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It’s been 19 years since Marie was cancer free. And it has been 19 years since she had health insurance. Doctors tell her at 19 years of survival, she has the same life expectancy of a nonsmoker her age without cancer.

But don’t tell the insurance companies. She has tried dozens of times and can’t get insurance. The state’s high risk health insurance pool won’t work either.

“I don't mind paying for health insurance,” she told me one beautiful day in May. “But the state’s high risk pool would take more than half my income. And the Well Woman Program only does mammograms and pap smears. I am more than that.”

It is National Women’s Health Week. The United States Department of Health and Human Services’ Office of Women’s Health is encouraging women to make their health a top priority. One goal is to encourage women to get a regular check up and preventive care.

But having no health insurance is a major barrier to meeting this goal. And not taking time to take care of ourselves is a problem many women face.

Ignoring a woman’s health comes at great peril to the woman and her family. The number one killer of women in the U.S is cardiovascular disease. The most common first symptom of heart disease among women is death. Only 13 percent of women see heart disease as a serious threat. There is a great deal of education to do.

Getting health education, a check up and preventive care starts with having health insurance. Frequently those without health insurance delay needed care until problems become very serious.

“If I had health insurance, I would have gone to the doctor quite a bit sooner,” said Marie. Her cancer responded to six rounds of chemotherapy -- something she described as a “little death.”

Cancer is second only to cardiovascular disease as the leading cause of death for both women and men in Wisconsin. The earlier cancer is diagnosed, the more likely the patient will survive.

Breast cancer is the most commonly diagnosed cancer among Wisconsin women. Lung cancer is the leading cause of cancer death in women with most, but not all, lung cancer deaths related to smoking.

“People who don’t have health insurance don’t treat minor symptoms and don’t go to the doctor till they become catastrophic,” said Marie. Yet, early diagnosis and treatment is the key to survival.

Some of the most serious health problems women face are not ones that usually come to mind. The leading cause of injury among women ages 15 to 44 is not car accidents, rape or muggings. Even combined, those three would not equal the number of women injured by domestic violence.

In 2005, nearly seven thousand Wisconsin women received refuge in a domestic violence shelter. That is an eight percent increase over the year 2000. The same year almost 1,500 people were turned away from Wisconsin shelters because no space was available. That is a 27 percent increase since year 2000.

Frequently domestic violence programs compete with roads, prisons, and education and health programs. Many health programs offered by the state are limited to women with children.

“I could get pregnant, be nursing or have a child under five and get health insurance; I could be a criminal and go to jail and get health insurance.” Marie told me. “If I worked for a big company and was part of a big pool, I’d be covered. But I run a small business. I have 20 employees and can’t get health insurance for any of them. I am an entrepreneur. I pay all sorts of taxes. And I’m being punished for running a small business.”

Finding solutions to affordable health insurance for small business owners -- women and men alike -- is the focus of my and others legislative work this summer. The answers are not easy and will involve the cooperation and commitment of many.

The urgency of the situation is clear. The lives of woman and men are at stake. And the long term costs for all of us will be lower if we can bring people into our health care system for preventive care and early diagnosis and treatment.

Take time this week to care for the women in your life -- encourage them to take time for health. For women like Marie, it will take all of our efforts working together to find solutions that make health insurance affordable so she and thousands like her can meet the goals of Women’s Health Week.

Democrat Kathleen Vinehout, Alma, represents the 31st state Senate District.