Can We Cure the Ailing U.S. Health Care System?

Below the Belt: A Column by NOW President Kim Gandy

July 6, 2009

In the United States it is entirely possible for an employed, fully-insured family to go bankrupt because of health care costs. The burden of a major illness, even with health insurance, can cause you to lose your job, force you to sell your home, and leave you no option but to move hundreds of miles to live in your grown daughter's storage room. That this can happen in the richest, most powerful country in the world (or so they say) is nothing short of criminal.

This is not a made-up scenario. This is the very real story of Donna Smith and her husband, Larry. Smith has survived uterine cancer and an abdominal hernia, and her husband has had several heart attacks and bypass surgeries. The Smiths allowed Michael Moore to document their move from their home in South Dakota to the daughter's storage room in Colorado for his movie SiCKO. Later in the movie, Smith took a trip with Moore to try out Cuba's dreaded "socialized" medicine. Not surprisingly, it put the U.S. system to shame.

Since SiCKO, Smith has gone to work for the California Nurses Association/National Nurses Organizing Committee. As co-chair of the Progressive Democrats of America's "Healthcare Not Warfare" campaign, Smith has campaigned across the country for single-payer health care. Because she took her misfortune and turned it into a cause, a mission to help others avoid the same fate, we honored Smith at our annual conference last month with NOW's Woman of Action award.

"Health care is a human right," Smith said. It is this humble belief that drives organizations like NOW to continue working toward the only real solution: universal, single-payer health care. Not only is health care a human right, it is a women's rights issue. Women's voices should be the loudest of all in the current debate over how President Obama and Congress are going to reform health care in the U.S.

Why is that? First, we know that insurance companies tend to charge women age 55 and under more than men for the same coverage, even without including maternity care! The insurers argue that women use more health care services. Frankly insurers, I don't give a damn. After all, you should know that it's better to go to the doctor early, to keep healthy and prevent an illness from becoming worse and costing even more. And, well, isn't that how insurance is supposed to work -- we all pay into it and some people use it more and some people less, but we all shoulder the burden collectively? Sadly, not in our messed up system.

In a country where health insurance is tied to employment and where a financial crisis means many people are losing their jobs or working at low-paying jobs that don't offer coverage, buying insurance in the individual market is the only option. But that option is out of reach for many people, and even further out of reach for women. A recent report by the National Women's Law Center confirms that women often pay significantly higher premiums than men when they attempt to buy insurance in the individual market. Most employers are not allowed to charge employees different premiums, but the insurance companies can get away with it in most states when selling to individuals.

On top of that, did you know that the majority of individual policies do not cover maternity care at all? Or that lots of them cover Viagra but don't cover oral contraceptives? Or that it's legal in nine states and D.C. for insurance companies to refuse to cover survivors of domestic violence? Astonishing.

Smith shared with NOW several other women's stories, which were collected by the California Nurses Association. Like Susanne McDowell, who was denied insurance because she had a pre-existing condition -- she was pregnant! With a complicated birth, she and her husband ended up saddled with $20,000 in hospital bills.

Or Vanessa Beck, who is a young woman with a chronic disease. She has had trouble finding and keeping jobs and getting health insurance, so she has had to skip doctor's appointments and try to"work under the table, off the books, with no job security, no sick days, not accumulating Social Security credits so that I might qualify for Medicaid."

Crystal Wagner was only 20 when she was diagnosed with cervical cancer. Her parents had to help with her medical costs and are now close to bankruptcy. But Wagner's cancer surgery could not wait for her to find a job with insurance -- if she had waited, the cancer could have spread, bringing death or sure financial ruin resulting from longer and more expensive treatment.

Stories like these abound, and they point up the folly of our health care system. A system run by for-profit companies that boost their own bottom line by denying care, rather than being rewarded for keeping people healthy. And you think costs are high now? They are getting worse every year. The national NOW office is essentially a small business, and I can tell you that insurance companies charge small businesses big bucks for insuring their staff. Last year our existing insurance notified us of a 25 percent increase, forcing us to increase co-pays; and this year they went up again, this time by 28 percent. Why exactly should we protect the companies that are picking our pockets and giving us lousy service in exchange? There is no good reason.

According to the Commonwealth Fund, 82 percent of people in this country think our health care system should be fundamentally changed or completely rebuilt. I say, let's do it! But right-wing forces are spreading misinformation and trying to put a stop to reform efforts or at least water them down.

Single-payer health care truly is the best plan for women, for everyone. And even though it appears that the single-payer solution is off the table in Congress, NOW will continue pushing for it, and we encourage every feminist to do the same. It does not have to cost more to run a single-payer plan -- in fact, if done right, it should cost less. Much less.

Right now, Great Britain, with universal coverage, spends 8.3 percent of its GDP on health care. The Netherlands comes in at 9.2 percent. The U.S., however, spends 15.3 percent. And what does all that spending get us? It gets us a spot at number 37 on the World Health Organization's ranking of the quality of health care in countries worldwide.

At the very least, a public option must be included in health care reform, or else this whole exercise is a giant waste of time. AND employees of small businesses like NOW must be allowed to participate in the public plan -- an option that could be denied to anyone who already has employer-provided coverage!

The people of this country deserve a public option that will allow people to take care of their health, avoid economic jeopardy and retain their dignity. And of course the full range of reproductive health services -- including pre-natal care, maternity care, emergency contraception (EC), oral contraceptives and abortion -- must be covered in any plan. Is that too much to ask?