As the Tribune editorial rightfully pointed out, no one - not even North Dakotans - is immune from the long-term systemic problems with our health care system.

According to a 2005 survey done by the Center for Rural Health, 8.2 percent of North Dakotans are without health insurance. The estimated number of uninsured is similar to the population of Bismarck, the second-largest city in North Dakota. And in North Dakota, having a job doesn't mean you have insurance, as more than 71 percent of respondents to the survey said they had no insurance but were employed.

However, what the editorial also fails to mention is that the nation needs a strong infrastructure for women's reproductive health care to ensure that access to the services critical to the health and well-being of families is never compromised. Proponents of quality reproductive health care for all women should be aware that the U.S. Department of Health and Human Services recently released a report that casts a bright light on the impact that the nation's health care crisis is having on women, particularly women of childbearing age.

The report states that "women are more vulnerable to high health care costs … (because) women's reproductive health requires more regular contact with health care providers, including yearly Pap test, mammograms and obstetric care."

Planned Parenthood health centers across the country are seeing an increase in patients who have lost their jobs, health insurance or who no longer have the money to pay for lifesaving medical care. Some women are deferring annual exams, including preventive cancer screenings, buying fewer cycles of contraception and increasing longer-acting contraceptive methods.

The Obama administration is clearly committed to making women's health care a priority. As a trusted health care provider for more than 90 years, Planned Parenthood commends the administration and members of Congress who understand that increasing access to quality, affordable health care for women will ultimately result in healthy women and healthy families

(Amy Jacobson is the North Dakota public affairs manager for Planned Parenthood for Minnesota, North Dakota and South Dakota. She co-authored this letter with Tim Stanley of Minneapolis, senior director of government and public affairs for the organization.)