October brings to mind the colors of autumn, the black and orange of Halloween, and pink, the color of Breast Cancer Awareness Month.  It is a time to reflect on strides made in breast cancer prevention and chart a course for the future.

The realm of breast cancer is far different from what it was in 1985, when October officially became Breast Cancer Awareness Month.  What once was a silent killer is now a widely talked about, often highly treatable disease.  Breast Cancer Awareness month has helped us overcome much of the stigma once associated with breast cancer, and women are now encouraged and are lauded for sharing their breast cancer stories.  As a result, many more women in America today have heard messages emphasizing the importance of early detection and screening and know they should schedule their first mammogram by age 40.  We know the mortality rate from breast cancer has decreased over the past two decades, and we know there are more treatment options than ever.  What we seem to have forgotten, however, is that breast cancer is still the second leading cause of cancer deaths in American women.

Today there exists an alarming thought that breast cancer is simply not as big a concern as it once was, but nothing could be further from the truth.  It is estimated 226,870 women will be diagnosed with breast cancer in 2012; in Iowa alone, it is estimated 2,350 women will be told they have breast cancer, and 400 women will die from the disease.  These are still huge numbers, so it is critically important the American public does not become complacent about breast health.

There are many proactive measures women can take toward detecting breast cancer, including:

Breast Self-Exam:  Every woman should perform a monthly examination of her breasts to check for physical changes.  If you are unsure of how to perform a breast self-exam, ask your health care provider to demonstrate and explain the ideal time to conduct one.  It is very important for women to become familiar with their breasts and understand what feels normal. Start early, beginning at age 20.

Clinical Breast Exam:  Be sure to ask your health care provider to give you a clinical breast exam each year. The exam consists of checking the breasts for any changes, lumps, or other possible warning signs of breast cancer through physical touch and appearance.  You should begin having clinical breast exams in your 20s and 30s.

Mammography:  By the age of 40, all women should have a mammogram, and it is important to talk to your health care provider about how often the test should be performed.  The mammogram is an "x-ray" of the breast and, at this time, is the most effective method of detecting breast changes that may be cancer, long before physical symptoms can be seen or felt.

While every man and woman is at risk for breast cancer, some are at higher risk.  Risk factors include a family history of breast cancer, inherited abnormal genes, a previous diagnosis of cancer in one breast, a sedentary lifestyle, and age - women over 50 are more likely to develop breast cancer.  Like all cancers, risk for breast cancer can be reduced by leading a healthy lifestyle, which includes exercise and not smoking.  New drugs have been developed to help prevent breast cancer in high risk patients, so if you believe you are at a higher risk for breast cancer, please talk to your health care provider.

In the paragraph above, you will notice it says, "every man and woman is at risk ...". Yes, men can get breast cancer. too. While breast cancer risk for women is calculated by state, the same information for men is available only for the United States as a whole.  In 2012, the estimate is 2,190 men will be diagnosed with breast cancer, and there will be 410 deaths.

Survival rates for breast cancer are higher now than they were ten years ago in large part because women are getting tested and catching it early.  Please follow the above guidelines and encourage friends and family to do the same.  A cancer diagnosis affects not only the patient and her immediate family, but also their entire community of friends, schoolmates, neighbors, colleagues, and service providers.  Protect your health this and every month, if not for yourself, then for the people who love you.

If you would like additional information on cancer prevention, please visit  www.preventcancer.org.

Barbara Grassley, a breast cancer survivor, is a member of the Congressional Families Cancer Prevention program of the Prevent Cancer Foundation and the spouse of U.S. Senator Chuck Grassley of Iowa.

Each year, Medicare beneficiaries in Iowa and around the country have a chance to select a new plan or keep their existing plan during Medicare's Open Enrollment period.  This year, the open enrollment begins October 15th and ends on December 7th.  By getting a head start on choosing their plans for 2013, seniors can ensure they will receive the benefits they need.  Any changes made will take effect on January 1, 2013.

The options for choosing a plan can be daunting, but the Medicare website - www.medicare.gov - is a good resource for seniors to select a plan and answer questions about their options.   The site also includes The Medicare Plan Finder, a unique tool that allows seniors to compare numerous drug and health plans simultaneously.  The Plan Finder breaks down monthly premiums, deductibles, co-pay levels, and prescription drug coverage.

The Medicare website also highlights the most popular and highly rated Medicare Advantage and prescription drug plans that have been reported by Medicare recipients.  The highest quality plans received an overall rating of five stars with the best performers receiving a "gold star" icon.  This guide can help Iowans analyze others' experiences with Medicare plans and choose the plan that's right for them.

I encourage all beneficiaries in Iowa to take a look at these new resources including http://www.healthcare.gov/, where Iowans can find more information about The Affordable Care Act - the landmark health law - and how it benefits them.

For more information about Medicare and the new changes, please visit the following sites:  www.cms.hhs.gov/center/openenrollment.asp or www.shiip.state.ia.us for information specific to Iowa.  If you do not have access to a computer, feel free to call 1-800-MEDICARE.  And of course, you can find more information on my website at www.harkin.senate.gov.

A PDF version of the column is available by clicking here.

Between blow-drying, teasing, flat-ironing, highlighting and lowlighting? there are many ways to change what Mother Nature gave us. But whether you're regularly straightening curls, lightening darker hair or vice/versa, there may be a price to pay for rebelling.

But most women don't think twice about the hair habits they've had for years and years, says longtime hair-care advocate and health scientist Audrey Davis-Sivasothy.

"Lackluster, frazzled, overworked hair?that's the price we pay for handling our hair like a pair of jeans. Hair is a fragile fiber that needs to be handled more like a silk blouse," says Davis-Sivasothy, author of "Hair Care Rehab," (www.haircarerehab.com). "Oftentimes, the style we feel the most comfortable with reinforces our bad habits. It's a problem with all the earmarks of an addiction."

Substances of choice include :

· Toxic chemicals (perms, relaxers & colors)

· Hair OCD (excessive combing, brushing & heat use)

· Environmental lifestyle (too much exposure to sun, surf, bad air and water)

· Nutritional/dietary (fad diets, smoking, low water consumption)

As with a drug addiction, once you've kicked your habit, you'll liberate your bad hair, unlocking new dimensions of hair potential, says Davis-Sivasothy, who has also authored the popular "The Science of Black Hair" (www.blackhairscience.com).

She offers a five-step rehab for damaged hair:

1. Chelating your hair: Products containing oils, conditioners, serums and pomades (or minerals), which make you feel better in the short term, can build up and actually prevent your hair's ability to hydrate. That's why the first step in detoxing hair is the use of chelating shampoo, which is typically clear and lifts stubborn buildup from products and hard water. While many chelating shampoos are sulfate-based, there are more sulfate-free products entering the market to accommodate sensitive scalps and hair. Clarifying shampoos are a good substitute when chelating shampoos cannot be found. Moisturizing shampoo should be used for general use after detoxing is complete.

2. Deep conditioning your hair: After chelating, deep condition for 10 to 15 minutes. This should be done every seven to 10 days using moisturizing conditioners such as instant and cream-rinse, deep conditioners, protein treatments or leave-in conditioners. To go the extra mile, consider an apple cider vinegar rinse to close the cuticle and enhance your hair's shine.

3. Moisturizing your hair: This step adds a layer of leave-on protection. You can use either leave-in conditioner or a dedicated moisturizing product, or both. For thick, dry or curly hair, this step hydrates and adds "slip." For fine or oily hair, these products should detangle strands while encouraging volume.

4. Sealing your hair: This is the last major step in your hair intervention. Sealing with an oil or butter product locks in moisture and solidifies the gains of rehab. It smoothes out the cuticle and keeps hair moisturized for a longer period. Always use sealant on slightly dampened or misted hair, or pair the product with a water-based moisturizer to maximize the benefits. If you have naturally oily hair, you can skip this step.

5. Styling your hair protectively: Imagine wearing a favorite sweater every day; washing, drying and ironing it several times a week - it would look pretty worn out after a few years! This is exactly what happens to hair that is bleached, colored, blown dry with artificial heat, ironed, weaved and on and on. Don't do this anymore! There are several measures you can take to preserve the health of your hair, including wearing it up more often, cleansing it cautiously, detangling strands with a large-tooth comb, protectively using blow-dryer heat, reducing chemical use and not coloring your hair more than three shades lighter or darker than your natural color. In general, be gentle. Do not pull to hard or rapidly when styling it, too; be slow and steady.

About Audrey Davis-Sivasothy

Audrey Davis-Sivasothy is a Houston-based freelance writer, publisher and longtime, healthy hair care advocate and enthusiast. Sivasothy holds a degree in health science and has written extensively on the science of caring for hair at home.

Senator Chuck Grassley issued the comment below following a New York Times story today that a provision in the 2010 health care law is being distorted in fall campaign ads.

Grassley comment:

"Remember, it was Republicans who made this law apply to Congress, not the Democrats who wrote the law.   The Democrats were perfectly fine with applying Obamacare to the entire economy but leaving themselves out.  Despite passage of my amendment, Democrats still carved out exemptions for high-level staff, despite Republican efforts to undo the carve-outs, and Democrats refused to make Obamacare apply to the White House itself."

Background information:

The provision in question stemmed from an amendment Grassley authored and for which he won Finance Committee approval in September 2009.  The Grassley amendment said that members of Congress and their staff must get their health insurance coverage from the exchanges that would be established in the health care overhaul.  This congressional coverage initiative built on many years of work by Senator Grassley to have Congress live under the laws it passes for the rest of the country.  In 1995, legislation authored by Grassley to apply 12 civil rights, labor and employment laws to Congress for the first time.

The story in today's New York Times reports that TV commercials being run on behalf of Democratic candidates for Congress assert that members of Congress who voted to repeal the 2010 health care law have voted to give themselves taxpayer-funded health care for life."  Senator Grassley said his provision, even in the final form it took in the law that was enacted makes no changes to the employer contribution to federal employee health care coverage and no changes to federal retiree health care.

New York Times story:

Democrats Use Health Law to Assail Republicans

By ROBERT PEAR

Published: October 18, 2012

WASHINGTON ? A little-noticed provision of the new health care law is causing big headaches for some members of Congress in this year's elections. And it is likely to cause even bigger headaches for lawmakers next year.

The provision, written into the law at the behest of a Republican senator, says members of Congress must get their health benefits through new insurance exchanges being established in every state.

Republicans have voted repeatedly to repeal the whole law. Now, in a barrage of television ads, Democrats are roasting those Republicans, saying they voted to give themselves "taxpayer-funded health care for life."

The accuracy of the commercials, judged even by the loose standards that often apply to political advertising, is open to question.

Democrats say the commercials are accurate. Under the law, they say, members of Congress would be removed from the federal program that provides health insurance to most federal employees and retirees. Repealing the law, they say, would restore that coverage.

Republicans say that the attacks are unfounded, and that the Democrats are misrepresenting the effect of the law on coverage for retired members of Congress.

In any event, the criticism, if it sticks, could be politically damaging. Lawmakers of both parties have often said their goal is to provide all Americans with health insurance as good as what Congress has.

In a typical ad, the campaign of Ann McLane Kuster, the Democratic candidate for Congress in the Second District of New Hampshire, says that Representative Charles Bass, the incumbent Republican, "voted to cut Medicare for you while voting himself taxpayer-funded health care for life." In upstate New York, Dan Maffei, a Democrat, assails the Republican, Representative Ann Marie Buerkle, saying she tried to privatize Medicare while "voting herself a tax-subsidized health care plan that she will be eligible for even after she retires."

Similar television advertisements have been run in California by Democrats trying to unseat Representatives Brian P. Bilbray and Mary Bono Mack, both Republicans.

In Michigan, the Democratic Congressional Campaign Committee is running an advertisement that says Representative Dan Benishek, a Republican, "voted to give members of Congress taxpayer-funded health care for life."

In another commercial, the committee says that Representative Tom Latham, Republican of Iowa, "voted himself taxpayer-funded health care for life," but "wanted to gut Medicare, basically do away with it," for older Americans.

House Majority PAC, a leading Democratic "super PAC," has run advertisements saying that Representative Chip Cravaack, a freshman Republican from Minnesota, "voted to give members of Congress taxpayer-subsidized health care for life," even as he tried to make older Americans pay more for their health care.

In an interview, Mr. Cravaack said the attack was based on "a deceitful stretch of the imagination," and he asked: "How can you possibly think that repealing Obamacare would provide me with health care for life? I do not understand the correlation."

However, Andy Stone, a spokesman for House Majority PAC, defended the commercials.

"The ads show the hypocrisy of Republicans who want to protect their health insurance while eliminating protections for people with pre-existing conditions and for children who want to stay on their parents' insurance to age 26," Mr. Stone said.

Jesse F. Ferguson, a spokesman for the Democratic Congressional Campaign Committee, said, "It's no surprise Republicans don't like us pointing out the truth ? that their vote to repeal the Affordable Care Act would reinstate the perk of taxpayer-funded government health care for members of Congress."

Senator Charles E. Grassley, Republican of Iowa, proposed the original requirement for lawmakers to get coverage through insurance exchanges. He has long said that "Congress should live under the same laws it passes for the rest of the country."

The television ads are based on two premises: that members of Congress now have taxpayer-financed coverage for life, and that the 2010 health care law will eliminate it.

The facts are more complicated than the ads.

Members of Congress and retired members are eligible for insurance coverage under the same system as other federal employees. This system, the Federal Employees Health Benefits Program, covers eight million federal workers, retirees and dependents.

The 2010 health care law says that the only health plans available to members of Congress, as a benefit of their employment, are health plans created under the law or offered through insurance exchanges.

The nonpartisan Congressional Research Service, an arm of the Library of Congress, says this section of the law implies that members of Congress "will no longer be eligible to enroll" in the Federal Employees Health Benefits Program.

That raises vexing questions for lawmakers. Under the program for federal employees, the government pays a hefty share of the premiums: 72 percent, on average. Will this money still be available to help pay premiums when members of Congress get coverage through the exchanges, starting in 2014?

The government contribution averages more than $10,000 a year for family coverage and more than $4,500 for individual coverage.

In writing the legislation, members of Congress apparently assumed that the federal contribution to their premiums would continue, but the law is silent on the question.

Though the law generally requires members of Congress and certain Congressional aides to get their coverage through insurance exchanges, it says nothing about retiree health benefits.

How the new law affects retiree benefits is unclear, say lawyers at the Congressional Research Service and at the Committee on House Administration, which is responsible for bills affecting lawmakers' pay and benefits.

Federal employees can often keep their coverage in retirement if they have been continuously enrolled in the federal employees health program for five years immediately before retiring.

Without getting into the fine points of health policy, Democrats are unleashing more ads. One says that Representative Sean P. Duffy, Republican of Wisconsin, voted to "give Congress taxpayer-funded health care for life."

Justin Richards, the manager of the Duffy campaign, said: "Sean Duffy doesn't get health care for life, not even close. His health care is the same as any federal employee from the F.B.I. agent to the park ranger."

A version of this article appeared in print on October 19, 2012, on page A18 of The New York Times

Description of Grassley effort to apply health care law to Congress:

For Immediate Release

Wednesday, January 26, 2011

Grassley re-introduces bill to apply health care reforms

to White House and administration leaders, and equitably in Congress

WASHINGTON - Senator Chuck Grassley today renewed his effort to apply the health care reform law to the President, Vice President, cabinet members, top White House staff, and the congressional staff who worked for passage of the massive overhaul enacted in March 2010.

Previous legislative initiatives by Grassley to establish accountability in Congress and the administration were rebuffed, both in 2009 and 2010, by the Democratic Majority Leader in the Senate.  "As a result, the health care reforms driven by President Obama and Senator Reid do not apply to President Obama and top administration officials or to the powerful congressional leadership staff who helped to make the overhaul the law of the land," Grassley said.  "The message to grassroots America is that health care reform is good enough for you, but not for us."

Grassley said that now that a new Congress has started, Senate leaders have another chance to make things right and should act immediately to pass his Health Reform Accountability Act.  "Until the health care overhaul is repealed and replaced with reforms that have broad-based support, the majority leadership in the Senate and the administration ought to make sure they are required to live under the health care law they put on the books."

Grassley started his accountability effort in September 2009, when the Finance Committee, where he served as Ranking Member, was acting on its reform proposal.  Committee members approved a Grassley amendment to have members of Congress and all congressional staff obtain their health insurance through the same health insurance exchanges where health plans for the general public would be available.  After the bill left committee and during the closed-door reworking of the legislation in the Senate Majority Leader's office, Senate committee and leadership staffs were exempted from the requirement.

In December 2010, when the carve-out was discovered, Grassley and Senator Tom Coburn offered an amendment to restore the requirement for all congressional staff and also to statutorily require the President, the Vice President, top White House staff and cabinet members to get their health insurance through the newly created exchanges.  The amendment did not apply to federal employees in the civil service.  The Grassley-Coburn amendment was never brought up for a vote.  The legislative fix also was not included in the final manager's amendment, controlled by the Senate Majority Leader, on Christmas Eve, when the Senate passed the legislation that ultimately became law.  Grassley made another attempt to have the special carve-out removed during Senate consideration of the health-care reconciliation bill in March 2010.  Again, he was rebuffed.  Grassley filed the same free-standing legislation introduced today immediately following final passage, but it has never been brought up by the Senate Majority Leader, who controls the calendar and Senate business.

Grassley said the motivation for his initiative is simple:  public officials who make the laws or lead efforts to have laws changed should live under those laws.  "It's the same principle that motivated me to pursue legislation over 20 years ago to apply civil rights, labor and employment laws to Congress," Grassley said.

That previous Grassley crusade met success in 1995, when President Clinton signed into law Grassley's Congressional Accountability Act.  Before then, Congress had routinely exempted itself from major laws, including the Age Discrimination in Employment Act of 1967, the Americans with Disabilities Act of 1990, Title VII of the Civil Rights Act of 1964, the Employee Polygraph Protection Act of 1988, the Fair Labor Standards Act of 1938, the Family and Medical Leave Act of 1993, the Federal Service Labor-Management Relations Statute, the Occupational Safety and Health Act of 1970, the Rehabilitation Act of 1973, the Veteran's Employment and Reemployment Rights at Chapter 43 of Title 38 of the U.S. Code, and the Worker Adjustment and Retraining Notification Act of 1989.  All 12 of those laws now apply to Congress, thanks to Grassley's reform legislation.

Today, Grassley also is working to make sure Congress lives up to the same standards it imposes on others with legislation such as his Congressional Whistleblower Protection Act.

As far as the health care law, as it stands today, because of the amendment Grassley included in the Finance Committee bill, at least members of Congress and their personal office staffs will be required to obtain their health insurance coverage through the newly created health care exchanges, when the law takes full effect in 2014, instead of the Federal Employees Health Benefit Program.

In March 2010, the White House announced that the President planned to participate in the health insurance exchanges in 2014.  Grassley said at the time that the move effectively endorsed his legislation.  "I appreciate it, but the principle of living under the law shouldn't be voluntary for political leaders."

The companion bill to the legislation filed today by Grassley was introduced last week in the House of Representatives by Representative Michael Burgess of Texas.  It's H.R.360.