Womenstake

Nowhere to Turn: Turning 61 Without Insurance

by Golda Philip, Health Fellow, 
National Women's Law Center 

My mom turns 61 this October without health insurance.  She has been uninsured for the past 2 years.  A combination of personal and medical reasons forced her into early retirement.  The below is a look into her journey to find health insurance coverage—a journey that led to her a disturbing realization: our current health care system doesn’t provide her with any affordable options for comprehensive, quality, affordable health insurance coverage.

Medicare, Medicaid.  Being 61, my mom has 4 years to go until she qualifies for Medicare.  Medicaid, the joint federal-state program that provides health insurance coverage to certain categories of low-income individuals, also isn’t an option.  To qualify for California’s version of Medicaid (called Medi-Cal), you need to meet both income eligibility standards AND what’s called “categorical eligibility.”  This means to qualify for the program, my mom would have to fit into one of the following categories:  65 or older, blind, disabled, under 21, pregnant, a recipient of various forms of state assistance, living in a skilled nursing home, a refugee, or a parent of a qualifying child under 21.  My mom doesn’t fit into any of these categories. 

Individual health insurance market.  We here at the National Women’s Law Center have talked a lot about the individual health insurance market.  My mom tried her luck with this option as well, and after searching and searching, she found an insurance company that would cover her.  For almost half a year, she paid almost $400 a month for her premium.  She soon got a letter in the mail from her insurer, informing her that her coverage was being rescinded because she had a pre-existing condition.  My mom has diabetes, but with regular exercise and diet, she has for years been able to control the condition with only minimal medication.  The insurers didn’t seem concerned, however, when my mom’s doctor wrote them telling them as much. As long as she had diabetes, they wouldn’t cover her.

Female Doctors Suffer Unequal Pay

by Golda Philip, Health Fellow, 
National Women’s Law Center 

My new primary care physician is a woman and she is all the things you want your doctor to be: caring, thorough, thoughtful, knowledgeable. She is also likely paid less than her male primary doctor counterparts. 

Women continue to bring home smaller paychecks than men for the same work. This inequity in pay occurs between female and male physicians as well. A recent New York Times survey, for example, shows that women surgeons make 40 percent less than male surgeons. You may be thinking: well, that’s because male doctors may log more hours than women, or have more total years of experience because they didn’t take time off to have children.

Unfortunately, it looks like just being a woman is enough to make a doctor’s paycheck smaller. A recent study on salaries among medical providers controlled for characteristics that you’d expect would lead to a differential in salaries, including things like the number of hours worked and seniority. The study found that female doctors in family practice had much lower incomes than male physicians in family practice. Additionally, among general internists and pediatricians, female physicians of all races/ethnicities had significantly lower incomes than their white male counterparts. The study, disturbingly, also found a trend toward a widening of the sex-income gap over time.

Rallying for Health Care Reform

by Golda Philip, Health Fellow 

National Women’s Law Center

This post is part of a series on Women and Health Reform. 

Health care reform activists are not the most likely of folks you’d expect to see outside the Ritz. This last Tuesday, however, over a hundred of them convened outside the Ritz-Carlton in Georgetown for a rally organized by Health Care for America Now and partner organizations. Just inside the Ritz, America’s Health Insurance Plans (AHIP), a national trade association that represents the interests of the health insurance industry, gathered to discuss their positions on national health care reform. In the words of the rally organizers, the rally intended to “demand lobbyists stop the rhetoric and start supporting true quality, affordable health care for all.”

The speakers at the rally were diverse and carried powerful messages. Among them was a medical student who voiced frustration about being trained to participate in a system that “denies care instead of provides care.” Larry Bryant, a leader with DC Fights Back, an HIV/AIDS advocacy organization, warned the crowd of the dangers of leaving health care reform in the hands of insurance companies. And then there was Donna Smith, who reminded us through her words at the rally and through her painful personal example that the for-profit health insurance system in our country is broken. You may know of Donna from watching Michael Moore’s documentary, Sicko. Donna is the woman who, along with her husband was forced by mounting medical bills (a result of Donna’s uterine cancer and her husband’s heart problems along with their inadequate health insurance) to leave their South Dakota home and relocate to Colorado — to the storage room of their daughter’s house to be precise. 

The messages from Tuesday’s rally need to be sustained: that profits should not come before people, that politics should not come before real reform. The goal is not to demonize insurance companies, but rather to point to the fact that certain groups have entrenched interests in maintaining the status quo. The status quo, when it comes to our health care system, is unacceptable: 46 million uninsured Americans, 25 million underinsured Americans, insurance companies that deny claims for legitimate care and that charge men and women different rates for the same coverage — and the list goes on. We need to fight against the status quo and for real change — change that guarantees every American affordable, comprehensive, quality health care. How can you get involved in making sure real change happens? Write, call, or visit your Senators and Representatives: tell them your story and why you think our health care system needs to be fixed. Get involved in local events that support health care reform. Do something because as we’ve said before, the cost of doing nothing is too high.

Health Care for All—Realizing the Dream

by Golda Philip, Health Fellow
National Women’s Law Center

This post is part of a series on Women and Health Reform.

"Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.”  ---Dr. Martin Luther King Jr., 1966.

Towards the end of his life, Dr. King increasingly confronted the intersection of racial inequality and other forms of injustice, particularly economic inequality.  This intersection created a framework in which Dr. King’s lifelong pursuit of justice applied, quite directly, to the disparities in health care that were part of America in the late 1960s and remain with us today.  Notes from Dr. King’s staff and his organization, the Southern Christian Leadership Conference (SCLC), reveal that bringing attention to health care inequities was a goal not far from Dr. King’s mind.  In fact, Dr. King’s closest advisers considered staging a sit-in at a hospital in the D.C. area to make evident, in the words of one King advisor, the “thousands of people in our nation in need of medical services.” 

Over forty years after Dr. King’s tragic death, America still has a long way to go when it comes to bridging inequalities in health care.  Disparities in health exist across the board.  In 2007, African Americans had a rate of new AIDS cases that was ten times higher than white Americans.  Inequalities between men and women also plague the system.  For example, a 2008 National Women’s Law Center report showed that women, on average, are charged higher premiums for health insurance on the individual market than their male counterparts. Even among women, Hispanic and Native American women were roughly three times as likely as white women to be uninsured in 2007. 

Insurance for Insurance

by Golda Philip, Fellow
National Women’s Law Center

As reported in a recent New York Times article, the health insurance company UnitedHealth has a brand-new product. The company is selling the right to buy an individual health policy with the company at some point down the road when you may need it. Yes, what we’re talking about here is insurance for insurance. This new offer is meant to “reassure” those who currently have insurance but are (rightly) concerned that they may lose their coverage in the future and then have insurers deny them coverage when they try to obtain it again for themselves.

But first, let’s give credit where credit is due. UnitedHealth, in offering this “guarantee of insurance,” reveals critical problems with our current health care system, especially with the individual market, a market that is particularly hostile towards women. Today, you or I could lose our health insurance if we lose our jobs, or if our employers stop offering coverage, and be left to purchase health insurance directly from insurance companies in the individual market. In the current economic situation in which thousands of jobs are being lost every day, this has already become a frightening reality for too many. And while laws require insurance companies to cover individuals who get insurance through their employers even if they have pre-existing conditions or poor health histories, there are few adequate protections that stop insurance companies from rejecting individuals who are looking to buy coverage on their own.

The Shameful Link between Health and Wealth

by Brigette Courtot, Policy Analyst
and Golda Philip, Health Fellow
National Women's Law Center

Today, a woman earns 77 cents for every dollar that a man earns. This wage gap is distressing in and of itself, but it becomes even more significant when you consider that a woman’s relative poverty could be a matter of life or death. Simply put, those with the fewest resources in this country are also the least likely to have access to high-quality health care. Not surprisingly, lower-income women experience poorer health outcomes, many of which could be prevented through access to high-quality care.

Insurance coverage is a major factor in the health inequities that poor families experience.  The relationship between access to health care and access to health insurance is well-documented, and women who are poor or near-poor are at greatest risk for being uninsured. While public health insurance programs play a critical role in extending coverage to many low-income women and their families (state Medicaid programs, for instance particular, cover more than 20 million women), there are millions more who don’t qualify for public health insurance. Their income may exceed program limits (in nearly half of the states, even a working parent with an annual income of $12,000 earns too much to qualify for coverage) or they may not meet other stringent eligibility criteria. 

'Drive-Thru Mastectomies': Dangerous, Dehumanizing, and Almost History

by Golda Philip, Health Fellow
National Women's Law Center

This post is part of a weekly series on Women and Health Reform.

In May 2008, Alva Williams testified in front of Congress about her experience with a “drive-thru mastectomy.” Alva left her house at sunrise for the surgery and was back before sundown. She wasn’t given the option of staying in the hospital. These are her words:

I was in shock – my God, my entire breast had just been removed!  I felt like a butchered animal.  And though my family really wanted to be there for me, they really couldn’t understand all of the feelings I was going through.  I just wished that I had been in the hospital, so I could have shared my fears with a doctor or a nurse…The worst part was emptying the drainage tubes…We had to empty the drains and then measure and record the bloody fluid…I ended up getting a staph infection and had to seek medical help…It’s not right for an insurance company to dictate how a physician must treat a patient.  I pay for health insurance to protect myself, in case the worst happens.  And when it did happen to me, I found out just how little coverage I really had.

Read Alva’s full statement here.

Last Thursday, the House of Representatives overwhelmingly passed a law that would prevent women, like Alva Williams, from enduring these “drive-thru mastectomies.”  The Breast Cancer Patient Protection Act stops insurance companies from forcing a woman out of the hospital within 48 hours of a mastectomy. The law doesn’t force a woman to stay for 48 hours; she and her doctor may decide that she can leave earlier. The law does, however, make insurance companies cover hospital visits for women who need to stay longer. Many states have already passed similar legislation to stop insurance companies from calling the shots in deciding how long a woman can stay in the hospital.  Now it’s up to the Senate to do the right thing and pass this law so that women, regardless of what state they live in, can have this important protection.