Women tend to pay higher premiums than men for health insurance. Insurers have argued this is because women tend to have higher health costs, particularly during the child-bearing years.But as the feds scrutinize health care, that disparity has come under the spotlight; earlier this week, Massachusetts Dem John Kerry introduced a bill that would prohibit insurers from charging women more than men.
And testifying in the Senate yesterday, Karen Ignani, the president of the big trade group for health insurers, said she doesn't think gender should factor into women's rates when buying individual policies.
I'll believe it when I see it, but this is a great start. Thanks Kerry!
Related posts:
Josh T's community post
Personal is Political: Buying my own health insurance
Women Pay the Price for Health Insurance
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So, let's see:
- We are not paid the equivalent salary of men because we bear children
- We do not get adequate maternity leave after we bear children
- We pay higher premiums because we bear children
- We are not given any social programs efficient and cost-effective enough to be able to both work full time and have children
- We are told that because of the above issues, we are better off at home...with children.
Is it just me, or does the U.S. hate mothers?
The bigger issue, of course, is the healthcare system in general. When a person's illness = someone else's profit, and when curing that illness = loss of profit, then guess what: we'll always be sick.
As I said in "Personal is Political", they need to cover ALL forms of birth control if pregnancy is really such a huge expense. It's like a catch-22: you pay outrageous premiums for maternity coverage, but if you opt out, they won't cover all birth control. Well, hey! I don't wanna get pregnant any more than you want me to, buddy.
And doctors need to stop trying to interfere in birth control choices (including voluntary sterilization) and discourage everything but the pill. But I guess that's another topic :)
It's not as good as it sounds. Actually, they offered to drop gender rating in insurance pricing *in exchange* for the government requiring that all Americans have health insurance AND taking a state-sponsored option off the table. Basically, they said, Sure, we'll drop gender rating...if you'll force everyone in the country to buy insurance from us without offering a cheaper program to compete. Check out the story on RHRealityCheck: http://www.rhrealitycheck.org/blog/2009/05/06/lets-end-insurance-discrimination-against-women-right-way
Because they make lots of money on males who are around twenty to thirty years old. If they charge those men more, then fewer of them will purchase health care, pushing premiums far higher then a simple average of the two rates, and lowering the companies profits.
I wonder when the backlash against charging men higher premiums for car insurance will start.
That was my thought too.
That was my immediate thought, actually.
It's going to take a lot more than just a vow to keep this marriage. And so what if women's premiums equal men's? If they keep co-pays for birth control higher than viagara or if they force women into higher deductibles for child birth and other reproductive health care, it won't matter.
There is a lot more work to do to bring equity to health care for women than just premiums.
I can understand why women of childbearing represent a relatively greater "expense" to insurance companies than their male counterparts, and I suspect it all has to do with the high cost of annual gyn care/prenatal/delivery/and post-natal care that MOST women in this group will eventually utilize, and there really is no comparable expense for men of this age. (How many 30 year old women do you know who see a gynecologist annually? How many 30 year old men do you know who see their urologist annually? That's the sort of thing I'm talking about). So in that sense I can wrap my head around higher premiums for women in this age group.
I agree with an above poster that if this is truly the motivation for charging women a higher premium, insurance companies are not doing themselves any favors by not covering birth control, which is much...much cheaper than covering birth. Not only is denying coverage for BC ethically wrong, it's simply bad business.
However, after the child bearing years are over, I strongly suspect that your average elderly male would represent a relatively greater expense to insurers than your average elderly female, perhaps (I am postulating here) due to the heart disease that is more prevalent in men, and is the overall leading cause of morbidity/mortality in the US.
Do post-menopausal women also have higher premiums than males of similar age? I'd like to see an explanation for that.
This is the sort of stuff that's deeply engrained in our culture, though. Men don't go to the doctor often because it isn't "manly". I have to think part of the resistance to Male Birth Control is that suggesting men be involved in birth control, having to go to the pharm or clinic regularly to get it, more visits to doctors for "men's annual", etc, is seen as "ridiculous" and something for women to do only.
And as long as women are burdened with more childcare while men get to father them and then live like they are single (and NO, MRAs, this is NOT an instance of "female privelege". Women are expected to be the single parents in our society after a separation, not men, and it is a detriment. Being a single parent is extremely difficult, yet it is expected of mothers way more than fathers. In fact a father who does it is seen as "exceptional" but for women it is just our duty, or punishment for being the whores we are:) ).
I truly think we'll only achieve equality in these areas when MEN are just as expected to "bear children" ie RAISE them. Birth control, pregnancy, childcare, maternity (parental) leave, high premiums are all seen as a woman's problem. Then, we get discriminated against for it.
Don't know why, but women spend more on healthcare than men do (at least, in the United States) right up until the end. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1361028 (in 2004, men spent an average of $270K over their life on health care, women $360K, adjusted for lifespan, men go up to $305K) - women even spend more on nursing homes. This remains true when you artifically inflate men's lifespans to match womens (http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1361028&rendertype=table&id=tbl2) - even for things like dental care, hearing care, whatnot.
Seems more likely that accepting/seeking healthcare just isn't manly (Real men™ should walk of any injury or illness).
walk off, not walk of, obviously. :(
By dying younger, men tend to end up costing less in terms of total health care dollars spent. Probably %80 of all health are spending comes in old age. Because men tend to spend less time in old age, they are less expensive than women to treat.
While you might think this, you'll find (for instance, in the study I cited above) that women's longer lifespans accounts for only part of their greater healthcare expenditure. The average 20 year old woman spends more than the average 20 year old man on healthcare, and this is the same at any other age.
I agree that's it higher for women at any age. My point was that it's MUCH higher for women in very old age because men tend to be dead.
Yes, you're right. If you account for the long life span, men get 85% as much medical care as women, if not, it's only 75%. But women are still using more doctors/nurses/hospitals than men. I can't imagine it's genuine need - I'd wager dollars to dimes men are more often injured, and probably more often ill, compared with women. Given the context in which we're discussing this, it's probably the inherent lower use of medicine by men (or higher use of medicine by women, however you'd like to frame it) that's of more interest.
I understand what your getting at, Brian, but it seems to me that women are being punished, for lack of a better word, for utilizing services that are OFFERED by insurance companies and intended to keep us healthy. At the risk of over generalizing, and in agreement with what you said above, women are much more likely to utilize the preventative care and avoid more pressing problems. (Read: wellness checks, mammograms, yearly ob/gyn exams)
It seems to me as though this type of health care is better than waiting until a crisis. There is a serious problem with our system when using basic preventative health care is frowned upon and punished with higher rates.
Our for-profit health care is seriously broken. We need to be encouraging these small cost check ups.
Err, I don't share your situation in many regards, living in Ontario, so I'll have to opt out of a lot, but:
Preventative care saves money on health care. Big time. When Ontario underwent the "Common Sense Revolution" under Mike Harris, that was the hardest right government we'd seen since well before the war, and they pushed preventative medicine like crazy, because it decreased healthcare costs (which is the provincial government's single biggest expenditure). During their time in power, they cut government spending to the tune of $10 billion, but they poured money into flu shots, Telehealth Ontario ... (there are others, but my memory fails me). Checkups, screenings, whatnot, save your insurance company money and they'd be daft not to encourage them (I can't speak for the actual practice of your insurance company, which is why I substituted the practice of my insurance company, OHIP, which encourages preventative treatments, checkups, all this stuff, both so I'll be healthier and so they'll save money.) Annual checkups, vaccines, whatever women do at the doctor (I dunno?) aren't why the costs are different, women are also being hospitalised more, getting more dental care, are more likely to be in nursing homes, whatnot.
I'll re-emphasize I don't really know what the difference is. It seems unlikely to me that women have a greater need for healthcare - it seems a lot likely that they have a lesser need for healthcare, but get healthcare more often when needed. Anecdotally (though that word makes my skin crawl) everyone I've known who has avoided medical treatment has been a man, and I could be easily made to believe it's just that for the same symptoms/injury, I'm less likely to seek medical treatment than an otherwise identical women, because of the difference in socialisation/biology/whatever (I'll remain agnostic on that, since I don't know) that leads us to believe seeking medical care is unmanly. Real men tape their finger back on and are back on the ice for the third period and all that.
Whether or not it's ethical to charge people different insurance rates based on criteria such as gender is a wholly different question, and I'm very reluctant to set myself up as a moral authority and take a position on that. Of course, since I'm not is a position to worry practically (since I pay for healthcare according to my income/land ownership/retail purchases, and not how much of a risk I am to use it), it might be sensible to not give my thoughts their much credence anyhow, since I've no stake in the matter.
If we are trying to say "rah, rah" for preventative healthcare bringing up Mike Harris is a very bad way to do it.
Flu shots don't prevent that many emergency room visits or the need for an MRI or staff for recovery care, yet those services were cut drastically. Cue the hole of wait times that we are still trying to dig ourselves out of. He may have slashed $10 billion from health services but unfortunately we probably still needed about $9 billion of that to provide timely healthcare, especially for our society with the average age going up the way it is.
Preventative healthcare is important but it shouldn't be at the expense of other care. And it can save money but let's be honest, some of the most expensive and debilitating diseases are not resolved by "preventative" care.
This isn't my point at all, but that even if your insurance company only cares about their bottom line, it's to their advantage to offer preventative care, because that decreases their cost. Which is exactly why Harris introduced Telehealth, for instance. That he did other things you might not approve of is neither here nor there.
Let's also reduce Social Security payments to women to account for the longer lifespans. And just wait until you have gender-neutral rating for auto insurance.
While we're at it, let's eliminate:
Gender as a basis for auto insurance rates
Gender as basis for life insurance rates
Males could use a break since they pay more than females for both of these types of insurance.
This is great news! But while we're at it let's tackle the whole men pay more for car insurance thing. We should just establish that using sex/gender in determining premiums is wrong. Of course there is still a lot about the health insurance industry that needs to change, but this is good to see.
Aaaand, here it is folks! The auto insurance canard. From two people, no less!
Let's review the ways in which auto insurance is different from health insurance:
*cars are not bodies, people.
*health is a human rights issue; driving is a privilege.
*health insurance covers routine maintenance, auto insurance does not.
*women pay more for health insurance b/c they use health care more often, not because they are sicker.
*men pay more for auto insurance b/c they cause more accidents and violate more laws, not because they are the victims of more accidents or vandalism.
*to be equivalent, auto insurance would have to cover things like oil changes. if men were charged more for auto insurance b/c they had their oil changed more often, it would be gender discrimination.
*health insurance covers routine maintenance, auto insurance does not.
This is an interesting point:
1. Should health insurance cover routine maintenance or only catastrophes (as the definition for "insurance" implies)?
2. Should auto insurance cover routine auto maintenance?
*women pay more for health insurance b/c they use health care more often, not because they are sicker.
*men pay more for auto insurance b/c they cause more accidents and violate more laws, not because they are the victims of more accidents or vandalism.
Don't you think both the points above are equivalent? Shouldn't people who consume more resources pay more?
It makes no economic sense for a health insurance company to overcharge its female customers vis a vis the men. If they do so then it is a weakness in their business plan and the easiest way to show them up is for us to form a feminisist health co-operative where we charge equal premiums from all. Since we can charge lower premiums than the other companies (since they are discriminating against without any basis) we will grow our business while they lose theirs and if they want to play with us they will have to lower their rates and thus our goals will be achieved.
So what you are saying is that actual costs paid for by the insurance company should not even enter into the premiums? By that logic you should charge the same premiums for life insurance irregardless of a person's age (and men do pay higher life insurance charges at the same age as females).
When it comes to insurance, be it health, life or auto, the argument that "it isn't fair" ultimately depends on who it isn't fair to.
Young males pay higher rates partially because they have worse experience, and partially because insurers charge more of a "risk charge" to insure them (essentially they want a higher profit margin off young male drivers).
Ok, you've got some good points. Cars are not bodies. Having a car is a privilege, having a body you can live in *should* be a right. And there is a lot more that needs to be done with the way health insurance treats women that people have already talked about here. But, I still don't think it's right to charge people more for something based on gender. I think it's wrong. You can disagree with me all you want.
I feel like I've made this comment before, but I'll say it again. Correct me if I'm wrong, but my understanding is that under some insurance plans, women must purchase a separate "pregnancy rider" for pregnancy-related expenses. And even then, it still costs a lot to have a kid in a hospital.
Even though I have pretty good health care, I won't be able to afford the expense of simply *having* the kid for a while, with the expense of the rider and the additional expenses that aren't covered by even the expanded insurance.
And as for annual exams, I can't get birth control without it. I wouldn't go to the doctor if it weren't for needing a birth control prescription. Give me an endlessly renewable prescription and then you can charge me less for insurance. Why aren't men required to get tested annually for STDs and pre-cancerous cells? Why should I be required to do that to continue to get my prescription?
I don't know if it varies by state or something, but I was able to get birth control from planned parenthood without an exam. I did have to have an appointment, but all I did was fill out a checklist saying I don't smoke and stuff. There was no pap smear or anything. (It has just occurred to me that the form might have asked when I last had a pap smear. In that case I guess you could lie, if you really didn't want one.)
I was able to do this as well at Planned Parenthood, but for only a certain number of months. I forget how many, it was quite a while ago. I'm not sure how it works now or in places outside of Maryland though.
You're right on that point. If we want to talk about fairness in health care and insurance, the line certainly does not end at gender. You bring up age. There is so much more, like genetics.
My view on health care and access to health care is, it should be based upon need, not cost. (No, women in general, are not "sicker," but based on the above figures, they do use more resources on average, then men. The elderly cost more than the young. Ask your health or life insurance representative to talk about actuarial statistics.) Are you perfectly healthy, or for some reason manage while choosing to avoid health care? Good for you. On the other hand, do you have a chronic, costly condition like kidney failure requiring dialysis? Were you born premature? Do you have cancer? Do you have HIV? Then you need assistance, despite the hundreds of thousands or millions it would normally cost out of pocket.
Just a couple of weeks ago, I was pondering with a male nurse coworker of mine, why is it that dialysis patients are subsidized by the government?
http://www.medicare.com/services-and-procedures/dialysis-coverage.html
"Medicare pays for the dialysis services of anyone suffering from end-stage renal disease (ESRD) or kidney failure."
ANYONE. My exact question to my coworker was "Why are dialysis patients special?" Meanwhile, we watch our clients in long term care and med-surg get sicker and die because government or private insurance refuses to pay for relatively minor items like pills, or hospitals and insurance companies must bicker over which medicine is less costly, or how long they will cover care. My father bled to death after the announcement his coverage (he was a retired federal employee, career national guard, with full coverage) stopped at ten units of blood. His insurer also did not want to pay for three days in the ICU when he died.
Of course it is true that dialysis patients require regular treatment to survive, and can't afford it otherwise, but that is also true of many other serious or chronic conditions. I am not bashing on dialysis patients and would not take resources from dialysis patients, but based on this policy, why are the lives of people with kidney failure worth "more" than the lives of people with heart problems, or cancer, or HIV? Why doesn't Medicare pay for ANYONE who needs a heart transplant or artificial heart to survive? Why don't they pay for ANYONE with cancer?
When talking about health care, since someone brought up human rights, I'd like to see less complaints about people who have "too many" babies, much less ordinary "breeders" who have one or two, and take "your" money. (I still await evidence that the funding has their name on it.) I thought reproductive freedom was a right for people who actually had children as well. Yes, some women or families make difficult to understand choices regarding family planning. But it certainly isn't the fault of the children, despite the recent octuplet birth costing an alleged two or three million dollars.
"So what you are saying is that actual costs paid for by the insurance company should not even enter into the premiums?"
It's important to point out that one is referring to COST, not actual state of health. A perfectly healthy person who visits the doctor for regular extensive testing uses more resources than the people who die never going to the doctor or never knowing what they have. Private insurers, and Medicaid/Medicare as well, are concerned with COST. I see it every day when prescription for medication X is denied, because "it isn't covered." I get it in corporate memos asking us to limit our use of supplies, reminding us of our fiscal shortfall ($64 million last year). If people's health (or dignity) was the primary concern, even a few hundred dollars (much less some freaking boxes of wipes or adult diapers) shouldn't be an issue. I'm not going to let some woman lie in shit for a few more hours because her diapers allegedly cost too much, nor will I force an incontinent woman to wear her own clothes (and wet them and her bed), to reduce the number of diapers she uses. For the sake of not cutting services and not declaring corporate bankruptcy, I'm even willing to accept salary freezes, salary caps, and restrictions on benefits to keep my job.
"When it comes to insurance, be it health, life or auto, the argument that 'it isn't fair' ultimately depends on who it isn't fair to."
Yes, like people (including young women here) who have no children and never plan to have children, complaining about paying for other people's children. I strongly disagree with that line of thinking, but by that reasoning, people who do have families (i.e. future PAYERS, not liabilities) or believe in having children shouldn't be "forced" to pay for people's birth control or abortions either. The only way to be fair is to include everyone, including for example, the currently chronically ill, the elderly, smokers, users of illegal drugs, and alleged non-contributors to society. It needs to be universal, and costs need to be shared.
There was a specific benefit for dialysis coded into federal law in 1972. More details are provided at
http://books.nap.edu/openbook.php?isbn=0309044863&page=176
if you can make any sense out of it.
A relevant quote from the conclusion seems to be this:
From what I can tell, at the time, there were a lot of people who had this specific medical condition, for which there was an effective, lifesaving treatment, and literally the only thing standing between them and said lifesaving treatment was ability to pay. So, they formed a lobbying group and got the benefit passed, as part of a general law extending Medicare benefits to the disabled, and the specific benefit for kidney dialysis is still on the books.
I thank you for your reply Doug, but it was a rhetorical question. Philosophical, not historical.
Most costly medical conditions you can name - cancer, heart attack, stroke, have "effective" "life-saving" treatments (dialysis is no cure, and life expectancy is not good). But those people are simply screwed if they don't have cash or sufficient coverage. They are simply allowed to decline or die by their insurer or the government.
Contrast this to advocates of dialysis patients, who still may not believe they are getting enough. I can't find the organization's site I was reading yesterday, but they condemned the policy of limiting coverage to three treatments a week as allowing people to die. People with renal failure don't deserve to be allowed to die for insurer's or Medicare's bottom line (more frequent hemodialysis treatment has been found to improve health and outcomes), but neither do millions of other people with other health conditions.
http://esciencenews.com/articles/2008/07/09/frequent.dialysis.may.benefit.what.cost
" . . . A a more frequent hemodialysis strategy might be expected to increase life expectancy by between two and 24 months depending on the frequency . . . "
All that, to prolong people's lives by 2-24 months. In contrast, aggressive treatment can completely ELIMINATE many people's cancer, or counteract effects of heart attack and stroke.
That is what I mean by "Why are dialysis patients special?"
How much does dialysis cost? Do a Google search, as a number of people online ask. I can see figures as high as $55,000 a month for four times a week, or $4,500 each. (Yahoo! Answers). That is in line with my local dialysis center, which charges $4,000 a treatment for non-citizens who need to continue treatments to survive while traveling. Americans of course, are eligible for coverage, even if for example, they have never been employed or paid in. A 2004 study reports that expected "lifetime medical cost of ESRD dialysis patients" is $253,000. People's milage may vary. It can reach near a million dollars if like my own patient, they are still alive after 11 years.
http://www.usrds.org/2004/pres/USRDS10.pdf
Meanwhile, people can't even get their birth control, routine pregnancy, or terminations covered, even when they are "productive citizens" and even when they DO pay their own premiums. People can't get routine exams covered in an effort to PREVENT future costly conditions.
It makes little sense.
I don't understand why a woman should have to pay more for pregnancy care and such when a man helped her get pregnant. Birth control and pregnancy aren't burdens or blessings to just a woman, but also to her partner. I also don't understand why my basic insurance costs twice my husbands, without a pregnancy rider, because I "may become pregnant", as they told us. Extra maternity coverage is available if I do get pregnant, but the possibility coverage costs us plenty in the meantime. If women continue to get charged more, then it just supports the notion that pregnancy and childcare are women only issues.
"I don't understand why a woman should have to pay more for pregnancy care and such when a man helped her get pregnant."
Now that is an important point, particularly when speaking of joint coverage. My employer is one of those that covers my entire family (four people for about the price of two, and according to my reading, it matters not whether or not the employee or spouse are male or female, nor our age, nor health history), and any expense incurred by any of us is under my policy.