow an abortion of an 11 week pregnancy in a dying woman was grounds for removal of the Blessed Sacrament from the hospital's chapel. It seems that if the mother had been allowed to die along with her 11 week fetus, they would still be able to celebrate Mass and receive Communion on hospital grounds. Hmmm. What would Jesus do? What would He say about that?

Congratulations o the doctors, nurses and administrators who did the right thing in that horrible situation--one which I have found myself involved in many times. In my opinion, there is no moral grounds for allowing someone to die for the sake of a religious belief, turning a tragedy into a travesty.

Kudos to all of us who went to the polls on Election Day and jettisoned the worst of offenders in Washington, as well as those in City and State government. But there are still more that need to be called out, and thrown out. Here in New York City we saw how close Mike Bloomberg came to being booted, after he flaunted term limits and declared himself too important to be allowed to step down as required by law. Bill Thompson might have won, if more disgusted voters had cast their vote.

We need to stay vigilant and in control. Credo has organized a campaign against more indignities being perpetrated against women, and it can't be any easier than one click to send a message, and one click to post the message to Twitter and Facebook about keeping birth control available to all women under the Affordable Care Act.

I suggest subscription to their newsletters with timely legislative action updates.

All the greetings of the season , no matter what you celebrate!

What I'm Thankful For Today: Endless Possibilities

2010-11-25T18:00:00.000-08:00

A long thread running through Someday I'm Going to Write a Book: Diary of an Urban Missionary is the story of my great grandmother, Jacinta, a/k/a Jenny Bruno. She was as a midwife, and I have the license and instruments to prove it, in the early 1900s (her certificate is dated 1911 which makes next year her centennial), tending to the women (and their families) of the Southeast Bronx, not coincidently, the same ones I am tending to right now.

There are many similarities between us so I feel comfortable concluding Jennie probably didn't love running out of the house at all hours of the night, leaving her eight kids (our of the thirteen she had) to fend for themselves, though I'm sure leaving her purportedly abusive husband and providing for them was driving her along.

My husband isn't abusive, in fact, I'm more likely to hit him someday than he is to ever hit me. Money is what keeps me in this insane business--three kids to put through college, my daily coffee, their daily bread, and some sense that there is a mission in all this. Some overlying need to persist despite the anguish and frustration.

The brick walls I run into day after day, erected by a broken health care system, big government and big institutional barriers, insurance companies, the economy, poverty, racial and ethnic discrimination, and yes, the patients and their families as well, show no signs of coming down. I chip away at the mortar; look for ways to sneak through, over, and around. Am nabbed from time to time for what Mark Legnini, DrPH described as "doing the right thing" instead of "the right thing to do." Get a leg up now and then, so I can climb over, pulling my charges along with me, though some can't hold on or aren't willing to take the risk of falling.

This is deliberately vague, for privacy as well as a myriad of privacy and compliance regulations. But this is a time of year to focus on what we have and give thanks. This article is very long, but its description of the overall mission of the hospital I work for made me proud to be a long time member of its staff. One of the very small dots on the southernmost point of the map is the health center in which I toil, day in and day out. And I've worked in several of the other hot spots over the years with some of the most talented and dedicated doctors, nurses, patient care techs, and other support staff on the Earth.

As an overview, the worker bees aren't acknowledged in the Commonwealth Fund Report. As usual, only the doctors are championed though much of what being done is accomplished by those of us without MD degrees. But coming at a time when I often wonder what it's all about, this affirmed I'm in the right place.

So I'm thankful for my health and family, without which nothing else would matter. But also my job, my co-workers, the patients who continue to place their trust in me and for the knowledge that I've made real difference. And to Jennie, who I have to believe is the little voice that guided me to where I am supposed to be and straightens me out with a kick the ass when I'm ready to give up.

This tribute to her, an excerpt of Someday I'm Going to Write a Book, was published last year in This Path.

Happy Thanksgiving.

The night seemed full of endless possibilities, like life thirty-five years ago. I stood in the lobby of the posh Marina Del Rey at the 75th anniversary of the Saint Frances de Chantal grammar school, Bronx, New York. The '50s vintage dress that called to me at an antique show fit like it had been custom made. I thought I looked pretty good with the gray dyed out and six pounds lighter than last year. Those anti-wrinkle creams seemed to work. They sure cost enough.

The dawn of the AIDS epidemic and the horror of working in the hospital on September 11, 2001 book ended a career during which time speaking up made me part of the enemy camp, not the liberating forces.

Video clips of domestic violence deaths, child abuse, infanticide, rape, incest, and the degradation of women played over and over in my mind. My theoretical model for dealing with families in crisis was of little use at 2 a.m., standing in between the guy who just beat up his pregnant wife, the woman bleeding to death, and the clerk getting insurance information before we could get blood for transfusion.

I had bargained with the gods to keep the demons away but no good deed goes unpunished. They stole my soul and reneged. Divorce from my high school sweetheart, the inevitable loss of beloved family members, and my own personal health challenges gave me pause to ponder the endless impossibilities of life.

I focused on my family, thankful for the second chance at marriage and motherhood. I once battled sexism, racism, conservatism, and elitism. Well into my third life and tired of fighting, I moved past activism into escapism.

I'd never attended a high school reunion but instead was drawn way back to my grammar school days. I remember only a few names and faces, most notably, Marianne. We don't see each other often, but just like tuning into a soap opera you haven't watched in years, we easily pick up the story line and move on.

I waited for her, watching the lights of the Bronx-Whitestone Bridge glimmer like tiny beacons over cold, dark Long Island Sound. I moved across the bridge to Queens seventeen years ago. I still work the streets of the Bronx but death, distance, or the ravages of time have broken all ties to friends and family. Alone, mesmerized by the tinkling fountain, I held back tears remembering when this neighborhood was an innocent idealist's only view of the world.

The cell phone bleated. "Sorry, I'll be there in a minute, got stuck in traffic." Marianne rushed in from the parking lot and gave me a hug. "You look fantastic."

We studied the collage of old class pictures. Marianne picked me out: the girl with a headband and hair in a pony tail, tights, uniform dress with a bow tie, and a big smile. We sipped drinks, nibbled hors'd'oeuvres, and found the "Class of 1971" table.

John, one of the two "boys" who had been my close friends, smiled when he saw me. "Hi, Carole Ann. You haven't changed a bit."

Sister Mary Lucille, at least eighty, peered at me and waved a gnarled, bony finger. "You're one of the Moleti girls, and none of you took French." Nuns never give up.

"That's right, Sister," I said, "but Spanish serves me well."

George suggested we take the few surviving sisters for a boat ride in the dark and dump them overboard to get even for all those bruises. We laughed, reminisced, and tears flowed on my way home in the pouring rain as I crooned Streisand's tune "The Way We Were."

I drove over the bridge, from my first life, past the second, and into the third. I let the dog snooze on the couch and walked through the dining room where Jennie was still smiling at me. The kids were tucked in; the cat warmed my side of the bed. I snuggled next to my sleeping husband and lay there in the dark and quiet thinking about all the stories still to be told.

"Get back to work," Jennie said.

And I did.

Copyright 2009 by Carole Ann Moleti

Bad Spells and Broken Dreams

2010-10-02T12:57:00.000-07:00

It's been a long time since I posted, but I just crawled out from under my rock. To think of the time and energy I expended last fall working to get the health care reform bill passed—all wasted. I still haven't recovered from the betrayal of the Democratic party when it stooped to the worst political pandering I have personally witnessed, producing a watered down version of a bill that is likely to cause more problems than it solves.

Between the health care mess, the continuous assaults and lack of meaningful action on endangered species, environmental concerns, climate change, the economic situation, which is not getting better for anyone I know, and the circus that is New York State and City politics, I would love to vote every single Democratic Senator and Representative out (take note Mr. Schumer, Ms. Gillebrand and Mr. Ackerman) if the Republican contenders didn't scare me as much as the kook, Carl Paladino, who just won the Republican nomination for Governor. He attacked a New York Post editor who asked him a perfectly reasonable question about the alleged out of wedlock daughter he fathered, at the same time as Mr. Paladino was slamming his opponent, Democrat Andrew Cuomo, for having extramarital affairs.

David Patterson, our current governor, has had his own affairs, interfered with the handling of a domestic violence incident perpetrated by one of his staffers, and even joked about his fall from the throne on Saturday Night Live. Two of the state senators responsible for the grid locked session last year (both from the Bronx) have been found guilty: one for misappropriation of funds and the other for domestic violence. And both were drop kicked by voters when they tried to get back into office by running in the primary for another post.

So both sides have a lot to be proud of, including Sarah Palin, “mama kill those grizzlies,” whose daughter is now on Dancing with the Stars while Bristol Palin's erstwhile "baby daddy" struts his stuff in a different venue.

They're all a bunch of clowns, and even my conservative Republican cousin and I agree they all need to go. I have now added every mailing list from the Democratic National Committee and Organizing for Change to my block list as spam. The only thing political I read are updates from Creedo, an organization whose sense and sensibility reflect not only honesty, and integrity, but sanity when it comes to the major issues we're facing: I strongly suggest if you care, subscribe. They do not abuse subscribers by sending fluffy thank you notes from the President which end with a button to donate more money.

I'm going back under my rock for now, spending time at my day job taking care of children and families in the Bronx who desperately need health and educational services being slashed and hacked by budget cuts, while the City prepares to spend millions replacing all the street signs to "better reflect light and be easier to read." How about not worrying about the motorists (I can see the signs just fine) and give the kids some decent conditions in which to learn and help them learn to read?

http://cosmos.bcst.yahoo.com/up/player/popup/?cl=22227813

Since I'm in a decidedly apocalyptic mood, I'm taking notes for the next chapter of Someday I'm Going to Write a Book, and immersed myself in writing fiction. My novel, The Widow's Walk, a paranormal romance set in a haunted house in Cape Cod is nearly finished. It's a sequel to Unfinished Business, continuing the story of Liz and Mike, a young widow and widower who fall in love, then discover they've been down this road before, and must battle the ghosts who fear they'll make the same mistakes the second time around.

Next up, will be an urban fantasy series being kicked off by Boulevard of Bad Spells and Broken Dreams, set in the near-future Bronx engaged in an epic battle between dark and light magic, which has been waged since the late 1970s.

So now you see what I mean by the slogan that my first love is science fiction and fantasy because walking through walls is less painful than running into them.

Check out all my writing related news at http://caroleannmoleti.blogspot.com/ or follow me on or Twitter or my new Facebook Fan Page.

Of Back Rooms, Back Alleys, Clowns, Roulette, Magic Mirrors and Viagra

2010-03-27T06:10:00.000-07:00

Here are a few meandering thoughts on what I call health care deform. And of of the most egregious examples of the nonsense that went on during reconciliation.

By 57-42, Democrats rejected an amendment by Sen. Tom Coburn, R-Okla., barring federal purchases of Viagra and other erectile dysfunction drugs for sex offenders. Coburn said it would save millions, while Sen. Max Baucus, D-Mont., called it "a crass political stunt."

Hold that thought.

I don't think I'm the only one baffled, bamboozled, and disgusted with the carnival known as health care reform. Back room deals, under the table nudges, and whispered expletives have exposed the true reflection of our President and Vice-President, Senators, and Representatives. Magic mirrors fill the Fun House of Representatives and they’ve relied on dizzying spins to gain political advantage.

Politics should have nothing to do with health care, and all we've got now is a big, fat bunch of deals that change with every spin of the wheel. Where it stops, nobody knows. What cheap prize they will hand the American people in this bait and switch game?

This law doesn't meet the criteria President Obama set for health care reform back in the days of reason and clarity of purpose. The days I was on board. The days I wasted writing letters, blogs, Tweets, making phone calls, and annoying all my Facebook friends imploring them to join me in supporting the cause.

There is no public option. This plan doesn't eliminate all pre-existing conditions. Now being female of childbearing age eliminates a person's right to obtain a legal abortion-a right guaranteed by the Constitution.

It forces people to buy coverage from the very companies who have been ripping us off all along, shunts coverage of children to their parent's policies, and leaves the most vulnerable and medically neglected (read: poor) people with decisions about whether to buy inadequate coverage or pay for food, clothing and shelter and be fined.

It might increase costs. Even if you are a number cruncher and like to play games with statistics, ignoring the realities of life, the cost of abortion is a lot less than the cost of pregnancy and delivery care, or the cost of caring for a preterm baby, neglected, abandoned or abused child. The number hasn't come up for tort reform and how to handle the role of malpractice claims in the exponential rise of costs.

Mirror, mirror on the wall, the view I see isn’t fair at all.

• The insurance companies now have a guaranteed source of new meat.
• The lawyers still gross big money on "pain and suffering."
• Pre-existing conditions.
Appears to be all show, smoke, and mirrors to me.

I was willing to compromise for the sake of the greater good. But this offers no benefit to me or to my patients:

• If I lose my job I can get health coverage. But it won't cover abortion, and I'm likely to lose that coverage even if I keep the job since the private insurers will likely now exclude all coverage for elective procedures since they are simply "following Federal standards." I'm not planning on losing my job, and I'm also not planning on having an abortion but shit happens.

• My teenage sons will have coverage until they are 26. Now they have a perfect excuse not to get a job. And I'm really worried about my daughter and her friends because their reproductive rights have been trampled.

• I will pay more for my benefits and might lose the tax advantage of health care spending account (the roulette wheel is still spinning on that one).

• As a health professional who cares for women and children, I have a whole new set of regulations to follow. I still have to worry about what money goes where, and what can and cannot be spent on who (illegal immigrants) or what (abortion). Where can I refer patients who need services? In these days of budget woes will New York City and New York State be able to subsidize the uninsurables like they do now? Will private companies still have grant funding to help out those who fall through the cracks?

• What happens in emergency situations when we can’t worry about insurance or someone dies? How do I prove the thirteen-year-old is an incest victim even though she doesn't know what that means, or is afraid to tell the truth to a bureaucrat? What if the strain on a pregnant woman’s damaged heart, transplanted kidney or out of control lupus will kill her, in which case I will have to work up the supervisory chain of insurance company clerks trained to just say no?

The Republicans just said no, and the Democrats refused to do the right thing, but tough shit ladies, someone had to compromise. I don't think the elimination of Viagra prescriptions would have been a bad trade-off. No one ever died from erectile dysfunction, less women would get pregnant, they cost big money-lots of cost saving there. No more preposterous than suggesting since abortions don’t cost too much so women should just accept the fact they’ll have to pay for their own mistakes.
But those old geezers in Washington D.C. grabbed their balls and called that a "political stunt." People in glass houses shouldn't throw stones. In my dictionary the definition of sex offender applies to quite a few public officials, especially if you use the term broadly.

Just say no might work in politics, but it doesn't in real life. The roulette wheel spins on. What will happen when the dust clears? Big effing deal indeed.

What Will Happen to Health Care Reform?

2010-02-24T14:23:00.000-08:00

What will happen to health care reform? Nothing, or a worsening of the situation unless the politics are left out and the Republicans stop using obstructionist tactics to derail this and just about every other initiative the President undertakes.

The Democrats aren’t blameless either. Their willingness to stoop to backroom deal making and concessions just to get a bill passed have resulted in the loss of two vital provisions: the public option and the threat of serious limitations on women’s reproductive services which, I maintain, creates another pre-existing condition the bill was envisioned to eliminate.

The insurance companies and pharmaceutical companies will do anything to maintain their profit margins. Witness Anthem Blue Cross raising rates in California in anticipation of a bill's passage.

Here’s what else can happen if people are forced to buy coverage from the very companies ripping us off now. Without a public option, if you lose your job and have a family to support, perhaps the only insurance you can buy will be on a private exchange. Even if you can't afford it, you’re required to buy coverage. How will you pay for that, as well as mortgage/rent, utilities and food? If your spouse makes too much for you to qualify for Medicaid (or an exemption from the mandatory coverage) this is all too possible.

And here is an example of the convoluted way reproductive health services would work: In the military, where men no doubt can obtain condoms, women can’t get emergency contraception. Most health plans will follow the Federal guidelines and likely exclude birth control abortion coverage unless you pay out of pocket. The argument: "It's a rather small expense." My argument: "Pay for your Viagra, penile pumps and other treatments for erectile dysfunction. If you can't afford it, not having sex won't kill you."

Here's an editorial from The New York Times on this issue: Showing Respect for Women In Uniform

http://www.nytimes.com/2010/02/15/opinion/15mon3.html?scp=1&sq=emergency%20contraception%20military&st=Search

How about respect for women in general? I'm sick of my body being divided into pieces deserving of care and parts that are "my responsibility" or "my irresponsibility" depending upon whose opinion is being voiced. It takes two to tango, as they say.

Meanwhile, yet another hospital here in NYC (St. Vincent’s) is bankrupt due to bad debt and charity care and lowered insurance reimbursement. They just had a layoff and more are likely. If they close, surrounding institutions will have to absorb the volume-and that means longer waits, understaffing which endanger patient safety and affect infection control measures (more crowding, less cleaning).

What about tort reform and provisions to address the malpractice morass? Lawyers are still advertising no fee unless we win, wasting money on frivolous cases, many of which have not merit but are settled to avoid costly litigation.

I have a great insurance plan, and would likely have to give up some perks, like my health care spending account funded from pre-tax payroll deduction. But my optical benefits have already been reduced and I must go to one vision care provider. I must fill all prescriptions at certain pharmacies to get that benefit.

We’re all going to have to give up something. But unless the health of the American people is put first, not ideology, politics and vengeance there will be no meaningful reform.

Without a viable public option, protection for women's health care services, and changes in the legal system reform is not going to reform anything.

Finally, this is a very intelligent op-ed from The New York Times on how the GOP can fix health care.

http://www.nytimes.com/2010/02/22/opinion/22healthintro.html?th&emc=th

It contains proposals for health care reform written by conservative Republicans. If they can write such reasonable suggestions why can't the House and Senate come to some consensus? The answer: politics.

No Matter Who Wins, We All Lose

2010-01-19T14:21:00.000-08:00

If Martha Coakley loses the Senate race in Massachusetts, health care reform is doomed, right?

Wrong.

Health care reform was doomed when politics and deal making became the goal, rather than health care reform. Why else would House and Senate Democrats "celebrate" the passage of a bill that discriminates against women and tramples their rights? And force people to buy health insurance from the very companies that are ripping us off already? And make deals to allow states to "opt out" when the American people can't. And eliminate the public option? And not address in any meaningful way tort reform and the liability insurance crisis which continues to drive costs higher.

Was I wrong to trust the Democrats and President Obama to do the right thing regarding health care reform? And that they heed the advice of experts from almost every major health care professional organization. Appears so.

Are the Democrats solely to blame? No, the obstructions put up by the Republicans have more to do with discrediting the Democrats in general, and the President in particular than anything else.

Is this politics as usual?

Yes, which is why most Americans are so disgusted with all our elected officials.

I worked very hard with Organizing for America during the initial efforts. Back and forth communication was great, the updates timely, and I felt like I was part of something wonderful. All that changed after the House sneaked through a bill eliminating any possibility of abortion coverage for women. The sight of Nancy Pelosi beaming for the cameras celebrating the deal still sickens me.

Then the communication stopped. No acknowledgement. No explanation, no justification, no strategy. All I get now are requests for money. Senator Gillebrand has never responded to any of my communications. Neither has Congressman Ackerman. Senator Schumer was tripping over himself apologizing, but he still voted for the bill eliminating the public option.

OFA invited me to a strategy session this weekend, but I can't face it. Politics is not my thing. I'm unsubscribing from OFA and am subscribed to Creedo Action, which is much more in line with my political views, and like me, not afraid to open their big mouths and complain.

http://www.credoaction.com/?r=11&id=7407-2377113-7NEBQkx

I hope this bill is defeated because it's bad for women, it's bad for health care in general, and it's bad for cities like New York who have always picked up the slack and offered coverage for those who fall through the cracks. I'm sad, but that's the way it is.

And as for Martha Coakley, the Democrats need to see this as a warning. The American people are fed up with this process.

But no matter who "wins", we all lose.

Kill This Health Care Bill Now!

2009-12-19T17:15:00.000-08:00

Well, the experts have spoken but no one listened.

To say I'm disappointed with the proposed health care reform bill is an understatement. Once again, number crunchers, lawyers and politicians (since most of them are lawyers it's double jeopardy) have hijacked true reform and crafted bill catering to special interests: conservative, power hungry males, the anti-abortion lobby, and big business in the form of commercial insurers.

The bill myself and other worked so hard to support has created being female as a pre-exisitng condition, requiring women to pay extra for a rider to include coverage for abortion services. Absolute, inexcusable discrimination.

And those who now have no insurance will be required to buy coverage from an exchange run by, guess who? The very same commercial insurance companies that have screwed us all in the past. If you can't afford to buy food and pay your rent and mortgage how are you going to buy insurance?

Back in the 1980s, insurance companies instituted draconian measures to rein in costs and created the myriad of reimbursement strategies including DRG's, precertifications, referrals, preferred provider organizations....The list goes on and on. In the 1990s the Federal government added a whole new layer of regulations to hold down Medicare costs.

Did it improve care? Hell, no! Anyone who has been in a hospital or emergency room knows that there aren't enough nurses or space, yet there are entire departments dedicated to billing, coding, and enforcement of CLIA, HIPPA and all the other mandates. Hospitals are going out of business because their reimbursement rates have been cut. Providers like myself have closed practices because the cost of doing business is higher than the money paid by insurance companies to provide care--and they pay less and less every year. Add to that the malpractice insurance debacle, which I'm not sure has even been addressed in this bill.

Do you trust these people to administer a new bill? Given the last minute, deal making sellouts by the House and Senate which hijacked the original intent of the bill, AFFORDABLE HEALTH CARE FOR ALL PEOPLE, and the betrayal of those of us who worked in good faith to support reform, I do not.

The Democratic Party gloats about winning but all they have won is a political game, likely to make the situation worse, especially for women and families. They ask us for money, phone calls, petitions, events, signatures, letters....then don't even address our concerns or provide a forum for us to voice our discontent.

Senator Gillebrand and Representative Ackerman have not responded to any of my emails or letters. Senator Schumer has, assuring me that he agrees--but he is still voting for this deeply flawed legislation.

Please, call your representatives and tell this to kill this bill and start over.

Op ed columnist Gail Collins has summarized this much better, and with much more humor than I:
http://www.nytimes.com/2009/12/19/opinion/19collins.html?emc=eta1

The Experts Have Spoken. Will the Politicians Listen?

2009-12-09T19:01:00.000-08:00

This letter was posted to the ACNM website and represents the joint efforts of a lot of organizations involved with women's health and women's rights. For a look at the posts that came before, check out my LJ blog which has been around longer.

December 1, 2009
Dear Senator:

The undersigned organizations committed to protecting and improving women's health appreciate efforts to advance health care reform that works towards improving access to quality, affordable and comprehensive health care for all Americans. To that end, we urge your support for Senator Mikulski's Women’s Health Amendment, which will help ensure that health care reform meets women's needs.

The Women's Health Amendment will ensure that women have access to key preventive services they need throughout their lives by strengthening the bill's existing protections. A May 2009 report by the Commonwealth Foundation found that nearly half of women delayed or avoided preventive care due to cost—a serious women's health issue that any health care reform plan must address.

While the current bill takes important steps toward improving access to preventive health care by making those recommended by the United States Preventive Services Task Force (USPSTF) available with no or limited cost sharing, USPSTF recommendations do not fully account for the range of preventive services a woman’s doctor may recommend or that a woman may need. The Women's Health Amendment will allow HRSA to develop evidence-based guidelines to help bridge critical gaps in coverage and cost-sharing for preventive health services, the same approach the bill takes to address gaps in preventive services for children. This needed change is intended to make women's unique health care needs – from family planning and well-woman visits to breast cancer screening and preconception counseling that promotes healthier pregnancies and optimal birth outcomes-- more accessible and affordable for women.

As you consider health care reform legislation, we urge you to vote in favor of the Mikulski Women's Health Amendment that will help millions of women receive essential health care.

Sincerely,

National Women’s Law Center
Advocates for Youth
American Association of University Women (AAUW)
American Civil Liberties Union
American College of Nurse-Midwives (ACNM)
American College of Obstetricians and Gynecologists (ACOG)
American College of Radiology (ACR)
American Medical Women’s Association
American Nurses Association (ANA)
American Psychological Association
Association of Maternal and Child Health Programs
Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN)
Break the Cycle
Center for Reproductive Rights
Family Violence Prevention Fund
Jewish Women International
March of Dimes
Maryland Women's Coalition for Health Care Reform
Medical Students for Choice
National Asian Pacific American Women's Forum (NAPAWF)
The National Campaign to Prevent Teen and Unplanned Pregnancy
National Cervical Cancer Coalition (NCCC) - HPV Cancer Coalition
The National Coalition for LGBT Health
National Council of Jewish Women
National Family Planning & Reproductive Health Association (NFPRHA)
National Institute for Reproductive Health
National Latina Health Network
National Organization for Women (NOW)
National Partnership for Women & Families
National Women's Health Network
Ovarian Cancer National Alliance
OWL - The Voice of Midlife and Older Women
Physicians for Reproductive Choice & Health (PRCH)
Raising Women's Voices for the Health Care We Need
Reproductive Health Technologies Project
Sexuality Information and Education Council of the U.S. (SIECUS)
YWCA USA

And this action alert was sent out by the APHA to it's members. They have been active in fighting the Stupak amendment, and the last word I heard was that the Nelson amendment was also defeated.

Senate debate began today on the Nelson Amendment to the Patient Protection and Affordable Care Act, which would significantly impact women who can't afford to purchase separate supplemental coverage for abortion services.
Please take the time to send this message to your Senators today urging that they vote NO when the Senate votes on the Nelson Amendment.
Thank you,
APHA Government Relations

I still don't see how it's fair to ask women to pay extra for premiums in the event they need or want and abortion, when men don't have to pay extra premiums in the event they need treatments for erectile dysfunction. Then again, I've never been (and never will be) a politician.

Please contact your Senators and voice your opinion-whatever it is.

My Livejournal blog is at: http://cmoleti-cnm.livejournal.com/

A New Blog

2009-11-29T15:41:00.000-08:00

I've started this blog in order to increase my visibility and coordinate with my other friends and followers on Blogger. For now, I will be cross posting between this site and my LJ site. Feel free to leave a message on either, or both.

Please be patient while I get the profile up to date and the page looking the way I want it. Between swine flu vaccinations, marketing, health care reform efforts and writing, I don't have a lot of spare time.