It is clear that the U.S. is on the bottom of the list of maternity/family-friendly countries:
"In countries with longer periods of parental leave, children were found to be breastfed for longer ..."
Hello Everyone. I'm moving this thread to the Lactivism forum where it's better hosted. In addition, as this discussion is getting a bit heated, I'd like to remind everyone of the User Agreement and the forum guidelines especially
Please review your posts and edit them as needed.
And, now, back to the topic at hand: Do you have any suggestions as to how the Affordable Care Act should "promote and support" breastfeeding? What other legislation might be helpful to support breastfeeding mothers and their children?
I would like to make the following 5 suggestions to the U.S. Secretary of Health and Human Services, Kathleen Sebelius:
1. Stop the games you've been playing with regard to supporting breastfeeding under the Affordable Care Act. You are losing your credibility. The American public will have a real problem entrusting you with a budget of $974 billion to operate the Department of Health and Human Services for fiscal year 2014 if you can't even figure out how to issue clear, effective guidelines for insurers as to how they are supposed to support breastfeeding.
2. The former U.S. Surgeon General, Dr. Regina Banjamin, who worked directly for you, explained many of the problems that have prevented breastfeeding rates in the U.S. from increasing. Her 2011 report is titled "The Surgeon General's Call to Action to Support Breastfeeding." I would encourage you to read that report.
3. Disregard the recommendation of the Institute of Medicine with respect to breastfeeding support in their "Clinical Preventive Services for Women" report. Their recommendation has no value. It was a waste of time asking for their opinion in the first place since you have many experts at the DHHS who could have given you much better advice... like the Surgeon General for example.
4. The U.S. Breastfeeding Committee and the National Breastfeeding Center teamed up to write their "Model Policy, Payer Coverage of Breastfeeding Support and Counseling Services, Pumps and Supplies." You can use that publication as a template to write a set of regulations that insurers will be required to follow in order to support breastfeeding.
5. Finally, the DHHS website has policy statements, goals, mission statements, etc. Talk is cheap Ms. Sebelius. Mothers all across our country deal with insurance companies every day. We know what sort of breastfeeding support we are supposed to be receiving. We know when our health care insurance coverage is inadequate because it directly affects the health of our children. We know that you have been given the authority to require insurance companies to provide us with breastfeeding counseling from a qualified professional if we have a question or a problem. We know that you have the authority to set standards as to what sort of training a qualified professional must have. We also know that you have the authority to require insurance companies to provide us with an appropriate breast pump when we need it. Please don't allow the mismanagement of this issue to continue. Use the authority you were granted by Congress to give us the "comprehensive lactation support" that we were promised.
Secretary Sebelius, I would welcome you to post your personal response to the above suggestions here in this thread.
With all due respect Mr. President, if your administration can't even get breastfeeding support done properly under the Affordable Care Act, why should we have any confidence that the Federal government can manage the rest of the health care system?
Since August 1, 2012, the vague "guidelines" issued by the U.S. Department of Health and Human Services have allowed insurance companies offering health care coverage to make up their own rules as to what sort of "breastfeeding support, supplies, and counseling" they will pay for. Due to the lack of meaningful regulations, the majority of insurance companies are simply not willing to provide "comprehensive lactation support and counseling, by a trained provider" as stated in the current regulations. Nor do the majority of insurance companies intend on providing quality breast pumps to their insurance customers. And the cheap breast pumps they do provide are often made available to the breastfeeding mother way after it was needed.
If the current regulations were written as an experiment in self regulation to see if the insurance industry would provide good "comprehensive lactation support" without a detailed set of rules to follow, then we have all learned a valuable lesson. This experiment has demonstrated that self regulation does not work! Even in light of well documented evidence showing that breastfeeding improves the health of the mother and child, the majority of insurance companies still will not pay for good "comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment." Thus far that has been the only requirement issued by the DHHS, and it has failed miserably. Get it right, or give it up.
I do have to say, as a working Lactation Consultant, as a mother and a lactivist to the core, I do not agree that "if ACA can't get breastfeeding support right, they won't be able to manage the rest of the system." I was not aware that breastfeeding support was the base from which we managed all healthcare for the ill.
And face it, lactation is a very small part of health care (I say that with lactation being one of the biggest parts of MY life) and it will take some time for this new and very revolutionary act to be ironed out.
Most Lactation support is not given to SICK people, and what is done in lactation is really different than treating sick people. I have to respectfully disagree with the notion that "Mr. President" (as it's the entire country's plan, not just his alone) should "get it right or give it up." Imagine if I told my clients that!
As I have said before, more information on Lactation Consultants, what we do and who we are (many of the good ones are NOT "nurses based in hospitals") would be of great help. LCs need to be compensated for our time, and insurance companies need to realize what is really a trained professional and what are a lot of people with little training little experience treating others and some made up letters after their name to make it sound official.
Why the IBLCE didn't get into the fray when the law was being drafted is beyond me. The Act needs more definition about Lactation, but it isn't by far the most pressing issue in the Act. Most women may have one lactation consult visit during each child's life, it's VERY important, but not even 1% of Americans' health needs. I think we do need to keep this in rational perspective.
But, there IS a lot more to Affordable Healthcare than just how Lactation is being handled, and I don't think we should use Lactation as a yardstick to measure the whole of ACA! Not by a long shot.
Even though breastfeeding is a small part of the overall health care system, it is important enough to be recommended by the U.S. Preventive Services Task Force as a preventive health service for women which is supposed to be "supported" by insurance companies under the Affordable Care Act. The new "regulations" issued by the Department of Health and Human Services for insurers are doing more harm than good to support breastfeeding. Insurers who used to provide quality breast pumps are now providing manual pumps to comply with the letter of the ACA law, not the intent of the law. Often those breast pumps take too long to get to the new mom which has caused her to stop breastfeeding. And if you're having problems breastfeeding and need to talk with a lactation consultant, well, good luck getting your insurance to pay for that!
In spite of the well documented benefits of breastfeeding, Congress cut funding for the very successful Women, Infants, and Children (WIC Program) breastfeeding peer counselors. Half of all infants born in the U.S. participate in the WIC Program, and approx. 80% of those infants (depending upon the state) are Medicaid eligible, so they are covered by Medicaid, not covered by the Affordable Care Act. The Federal government has a dismal track record of providing breastfeeding support through the Medicaid program. Since breastfeeding support under Obamacare (as of today) has gotten worse, and Medicaid doesn't support breastfeeding, and breastfeeding support from the WIC Program has nearly been eliminated, I would say the Federal government places a very low priority on breastfeeding support.
The current vague and inadequate regulations for insurance companies issued by the U.S. Department of Health and Human Services took effect on August 1, 2012. A year earlier, in 2011, former U.S. Surgeon General Dr. Regina Banjamin issued her "Call to Action to Support Breastfeeding." In that document Dr. Benjamin wrote this: "The U.S. Preventive Services Task Force specifically recommends that promotion and support for breastfeeding be provided throughout the encounters women have with health professionals during prenatal and postpartum care, as well as during their infants' medical care. In addition, education and counseling on breastfeeding are unanimously recognized by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists in their "Guidelines for Perinatal Care" as a necessary part of prenatal and pediatric care. Similarly, the American Academy of Family Physicians and the American College of Nurse-Midwives call for the consistent provision of breastfeeding education and counseling services. Yet many clinicians are not adequately prepared to support mothers who wish to breastfeed." The U.S. Secretary of Health and Human Services, Kathleen Sebelius, has done nothing in response to that "call to action."
In July, 2013, the U.S. Breastfeeding Committee and the National Breastfeeding Center released their "Model Policy, Payer Coverage of Breastfeeding Support and Counseling Services, Pumps and Supplies" which is intended as a resource for insurers to follow when providing breastfeeding support through health care insurance. That document was issued because of what they described in their press release as "chaos surrounding mandated coverage of breastfeeding support, supplies, and counseling" due to "the lack of guidelines or recommendations as to who may provide and be paid for lactation care, and what kinds of equipment should be covered for breastfeeding families." Furthermore, according to the U.S. Breastfeeding Committee, the DHHS has not adopted the Model Policy in lieu of drafting their own set of regulations for insurers. The DHHS has stated that they have "no intention of providing any further detailed guidance at this time." In other words, don't expect insurance companies to improve their support of breastfeeding because the DHHS refuses to require them to do so.
While it may be true that lactation is only a small part of our health care system, there seems to be universal agreement among health care professionals that more needs to be done to make breastfeeding support effective under the Affordable Care Act. Also, the solutions to the current insurance problems have been written by health care professionals and given to the U.S. Secretary of DHHS by the U.S. Breastfeeding Committee. She has flatly refused to deal with the problems. Is that the type of health care that Americans can expect under Obamacare? Isn't that exactly what everyone was fearing with a national health care system... that decisions would be made by politicians instead of health care professionals? To me that is a symptom of a much bigger problem. If the Federal government can't fix the smaller problems with the Affordable Care Act, especially when the solutions are literally right in front of their faces, then I have serious doubts about their ability to manage the more complicated problems in the Affordable Care Act. The Federal government loves to talk about how great breastfeeding is, but when it comes to putting those words into action, they simply won't do anything. That is the case with Medicaid. That is what has happened in the WIC Program. And now the same thing is being repeated with Obamacare. I have reached the point where I don't wish to hear Republicans blaming Democrats since the Republicans can't seem to come up with any alternative solutions to health care coverage. I'm tired of the Democrats claiming that Obamacare is perfect and doesn't need fixing when the truth is that the new law has done more harm than good when it comes to breastfeeding support. And I'm really tired of politicians from both parties selling out to the formula industry lobbyists by making all the Federal programs as ineffective as possible with policies that actually discourage moms from breastfeeding. Enough is enough! I will stick with the statement I made before to President Obama: Get it right, or give it up!
Sorry this one is for Obamacare
You the President Of the United States I voted For YES i VOTED YOU IN .
You went with this insurance the wrong way there should have been caps and different things so people could effort it instead having health care charge outrageous prices for the poor never mine rich. I make about 29000.00 a year and believe me in New
Jersey is poor. I am lucky if I got 50.00 for two weeks to live on. Now I got to buy insurance that the insurance companies can charge an arm and a leg for. I have not been out in ages thinking you could change things for better it only gets worse. There should have been a cap on insurance companies,
I do know this cap thing would have worked cause I have a cap on my mortgage and my life insurance which I may have to cancel because of health care not mentioning my home phone and TV services and that won't be enough to support the health care thing on my table. This health care is going to cost to much for the little people. OH and making a smoker pay more well think that some type of discrimination you got your drug addicts and alcoholics using the system like a ride believe me I know a few and always in and out of rehab smokers don't cost anyone and as for second hand smoke don't believe it my mother a non smoker got lung cancer and she won't even go near a smoker cause it made her eyes tear like being near a chopped onion would you go near a onion if it annoyed your eyes. There is no such thing as second hand smoke just say a lot of people rather not smell it. There are no one on earth that a doctor put on death certificate yet second hand smoke.
OH and now wic really what is wrong with you many young people don't make what I am making and they too are going to suffer you need to wake up and change some of these things to make it affordable or all of us well be saying we got 5 kids and not give the government a dime of our hard earn money when tax time comes. Try and put all of us in jail for not taking the health care program you created. This is hard times not like 1990's no one has money.
I tried to understand you post but is is unreadable. Sorry. Is English your second language like mine? Consider cutting really long sentences into two or even three shorter one with one idea per sentence.
Are you saying damage form second smoke is not real? Eyes tearing up from onion are not the same thing as damage from second smoke. Yes, some people get lung cancer even thought they never smoked, but there other illness one gets from second smoke damage as well.
I'm not an expert on the baby friendly certification process, but I do know that I recently gave birth at a hospital that is working towards this designation, and it was a fantastic experience as far as breast feeding goes. And I will say I was very nervous about breast feeding because it was not easy at all for other women in my family and I have flat, at times inverted, nipples. I went into it assuming I might have to supplement or formula feed if I couldn't latch - but thanks in large part to the support I got in the hospital that was not the case and I have been able to EBF my 6-week old son. Here is what my experience looked like:
- skin to skin contact immediately upon delivery (unless certain extreme complications had been present, but they weren't)
- baby never had to leave my room for any procedures, and I was able to breast feed through procedures when feasible
- salaried IBCLC on staff who spent lots of time with us
- all nurses had been trained by the LC to assist moms when she was unavailable
- by giving birth in that hospital I have access to that LC for LIFE, at NO additional charge. (I assume the hospital has simply built the cost of her salary into the labor & delivery fee).
- formula was provided on request only. No "gift bags".
- I happen to have very good insurance. It covers for every new mom one double electric pump per birth (you can get manual if you prefer). It does require you to purchase it through a "durable medical equipment supplier" BUT the LC at our hospital WAS one of these suppliers, so after delivery she just brought my new pump to my room and showed me how to use it. She took care of the insurance claim for it, I didn't have to do anything. This was a BIG help and really took the anxiety away for me in regards to selecting a pump and trying it out.
My wife (31) and I (33) were married in 2006. We are proud queer mamas to W, born Oct 2013, conceived at home IVI via frozen WTBK donor sperm. Planning on TTC #2 starting in Sept 2015 through the same method. I am/will be the gestational mom.
Sphinxy - first, congratulations on the birth of W! You are very fortunate to have received good breastfeeding support while in the hospital AND from your insurance company. Your experience is not typical. I would really like to know what convinced the hospital you were at to seek the "baby friendly" designation. What compelling information do they have that other hospitals seem to be ignoring? The same is true for your insurance company. Insurance companies are big on crunching numbers to get information they use to determine what sort of service they will provide. I would really like to know why your insurance company has decided that it makes good business sense to provide good quality breast pumps, as well as access to a LC when a problem occurs. What do they know that other insurance compaies haven't figured out yet? As I wrote in an earlier post, many insurance companies have clearly demonstrated that they are unwilling to provide good "comprehensive lactation support" unless they are required to do so. We are on the verge of squandering the best opportunity we've had at increasing breastfeeding rates in the U.S. The U.S. Secretary of Health and Human Services, Kathleen Sebelius, must act immediately to put in place a set of guidelines for insurance companies to follow which are similar to those proposed by the U.S. Breastfeeding Committee in their "Model Policy, Payer Coverage of Breastfeeding Support and Counseling Services, Pumps, and Supplies."
If the Obama administration sincerely cared about the health of young Americans they would do everything in their power to increase the number of infants who are breastfed. As you can see from the information in this thread, the U.S. Secretary of Health and Human Services ignored the advice she was given from a panel of experts at the U.S. Breastfeeding Committee on how to strengthen regulations for insurers which would have improved support for breastfeeding mothers and their babies. An increased number of breastfed babies would result in healthier babies (and mothers), which in turn would result in lower health care costs and improved productivity at work. When it comes to improving health outcomes, there is no downside to increasing breastfeeding. The fact that the Obama administration has chosen to disregard this recommendation is one of the reasons why Obamacare is failing.
Exactly. And I've said before, if you...or anyone... thinks that the US government "cares" about its citizens, you are living in a fantasy land. "You" is being used in general terms and is not meant to single out you, the OP. Of note, wasn't there a "study" that came out recently that claimed that breastfed babies are no better off than formula fed babies? I wonder who sponsored that study?? Follow the money trail I guess. If I can find a link, I'll post it. Stuff like that doesn't help the breastfeeding cause... AT ALL.
When Ms. Burwell appears at her nomination hearings she will be asked various questions. Here are four questions she should be asked:
1. Have you read former Surgeon General Dr. Regina Benjamin’s 2011 report titled “Call to Action to Support Breastfeeding”?
2. Have you read the "Breastfeeding in the United States: A national agenda" report issued by the U.S. Breastfeeding Committee in 2001?
3. If you are confirmed as the new Secretary of DHHS, what specific actions do you intend to take to support breastfeeding in the United States?
4. Will you seek the advice of the state breastfeeding coordinators in all 50 states when setting Federal policies that will affect breastfeeding? Please note: those breastfeeding coordinators have not provided their valuable input in the past because they have feared retaliation from lawmakers in the form of funding cuts to their programs and/or job loss if they criticized programs or regulations that were anti-breastfeeding.
Please submit these four questions to your U.S. Senators so that Ms. Burwell will have the opportunity to let us all know just how committed she is to promoting and supporting breastfeeding. Thank you!
In other words… insurance companies (and Medicaid!) will save money by providing a good quality breast pump and access to a certified lactation consultant in order to help prolong the period of breastfeeding. That is good public policy and a wise business strategy.
Last edited by devoted2kids; 10-15-2014 at 09:25 AM.
Both the U.S. Breastfeeding Committee and the National Breastfeeding Center are non-partisan organizations. Therefore, neither the Republicans nor the Democrats will be able to take credit for writing the new guidelines since neither party had anything to do with writing the guidelines. Also, this will relieve the U.S. Department of Health and Human Services from having to figure out how insurance companies should promote and support breastfeeding under Obamacare. All the Secretary of DHHS has to do is declare these guidelines to be the official regulations which insurers must follow and the job is done. No guilt, not shame, no glory, no blame… just common sense insurance coverage for America’s women and infants. It’s the perfect solution for our dysfunctional federal government!
If you are breastfeeding and are having difficulty getting a breast pump and/or doctor’s office visits paid for by your health care insurance, the reason the insurance company is denying your claim could have to do with your doctor’s office not knowing how to submit your claim to your insurance company. If your insurance claim has been denied, please call your doctor’s office and suggest that they go online and look at the document at the link above. This could help your insurance claim to be paid, and you could be helping other breastfeeding mothers receive the insurance coverage they deserve.
Also, you may want to look at this document yourself. It has some good information which might help you describe to your doctor what the problem is that you are experiencing with breastfeeding.
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