Tuesday, October 27, 2009

The Issue of Women and Health Insurance, As Well As News That Will Be A Surprise

There has been a great deal of talk and debate about health care in the country recently as the Democrats push Heath Care Reform. A lot of animosity has been directed at the Health Insurance Industry as a whole. As it turns out, some is justified, but some is not. I was surprised by what is NOT justified, and I think you might be, too

But first, another reason to be angry at insurers, especially if you are female, and living in one of thirty-nine states in the union, as this article highlights, Women Pay Up To 50% More For Health Insurance Premiums. Now, maybe I was just naive to not realize this was happening, but happening it is. This article focuses on the state of Colorado:
Checking the "female" box when buying health insurance is likely to cost extra — perhaps up to 50 percent more than a man would pay for the same coverage.

Gender-rating — or what some term as flat-out sexual discrimination — is linked to the simple fact that women, particularly those under age 50 or so, go to the doctor more often than men.

But outrage over how women are treated in the individual health insurance market is mounting as stories emerge of companies refusing to cover maternity benefits and denying coverage because of past domestic violence or cesarean sections, including a Colorado woman who was told she would have to get sterilized to qualify for insurance.

Federal proposals, as well as pending state legislation, would ban gender-rating and require maternity coverage, even as the insurance industry warns that lowering premiums for younger women could mean higher premiums for most everyone else.

Colorado women age 40 and under shopping for health insurance in the individual market, not through an employer, pay from 10 percent to 59 percent more than men, according to analysis by the National Women's Law Center.

They pay more even when maternity coverage is not included. And in many cases, a female nonsmoker pays more for health coverage than a man who smokes.

"Women should not be penalized because their plumbing works differently and needs ongoing maintenance," Colorado Insurance Commissioner Marcy Morrison told a state health care task force.

Holy smokes. Did you know this?? So, being a woman is a pre-existing condition? That's a pretty difficult one to overcome. Especially since we're the only ones who can get pregnant, which has its OWN set of issues:
As a state lawmaker, Morrison fought insurance companies to stop "drive-through deliveries" so women could stay in the hospital longer after childbirth. She said gender-rating is discrimination tied to decades-old salary disparity, particularly in female-dominated professions such as nursing and teaching. And she is skeptical of insurance company claims that "the sky is going to fall" and premiums would rise if gender-rating were outlawed.

America's Health Insurance Plans, the industry's national association, proposed ending gender-rating and the practice of rejecting customers based on pre-existing conditions. In exchange, insurance companies want powerful legislation that would compel everyone to buy insurance.

Discrimination against women in the insurance market goes far beyond premium rates, reform advocates said.

And you are not even going to believe how:
Sterilization Suggested

Take, for example, Centennial resident Peggy Robertson, who was denied insurance by Golden Rule Insurance Co. because she delivered her second child by cesarean section in 2006. Maternity benefits weren't even part of the package.

Robertson, whose husband is a self-employed chiropractor, contacted the International Cesarean Awareness Network and filed a complaint with the state Division of Insurance, arguing the denial was unfair and that the company had asked her offensive questions during the application process.

Later, she received a letter from Golden Rule telling her the company would consider covering her if "some form of sterilization has occurred since the caesarean-section delivery."

"It was just really horrific and terribly insulting," said Robertson, a stay-at-home mom of two boys. "You felt like you were a herd of cattle or something."

Robertson's recent testimony before the U.S. Senate health committee in part prompted Sen. Michael Bennet, D-Colo., to write a letter to Senate leaders adding his voice to the call for reform to ban gender-rating and other "harmful insurance industry practices."

Since denying Robertson, Golden Rule, an Indianapolis-based division of United Healthcare, now covers women who have had cesarean sections but only with increased premiums to cover the risk of a future cesarean birth or with exclusionary riders — clauses that deny coverage for cesareans for a certain number of years or forever.

"This helps us extend coverage to more people while keeping premiums lower for all of our customers," said Ellen Laden, public relations director for Golden Rule. "The real issue is how to deal broadly with providing access to health care for everyone while still keeping health insurance from being cost-prohibitive."

Sterilization??? What, are we back in the mid-1950's or something?? I noticed that they didn't suggest sterilization for MEN, which makes a lot more sense for the health insurers since it's CHEAPER, and doesn't require hospitalization. This is just staggering in this day and age. Thank heavens there are people fighting this suggestion:
Bennet and others, including the National Women's Law Center, are calling for an end to coverage denials based on pre-existing conditions such as pregnancy and surviving domestic violence or sexual assault — a problem revealed in a recent report from the law center.

Along those lines, there is another big issue that applies to women only:
Lack Of Maternity Benefits

Another common frustration among women who buy insurance individually — and there are 125,000 such women in Colorado — is that maternity benefits are almost nonexistent.

Suzanne Pariser, a Denver lawyer and mother of 2-year-old Willa, is putting off expanding her family because she cannot find an affordable insurance plan that includes maternity coverage.

"That's the main reason we're not having a baby right now," she said. "We definitely want to have another child."

Pariser is annoyed that insurance company executives, in essence, are determining her family planning.

"My anger is mostly that insurance companies view having a baby as a medical complication that costs them money," she said. "They view it as a disease."

The only plan she could find that offered maternity coverage was more expensive in the long run than paying out of pocket to have a baby, Pariser figured.

Costs vary by hospital or birthing center, but the average bill for a vaginal birth with no complications is about $7,500 and for a cesarean section, $13,200.

Viewing having a baby as a "disease." That is quite an indictment, especially taken in conjunction with suggesting sterilization.

Back to the overall concept of gender-biased insurance:
The insurance industry in Colorado has not taken an official position on statehouse bills that would ban gender-rating in the individual market and require maternity coverage. Their stance likely depends on national reform — and in particular, whether federal law will force everyone, even the healthiest people, to buy insurance.

But industry officials point out that higher premiums for women are based on analysis from actuaries, which show women are much more likely to visit the doctor. The rate at which women visit primary care physicians is more than 50 percent higher than for men, according to the New America Foundation.

By about age 50 or 55, men typically begin using health services more than women, and premiums for older men are typically more expensive than those for older women, said Ben Price, executive director of the Colorado Association of Health Plans.

"The insurance industry is engaged in its own internal discussion on this issue, and health plans here in Colorado are of course taking a fresh look at gender-rating and many other issues that have been raised as a part of the debate both in Washington and here in Colorado," he said.

Officials with Anthem Blue Cross Blue Shield of Colorado have "strong reservations" about eliminating gender-rating and requiring maternity coverage. The practice is rampant in the auto insurance industry, they argue.

"The most expensive purchase in auto (insurance) is the young, invincible male; they are the risk-takers," said Rebecca Weiss, director of government affairs. "For some reason, auto insurance doesn't seem as inflammatory to people as health insurance.

"Shouldn't health insurance premiums be based on some degree on how many medical services you receive so that everyone is paying according to what they are using?"

I am no doctor, or health insurer, but if women go go the doctor more often, isn't it possible that will keep them out of the hospital more often? Unless it's for a "disease" like having a baby or something. Ahem. But you know what the bottom line is: "
It Would Raise Prices"

Insurance companies probably would have to raise prices on other groups to make up the difference if they were forced to lower prices for younger women, said Tom Gosselin, director of small-group underwriting at Anthem.

"It definitely would raise the prices, is the simple thing," he said. "You are now charging the 22-year-old guy who has no concept in the world about having a baby for maternity. He's more likely to choose not to have health insurance at all."

Eleven states ban gender-rating in the individual insurance market.

A review by the National Conference of State Legislatures found that those states had not determined whether their bans caused health insurance rates to rise.

In Montana, which outlawed gender-rating in 1983, some lawmakers want to repeal the ban, arguing fewer insurers are willing to operate in the state because of it.

Colorado is among several states that have banned gender-rating in the small-group insurance market, which in this state applies to businesses with 50 or fewer employees. For businesses with more than 50 employees, insurance companies can consider age and sex when setting rates — but the risk is spread throughout the company so everyone's premiums are equal.

Reform advocates argue the policy adversely affects businesses where the workforce is predominantly female, such as child-care centers or home health agencies.

I just wonder if this issue is being addressed by the Congress as it looks at this whole health care reform thing? Seems to me it is a pretty big issue, as is the cost in general:
Care Requires Doctor Visits

A Denver Post review of online health insurance quotes found that a woman living in the same Denver ZIP code with the same date of birth would pay $20 to $35 per month — or up to $420 more per year — than a man for the same coverage. The rates reviewed were for basic, high-deductible plans, ranging from $71 to $158 per month.

NARAL Pro-Choice Colorado is among those fighting for change in the law, arguing that women are typically the responsible sex when it comes to birth control and that those prescriptions often require an annual doctor visit.

"Under the current health care system, women are penalized for taking responsibility for their own health," said Toni Panetta, NARAL's political director.

State Rep. Beth McCann, a Denver Democrat sponsoring the bill banning gender-rating, said insurance companies failed to produce "sufficient factual basis to charge different premiums for women and men."

"It seems as though it's somewhat arbitrary," she said. "It's a matter of equality and fairness."

If the state legislation passes during the next legislative session, it probably would take effect about two years ahead of national reform.

Mary Saracino, a self-employed writer in Lafayette who has had to purchase insurance on the individual market, said she is shocked "and, dare I say, angry" that monthly premiums for women are higher.

"It seems highly discriminatory," said Saracino, 55. "Would consumers put up with that if, say, men had to pay more for tires than women because some statistic says that male drivers are harder on their cars than female drivers?"

Uh, hell to the yes, it seems discriminatory! There just isn't a whole helluva lot we can do about being female (without getting into the whole issue of gender-realignment surgery, that is). Or want to do anything about it. A whole lot of us are actually happy to be women. To make us pay more money, especially when we typically make less money, for health insurance is reprehensible.

Here are the places you can live without fear of being charged for being a woman:
Some Protection

These 11 states ban gender- rating by insurers in the individual insurance market:

California, Maine, Massachusetts, Montana, Minnesota, New Hampshire, New Jersey, New York, North Dakota, Oregon, and Washington. (Jennifer Brown: 303-954-1593 or jenbrown@denverpost.com)

That's it.

And now for the big surprise. I am telling you, I was really shocked when I learned this. Would you like to take a guess as to how much Insurers actually make in profits? About 2.2% above the amount of money they take in. In fact, they are 35th out of 53 for industries. I have no love lost for insurance companies, especially in light of articles like the one above, but that is startling. It is in complete opposition to EVERYTHING we have heard about them. Are they a pain in the ass to deal with in general, like filing claims, or having claims paid? Often, yes. But are they raking in the cash hand over fist as we have been hearing from Congress on a daily basis? Apparently not. That shocked the crap out of me. That doesn't immediately absolve them, of course, but it does greatly affect the very foundation for the arguments about health care in this country. Something to consider.

And since we are talking about women and health care, October is Breast Cancer Awareness Month. Many of us, myself included, need to take the appropriate actions for our health.

Along those lines, I would like to leave you with the following, a recent interview with Elizabeth Edwards:

A brave soul, Elizabeth is. And one who is in my thoughts and prayers as she continues to live with breast cancer (I am trying really hard not to say something snarky here about her husband...). All the best to her. And to all women who are living with this disease, and hopefully, being cured of it.


Mary Ellen said...

I was forced into one of those "drive by" deliveries when I had my son, 19 years ago. We had Cigna at the time. I went to the hospital at about noon and he was born at 4:00 pm. I was in the recovery room until 8:00 pm because my heart would not stabilize (which is why I had to stop having kids...bad ticker). My insurance company would only allow me to stay in the hospital until noon the next day, even though I had the heart complications.

Then... by law the baby was not allowed to leave the hospital until he was given a phenylketonuria (PKU) test, but the test would not be effective until he was 48 hours old. So, to get around this, they gave him a blood test that they knew would not be valid, just so they could mark the box that it was done, and then I had to bring him to a doctor or back to the hospital in 48hours to have the test done again.

Ridiculous! The poor kid had to be stuck twice with a needle AND I had to drag him out to see a doctor, which wasn't easy for me to get in and out of a car after just giving birth.

Women are treated like cattle by the insurance companies. No doubt.

Rabble Rouser Reverend Amy said...

Mary Ellen, I am so sorry that this was your experience (not to mention the bad ticker. What a blessing that you are still with us!). That is astonishing that they basically booted you out the door, especially given the complications! Then to make you and the baby come back so soon? Appalling!

Wow, ME - I'm just shaking my head in disbelief. Thank you for sharing your story...

Mary Ellen said...

Rev.Amy- I can't complain too much, the birth was easy..short labor, and my only son is the light of my life. All in all, it could have been a lot worse.

The heart problem isn't that big of a deal. It's just a defect that I've had all my life and during times of stress I get tired easily, that's all. I guess there is a portion of my heart that doesn't function, but not because of damage, that's just the way it is, so the rest of my heart has to do the work...hence, when my heart is working hard (like in labor), I wipe out easily. I don't let it slow me down too much. Life's too short and I don't want to miss out on anything.

Besides, God has a plan for me...to make Obots miserable. :-D

Anonymous said...

This is beyond outrageous. All these people who've been crying "racism" for the past couple of years and minimizing sexism owe every female in this country a great big apology.

This is the main reason why I'm against the current "health care" reform being jammed through Congress. We don't need health care reform, we need health insurance company reform.

And I don't believe the insurance companies should be forced out of business, that would put millions out of work and leave an incompetent government to manage health care. We need to reform and regulate health insurance companies, beginning with the sexist gender profiling and denial of services simply for being a woman.

And as far as that "22 year old guy who has no concept about having a baby"... bet he'll change his mind in a hurry when his girlfriend gets pregnant.

Oh yeah, and insurance companies want "powerful legislation that would compel everyone to buy insurance"...smells a bit like blackmail to me.

Sterilization???? I don't even know what to say about that.

And I am surprised by the only 2.2% profit. Maybe if the health insurance industry was reformed and regulated, we'd all find a way to pay less for insurance, get better coverage, and make sure the insurance companies made a bit of profit.

Sexism and misogyny - alive and well in this country. But I'm probably being a racist for saying it.

Rabble Rouser Reverend Amy said...

Hey, Mary Ellen -

No doubt God has a plan for you. And I think making the Obots miserable is just a bonus for all that you do!

Glad your labor was short, and that your boy is such a bright light in your life. Still, it sounds like a bit of a "bum's rush" to get a new mother out of the hospital within 24 hrs. That's nuts!

Thank heavens your heart problem isn't too severe. But you know it is very clear you have a large heart, friend! :-)

Rabble Rouser Reverend Amy said...

Hey, SF -

I know - the sterilization thing is just mind-boggling. Can you believe that someone would even suggest such a thing in this day and age?? Shocking.

I think you are right - it isn't so much health care reform but health ins. reform. I couldn't believe where they fell in the industry, but too many of them DO make it hard on their members, which doesn't help the overall feeling abt them.

Anyway, yes, excellent observation abt what changes need to be made.

Sexism and misogyny are alive and well, as we know in the depths of our hearts after this past election. And it just seems to be getting worse. We knew it was going to be this way, though, didn't we? We knew they had just opened the floodgates, and so they have. What a uniter we have in the Golfer in Chief.

Anonymous said...

ROFLMAO at Golfer In Chief!

Rabble Rouser Reverend Amy said...

:-D Teehee!

Well, we thought BUSH golfed way too much for all with which we were dealing.

Now we have Obama, who has played almost 4 - 1 as many times. That's just remarkable. I'm serious - he treats the White House like it's a real life Wii or something...