On women's health and privilege.

I just read Angelina Jolie's OpEd in the New York Times about her decision to have a preventive double mastectomy after testing positive for the breast cancer gene BRCA1. She titles it "My Medical Choice." It is an amazing and wonderful thing that she has knowledge about her health risks and options to deal with them. Without a cure for cancer, this is the next best thing for taking control of one's own health care and future.

I have loved Angeline Jolie as an actor ever since her performance in my favorite coming of age film, Foxfire, based on the Joyce Carol Oates novel of the same name. I love her work for the United Nations and all she has done for refugees around the world. And I love her now for raising awareness of the options for women looking to prevent breast and ovarian cancers.

What her piece highlights for me is the very different worlds she and I live in. As a woman of privilege, she is able to make a fully informed decision about her health care. She can access state of the art genetic testing to better understand her risks. Then, with this knowledge, she can choose from several options for prevention and screening.

Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.

For me, as I also consider myself a woman of privilege, I could probably afford the $3,000 for the genetic test, which would be a hardship, but not completely out of reach. Then, if I tested positive, I could consider some of the options, but first I would have to see what my health insurance company covers. I will never have access to the best surgeons in the country as Jolie did, nor will I be able to receive care at the Pink Lotus Breast Center or any place like it. But I might be able to get a double mastectomy and reconstructive surgery with my limited health insurance, again, at some significant cost. I could probably scrounge up the funds or take out a loan.

For millions of other women in the United States, none of these options are available. They do not have health insurance, nor do they have access to the thousands of dollars for just the genetic screening.  They likely will not even receive a breast cancer screening. For them, they wait until something goes seriously wrong. They find the lump, if they are lucky; but then what? Without health insurance, how does she even seek treatment? 

I don't need to take this to its conclusion. You get the picture.

Angelina Jolie is brave. She is an important voice in the fight for women's health. I hope she can speak louder on behalf of the millions of women for which these options are out of reach. The advances in breast cancer prevention and treatment are truly remarkable. We should ensure that all women can access them.

This is why I support the Affordable Care Act. It is one step closer to ensuring that all women have access to the screening, prevention, and treatment afforded to Angelina Jolie. It is the moral and right thing to do for all Americans.