A question has been raised in other letters about the effect of health care reform on mammogram testing. Experts are now debating whether mammograms should be done every year or every other year. One clearly documented finding that has received little attention is that there is a 50 percent increased risk of death due to breast cancer for uninsured women (Institute of Medicine, 2002).

The recently passed House of Representatives health care reform legislation addresses this in two ways. First, by providing access to insurance for 96 percent of the uninsured, the number of women covered for mammograms will increase significantly. Second, the House bill requires insurance policies eliminate deductibles and co-pays for this and other preventive services.

Senate consideration of reform is ongoing, and there is no guarantee that service enhancements for preventive care will be preserved in the Senate bill or a bill from a conference committee. This is the time when all those who understand the value of preventive health services, including mammograms, should be contacting the offices of Sens. Herb Kohl at (202) 224-5653 and Russ Feingold at (202) 224-5323 to support legislation that includes preventive care benefits.