Affordable Health Care: A Christmas Wish

by Molly M. Ginty

Whatever stage of life you’re in, and whether you’re physically fit or living with chronic illness, you can find ways to be a wise steward of your health and well-being. Our health and wholeness are important keys to responding to God’s call for us and acting boldly on that call. That’s why Women of the ELCA have embarked on a new health initiative: Raising up Healthy Women and Girls. This ongoing column represents our commitment to the issue of women’s health.

In Pender, Nebraska, Teresa Kai lost her Medicaid coverage due to government policy changes. A part-time cook with little savings, she could no longer pay for the drugs she needed for diabetes, high blood pressure, clinical depression, and asthma.

In Boise, Idaho, Martie Balmer needed a bladder operation. A self-employed hairstylist with no health insurance, she couldn’t afford the $25,000 to have the surgery near home. She had to travel to Southeast Asia to have the procedure done for 10 percent of what it would have cost her in the United States.

In New York, Jill Zimmerman contracted a bacterial infection that required six days of hospital care. Her health insurance policy, provided by the YMCA where she worked as a yoga instructor, would not cover the full $28,000 bill. Three years later, Zimmerman is still struggling to pay off the $8,000 balance.

Across the United States, stories like these are becoming more common as women of all economic levels — from low–income–aid recipients to middle–class working women — cannot afford health insurance or lose the benefits on which they have come to rely.

Americans over age 65 can qualify for government–sponsored Medicare, but a growing number of younger Americans are losing health coverage that is already spotty or inadequate. With 46 million Americans living without health insurance, more and more women are making affordable medical care their number–one Christmas wish.

"America’s health care crisis is one that affects women disproportionately," says Judy Waxman, vice president for health and reproductive rights at the National Women’s Law Center. "Women use more health care than men do, especially during their reproductive years. But women are less likely to be able to afford coverage because they are poorer, earning 76.5 cents for every dollar men make. And women are less likely to get health insurance through work because they are more likely to work part–time."

Surveys by the Kaiser Family Foundation show that women are 30 percent more likely than men to have a health condition that requires ongoing treatment, 50 percent more likely to delay or go without treatment because they can’t afford it, and 60 percent more likely not to fill a prescription because of its cost.

Like Teresa Kai, 9 percent of American women rely on Medicaid, which covers low–income Americans with disabilities or dependent children. Funded by state and federal governments, Medicaid faces budget cuts on both fronts. According to the National Women’s Law Center, a growing number of states are requiring recipients to pay for prescription drugs and doctor co–pays. And according to the Kaiser Family Foundation, the federal government and all 50 states have recently cut Medicaid programs.

Like Jill Zimmerman, 64 percent of women have health insurance through their jobs. But the cost of this type of insurance has spiked 73 percent since 2000, prompting many businesses to buy cheaper, high–deductible plans or to stop offering coverage to workers altogether. Women who lose employer sponsored health insurance can buy private insurance (which 6 percent of U.S. women have). But these policies cost the individual 10 to 15 times as much as employer–sponsored policies: $200 to $600 per month for individuals and $800 to $1,200 per month for families.

Like Martie Balmer, 19 percent of women have no health insurance at all. For the uninsured, America’s health care crisis poses the biggest threat. According to a 2005 Harvard University study, medical bills are the leading cause of bankruptcy in the United States. And according to the Washington–based Institute of Medicine, lack of health insurance leads to 18,000 unnecessary deaths per year.

Why are both public and private insurance faltering, leaving one–sixth of the population without coverage? Expensive technologies are becoming the standard of care. Health maintenance organizations (HMOs) are cutting corners to make profits. Doctors’ costs of doing business, in particular malpractice insurance premiums, are rising. Baby boomers are aging and developing health problems that further strain the health–care system. All of this translates into higher costs for the consumer.

"In addition, our health care system is an employer–based model dating from World War II," says Alina Salganicoff, Kaiser Family Foundation’s director of women’s health policy. "It wasn’t designed for people who switch jobs as often as they do now, any more than Medicaid was designed to fill its current function of serving all the poor."

How can we solve the problem? Some say we should expand Medicare to cover every American. Others recommend a national program modeled on Massachusetts’ new health plan, which mandates health insurance for every resident. Some promote Health Savings Accounts, which allow policyholders to save money for health expenses tax–free. Others recommend enrolling every citizen in the federal employee health benefits program.

Until America addresses its healthcare coverage crisis, experts say every woman must look out for herself. If you’re uninsured, check www.cms.hhs.gov/home/medicaid.asp to see if you qualify for public coverage. If you already have insurance, read the fine print so you know whether your coverage is best for you and whether you need to switch plans.

"Until my health insurance policy failed to cover my care, I had no idea I was underinsured," says Jill Zimmerman. "Thousands of dollars in unpaid bills later, I only wish that I had taken charge and taken time to do my homework."

Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.

For more information:
Kaiser Family Foundation
"Health Insurance Coverage & the Uninsured" www.kff.org/uninsured

National Women's Law Center
Visit www.nwlc.org and search for "Women and Health Insurance"