Friday, October 31, 2008

Health Insurance and Women, Why pay more?

Health Insurance and Women, Why pay more?

If you didn't have enough reason to support universal health insurance, the New York Times' article on October 30, 2008 just gave you another one.  Headlines read "Women Buying Health Policies Pay a Penalty."

The long and short of the article is that, in most states, insurance companies charge women more for an individual health insurance policy than they charge men. Up to 49% more! The justification is that women incur child bearing costs and that they use more health services than men.  What is the problem with this logic?  First, lets take the child-bearing argument.  Biologically, having children is a project of a male and a female.  Since women bear the responsibility for carrying the fetus prior to birth, maybe we should place the cost burden of the birth on the men?  That makes more sense to me than putting all the burden on women.

I can hear the complaints -- why should all men bear the extra cost when many of them are not married or having children?  But that same complaint goes for women who are paying the higher costs but aren't having children.  This is insurance, which means there is a decision to spread the cost of having children to some group of people.  The question is who should that group be.  It makes more sense to spread it to all persons (i.e. universal health insurance) as both sexes are involved in incurring the costs.  Also, having children benefits all of us even if they aren't our children.

But logical arguments aside, shouldn't health care be a right of all Americans regardless of your race, gender, or age?  And if it is a right, shouldn't we all share in insuring that everyone has it.  This isn’t about what is logical, it is about what is moral.  What is right.  As a society we don't want some people being able to get health care while others, for lack of money, can't get the care they need. Why should individual women bear more of that cost.   Already women loose earnings to care for children and other family members.  Women still are paid less than men.  The result is that women as a group are poorer than men.  So why would we allow insurance companies to divide their markets into men and women and make the women pay more?  It just isn't right.

Ellen A. Bruce

President, OWL

Saturday, October 18, 2008

Potholes on Elm Street

We’ve heard a lot of talk about Wall Street and Main Street the past few weeks; most of it focused on how we can save them both. And we are putting our collective future at risk on schemes to save these economic engines. Only as an aside do we hear about what is happening on the street where we live – let’s call it Elm Street. We work on Main Street and a few of us work on Wall Street, but we don’t live there.

As we walk down Elm Street, at least every fifth house contains a family that is providing care for an elder or an adult – a spouse or adult child – with long term care needs. This family includes a couple who are working and hoping that they aren’t personally affected by the lay-offs they are seeing around the neighborhood. There might be young children, friends or various other family members in the house as well. The person they are helping might live with them, around the corner or across the country.

In the US, as in other industrialized countries, families provide 80% of the long term care services for an adult with care needs. Families do everything that is needed by the person they are caring for – from simple errands to more complex medical care tasks. It is estimated that these “free” services save the nation’s health care budget a whopping 20% of overall costs each year. One big difference between the family caregivers in the US and those in other developed countries is that, in the US, we don’t have universal health care. Even older Americans covered by Medicare who have the closest thing to universal health care we have, have large out-of-pocket costs. The US has employer-based private market health care which means the only thing standing between you and ongoing health care services is the relationship between you, employer and external market forces.

Last winter the findings of a study looking at the out-of-pocket costs of family caregivers were released by the National Alliance for Caregiving. The study, sponsored by Evercare, examined what families were spending on behalf of the person they were helping and how they managed that expense. In a survey of 1,000 family caregivers across the country only 178 respondents said they were spending nothing. The remaining 822 respondents were spending an average of $5,500 a year on services and products needed by the person they were caring for; the most common category being medical expenses. One out of five respondents reported spending their own money to pay for the medical costs of the person they were helping at an average annual expense of over $1,100. This means that not only are these families spending hours of their time each week – an average of 35 hours weekly; roughly equivalent to another full-time job--providing hands-on assistance, they are also purchasing goods and services with their own funds. When asked how they manage the extra costs, half reported they cut back on their own spending for leisure activities, a third reduced or stopped saving for their own future and one out of five borrowed or used a credit card to finance these unexpected expenses.

In the US, nearly half of personal bankruptcies continue to be due to medical expenses and, even more shocking, 75% of those who file for bankruptcy as a result of medical expenses had health insurance when they became ill. The costs of a market-based health care system have become unsustainable to Main Street as employers find their own global competitiveness diminished by the cost of covering their employees and to Elm Street as families find they can not continue to pay for their own health care or the health care costs of an elder, spouse or adult child. We have the most expensive health care in the world and the largest group of uninsured citizens in any developed nation… 47 million and counting.

A full recovery from the nation’s financial woes cannot be accomplished without addressing our out-dated and inefficient health care system. It is shortsighted to suggest that, because we are increasing our national debt to bail out failed banks and mortgage lenders, we can’t afford to take on the needed change in our antiquated and inadequate health care system. Addressing the problems of Wall Street and Main Street cannot overshadow the problems on Elm Street or a full recovery from our sick economy will not take place.

Donna L. Wagner, Ph.D.
Professor of Gerontology, Health Science Department
Towson University, Towson, MD

Monday, October 6, 2008

Regulation and Our Future

"Regulation and Our Future"

Last week Congress passed and the President signed a $700 billion financial package aimed at stabilizing the banks, restoring confidence, and loosening credit. A huge bailout that we hope will stop the failure of even more financial institutions.

All this taxpayer money isn’t expected to get us out of a recession, won’t provide universal health care, won’t improve our schools, won’t help young parents pay for childcare, nor will it build low-income housing.

Liberals and conservatives alike are mad because we are spending taxpayer money (which by the way is yet to be collected) to make up for the excesses of greed. We –the country—are like a family with an uncle who went out drinking and gambling, spent the family savings, mortgaged the house, and ran up a debt the family now must pay. One member of the family just sucked up all the dreams of the rest of the family.

Why did we let this happen? Yes, we let it happen. This financial crisis is not a natural disaster, it is man-made (and most of the actors are men).

The greed and “irrational exuberance” at the base of this disaster is troublesome, but what worries me the most is the rhetoric we have lived with for over 28 years that government is bad and that we need to trust in individual ingenuity. Individual ingenuity can create great companies but it also destroys great companies. Government isn’t bad—it is as good as the people who make it up. A government that is made up of people who don’t believe in the role of protecting its citizens will fail, and fail it has.

The New York Times reported on Friday that the Securities and Exchange Commission in 2004 changed a rule that limited the amount of debt a large investment bank could incur, thereby opening up the opportunity to make more money but at great risk – risk not only to the bank, but as it turns out, to our economy and consequently to the wellbeing of all of us.

The last two weeks have demonstrated in a very costly way why good government is important to all of us. Not since Katrina have we seen such disastrous results of government agencies that don’t function. I want a government that believes in its role of protector of its citizens, not only from foreign invaders but also from the excesses of individual citizens.

Because we, as a society and as world, are so interconnected we need to have a government that is not afraid to regulate individual behavior. Whether it is monetary risk-taking, pollution, the safety of our food, or a host of other dangers, we need a government that has the tools to protect and is run by people who believe in its role to regulate for the good of all of us, not the profit of a few.

Ellen A. Bruce
President, OWL National Board