Ah, the power of a little fear to make corporations do the right thing. And what could be more terrifying than the specter of (a teensy dose of) socialism? Seems that, faced with the threat of a government-run plan, health insurers are ready to mend their discriminatory habit of charging women more than men for health insurance. This is only the latest bone they’ve thrown: In November insurers agreed they’d accept all customers, without regard to preexisting conditions, and in March they said they’d stop charging more to sick people. Apparently they’ll concede anything to fend off having to compete against a public option, as the Wall Street Journal put it.
It bodes well that the issue is being framed in the terms (and in the Wall Street Journal, no less). All us good capitalists are in favor of competition, right? Why should a private company fear having to compete with clumsy, bloated, ineffective government? This is just the framing supporters of a public option would want. Still, the fight to ensure that there is a public health plan option will be monumental, insurers correctly sensing that this is the crucial nose of the camel of eliminating our crazy system of private insurance.
Back to the issue of gender discrimination in health coverage: When The New York Times began covering the discriminatory insurance practice last fall, insurers defended the practice as based on sound actuarial data; women use more health care than men, especially during their reproductive years.
They were right.
On the data, that is, not on the morality of their discrimination. The issue raises important points about the need to socialize health costs, especially the costs associated with reproducing the species.
The insight goes beyond health costs. Should women bear the overwhelming burden of the caregiving (of both children and the elderly) necessary to continuing the species or should society as a whole share that burden? And what should sharing that burden fairly look like?
Wouldn’t it be nice if health care reform provoked that long overdue conversation. Don’t hold your breath.
P.S. Check out MoveOn's funny ad on the issue of a public health coverage option.
Showing posts with label health insurance. Show all posts
Showing posts with label health insurance. Show all posts
Thursday, May 7, 2009
Thursday, October 30, 2008
Health insurers discriminate against women
This one sent my outrage-o-meter off the charts: The New York Times is reporting that women pay significantly more for individual health insurance than men do, and the difference persists even when you consider only insurance that doesn’t cover childbirth. One insurance company, Anthem in Columbus, Ohio, charges 30-year-old women almost 50 percent more than men the same age.
The health insurance companies claim that women go to the doctor more often and have more lingering health problems. Just when you thought you couldn’t get more offended, read what the spokesperson for one of the insurers, Humana, said by way of justification, which just justified my belief that insurers are the lowest blood-suckers of the earth: “Bearing children increases other health risks later in life, such as urinary incontinence, which may require treatment with medication or surgery.” Screw you, too, buddy. As if having to suffer humiliating long-term medical issues as a result of helping continue the human race weren’t unfair enough, he has to throw it in our faces as an excuse for ripping us off? (See my earlier post.)
The article quotes Marcia Greenberger, a lawyer for the National Women’s Law Center criticizing the discriminatory practices. Greenberger claims that this practice can’t be justified by actuarial principles. That may be true—men probably incur more costs associated with heart attacks, say—but it misses what seems to me the deeper lesson. If anything is by rights a social cost, the burden of childbirth is. That our current system lays this cost at the feet of individual women throws into dramatic relief the utter bankruptcy of our system of treating health care as a private issue. The only insurance pool that makes sense is all of society, as (historical paradox though it is) United Autoworkers founder Walter Reuther saw. Or, as Malcolm Gladwell has put it, we should ditch the actuarial model of insurance for a social model of insurance.
These gender disparities show what a discriminatory dead-end efforts, like John McCain’s, to further privatize the system are. Greenberger notes that tax credits for health insurance—like those McCain would offer—would be worth less to women than men because of the higher premiums they face.
If McCain wins, and implements his health care plan, further privatizing the costs of reproduction, I suggest women go on reproductive strike. (Not a new idea, I’ll admit, although we’ve got one up on the Athenians, since we could go on reproductive strike without going on sex strike, at least until McCain and Palin outlaw abortion and contraception.)
The health insurance companies claim that women go to the doctor more often and have more lingering health problems. Just when you thought you couldn’t get more offended, read what the spokesperson for one of the insurers, Humana, said by way of justification, which just justified my belief that insurers are the lowest blood-suckers of the earth: “Bearing children increases other health risks later in life, such as urinary incontinence, which may require treatment with medication or surgery.” Screw you, too, buddy. As if having to suffer humiliating long-term medical issues as a result of helping continue the human race weren’t unfair enough, he has to throw it in our faces as an excuse for ripping us off? (See my earlier post.)
The article quotes Marcia Greenberger, a lawyer for the National Women’s Law Center criticizing the discriminatory practices. Greenberger claims that this practice can’t be justified by actuarial principles. That may be true—men probably incur more costs associated with heart attacks, say—but it misses what seems to me the deeper lesson. If anything is by rights a social cost, the burden of childbirth is. That our current system lays this cost at the feet of individual women throws into dramatic relief the utter bankruptcy of our system of treating health care as a private issue. The only insurance pool that makes sense is all of society, as (historical paradox though it is) United Autoworkers founder Walter Reuther saw. Or, as Malcolm Gladwell has put it, we should ditch the actuarial model of insurance for a social model of insurance.
These gender disparities show what a discriminatory dead-end efforts, like John McCain’s, to further privatize the system are. Greenberger notes that tax credits for health insurance—like those McCain would offer—would be worth less to women than men because of the higher premiums they face.
If McCain wins, and implements his health care plan, further privatizing the costs of reproduction, I suggest women go on reproductive strike. (Not a new idea, I’ll admit, although we’ve got one up on the Athenians, since we could go on reproductive strike without going on sex strike, at least until McCain and Palin outlaw abortion and contraception.)
Monday, June 2, 2008
Got sliced? No health insurance for you
Another way the American birth system and the you’re-on-your-ownership economy rip women off: The New York Times reported this weekend that some insurers are denying health coverage or raising rates on women who’ve had C-sections. With more than 30 percent of all births in the U.S. now ending in C-section—and rising—and more and more people self-employed or freelance and therefore looking for individual health coverage rather than the group coverage sponsored by employers, this potentially affects a huge number of women.
These insurers are being entirely rational. C-sections are hugely expensive compared to vaginal births, and when you’ve had one C-section you’re nearly guaranteed having them in subsequent births. Ninety percent of women with a previous C-section now have repeat C-sections, thanks largely to guidelines issued in 1999 by the American College of Obstetricians and Gynecologists that strongly discouraged vaginal birth after caesarean, So a woman who has had a C-section does represent a risk of heightened medical costs. Insurers, like the rational capitalists they are, seek to off-load that risk, just as employers seek to offload risk to workers by hiring them on a freelance basis, without offering health coverage.
The insurers may be acting rationally, but the larger medical system is crazy. If capitalism worked the way it’s supposed to work, “the market” in its infinite wisdom would push C-sections to a minimum, perhaps lower than the WHO recommended maximum of 15 percent. Instead, the C-section rate keeps rising.
Despite mythology about women who are “too posh to push,” this rate is not driven by women asking for C-sections. A 2005 survey by Childbirth Connection found that only one woman among the 1600 polled said that she’d had a C-section at her own request for no medical reason. On the other hand, one quarter of those polled reported feeling pressured by a medical professional to have a C-section. And then they pay for it, in a high rate of infection of the incision, extended recovery and pain in comparison to vaginal birth, risks of injury to the baby, greater difficulty initiating breastfeeding, and greater risks of breathing problems in the baby—and finally in a loss of insurance coverage.
Ponder market insanities like this when presidential candidate John McCain advocates pushing our medical system even further into the 'free' market (you can go to his site if you're willing to translate the rhetoric into English, but Elizabeth Edwards' explanation of his plan is a whole lot more direct).
These insurers are being entirely rational. C-sections are hugely expensive compared to vaginal births, and when you’ve had one C-section you’re nearly guaranteed having them in subsequent births. Ninety percent of women with a previous C-section now have repeat C-sections, thanks largely to guidelines issued in 1999 by the American College of Obstetricians and Gynecologists that strongly discouraged vaginal birth after caesarean, So a woman who has had a C-section does represent a risk of heightened medical costs. Insurers, like the rational capitalists they are, seek to off-load that risk, just as employers seek to offload risk to workers by hiring them on a freelance basis, without offering health coverage.
The insurers may be acting rationally, but the larger medical system is crazy. If capitalism worked the way it’s supposed to work, “the market” in its infinite wisdom would push C-sections to a minimum, perhaps lower than the WHO recommended maximum of 15 percent. Instead, the C-section rate keeps rising.
Despite mythology about women who are “too posh to push,” this rate is not driven by women asking for C-sections. A 2005 survey by Childbirth Connection found that only one woman among the 1600 polled said that she’d had a C-section at her own request for no medical reason. On the other hand, one quarter of those polled reported feeling pressured by a medical professional to have a C-section. And then they pay for it, in a high rate of infection of the incision, extended recovery and pain in comparison to vaginal birth, risks of injury to the baby, greater difficulty initiating breastfeeding, and greater risks of breathing problems in the baby—and finally in a loss of insurance coverage.
Ponder market insanities like this when presidential candidate John McCain advocates pushing our medical system even further into the 'free' market (you can go to his site if you're willing to translate the rhetoric into English, but Elizabeth Edwards' explanation of his plan is a whole lot more direct).
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