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Women make three-fourths of the health care decisions in American households and spend almost two of every three health care dollars It has also been noted that more than 61% of visits to physicians are made by women, 59% of prescription drugs are purchased by women, and 75% of nursing home residents over the age of 75 are women These statistics suggest that women continue to make a large proportion of health care decisions for their family as they have historically, especially regarding their children and elderly relatives (Of ce of Women s Health, 2000) Women typically visit their doctors on a regular basis and use preventive services twice as much as men, but, unfortunately, women spend more money out-of-pocket for needed medical care (Commonwealth Fund, 1994) Health Insurance Managed care is a signi cant source of women s health care.

control is reduced to multiple one-to-one congestion control, again, effectively solved by TCP Easy Deployment Application layer multicast not only addresses the transport issues simply and effectively but is also much more deployable and controllable For any application vendor, deployment issues govern whether and to what extent they can nancially pro t from the applications that they sell Thus, being easily deployable often drives the design choices in application development For example, suppose that a multi-party Internet game vendor needs reliable multicast among its game players Should they use reliable IP multicast From the deployment angle, the players could be dispersed in various ISPs that may or may not support IP multicast internally, not to mention inter-ISP IP multicast forwarding Even if they all do, the game operator may need to negotiate service-level agreements for the IP multicast service, potentially with every ISP where potential game players reside.

Women usually have some type of insurance coverage; however, they are more likely to be covered by public insurance, speci cally Medicaid (Clancy, 2000) Furthermore, women are substantially more likely than men to have minimal or no coverage because they represent the majority of part-time and service employees (Commonwealth Fund, 1994) Women of color and women with low incomes have the highest risk of being uninsured (OWH, 2000) As expected, women without health insurance go without needed medical care, especially vital preventive services including mammograms and Pap smears (Commonwealth Fund, 1994) Insurance also in uences use of various health care services and treatment options For example, women in HMOs are more likely to receive medications than psychotherapy compared to women with fee-for-service payment plans (Glied, 1997) The lack of health care coverage also may help explain why many diseases go undetected in women.

Therefore, the deployment of the Internet game that requires ubiquitous IP multicast support is dependent on the deployment of ubiquitous IP multicast support Currently, there is no ubiquitous IP multicast support on the Internet; but there is ubiquitous IP unicast support Consequently, there is only one choice available to the game vendor Instead of using reliable IP multicast, they choose to simulate the effect of reliable multicast using a central game station (an overlay node) to relay players moves to each other via unicast Many application developers have made such a design choice ever since the inception of IP multicast Because of the lack of compelling applications for interdomain IP multicast, its deployment on the Internet has been slow, which in turn deters application developers from adopting it Hence, the vicious cycle continues and is the chicken and egg problem facing IP multicast deployment.

One may ask whether, if IP multicast has this chicken-and-egg problem, wouldn t any emerging technology would face this problem and how any new technology could be deployed The central test is whether incremental deployment is possible and useful IP multicast doesn t do well in the test in that the value of IP multicast becomes compelling only when it s universally available on the Internet, that is, available across various ISPs, as IP unicast is today On the contrary, application layer multicast is incrementally deployable and makes minimal assumptions about the underlying network, speci cally, assuming universal IP and TCP connectivity To deploy an application that requires application layer multicast is equivalent to deploying the application itself because application layer multicast is bundled with the application.

Relationships with Health Care Providers Women frequently receive services from more than one physician because reproductive services are traditionally isolated from other health services (Clancy, 2000) As a result, many women have dif culty navigating the health care system to receive appropriate medical care According to the OWH, research indicates that women are often unsatis ed with their health care provider or the level of communication with their provider, and several studies have indicated that health care providers treat women differently from men They also noted that, Health providers may give women less thorough evaluations, minimize their symptoms, provide fewer interventions, and give less explanations in response to questions (OWH, 2000)..