We Need A Shot In The Arm

Below the Belt: A Column by NOW President Kim Gandy

October 17, 2008

It's been a few years, but I had a brush with the kind of "socialized" medicine that John McCain invoked with such derision in Wednesday night's debate. I'm delighted with the size of my family and my two daughters, ages 13 and 15 -- but they might have had an older sibling if I hadn't suffered a miscarriage while visiting my husband's sister in England.

Having surgery under general anesthesia was not part of my plan for that trip, and the visits from multiple specialists made me worry that the cost would be a real financial setback. In the hospital, there was a nice warm robe instead of a paper gown, and imagine my surprise when the doctor dropped by my sister-in-law's house, not once but twice, to see how I was recovering.

My surprise was even greater when the hospital personnel looked actively for ways to avoid charging me for my stay ("Are you sure you're not here on any kind of business?"). And when I assured them that I had insurance, they presented me (quite regretfully it seemed) with the full bill. It was under $400, a shockingly low price tag even then.

Do Women Care More About Health Care?

Actually, women are disproportionate consumers of health care, taking the primary role in health care decisions not only for themselves but also for their families. The issue of health care is front-and-center in the upcoming election. I was already an advocate of universal, single-payer health care coverage, which NOW has long supported, but my experience in England definitely reinforced the dramatic differences between our current consumer-heal-thyself system, where poor often equals sick, and a truly universal system.

Put simply, health care is one of those "make-or-break" issues for women. For too long, women and our families have done without medication we needed, skipped screenings, and bypassed both prevention and treatments because we were forced to choose between health care and our families' basic needs. Our current health care system is so broken it's hard to remember how it's supposed to work.

Some Similarities in the Plans, but Not Many

For this election, we are presented with two different visions. Both Senator John McCain and Senator Barack Obama agree on some changes that would alter our health care system, at least moving it from the Stone Age to the Colonial era; they just disagree on how, and the number of people who would be covered vary dramatically as a result.

Both candidates agree that the current system isn't working like it should. Both want to implement information technology and make health care more cost efficient by getting rid of excess - excessive testing, excessive paperwork and excessive costs. They also both agree that generic drugs should be made more available and less costly.

And that's where the similarities end. The two plans would be funded differently, structured differently, and oh, by the way, McCain's plan is projected by the independent Tax Policy Center to insure only one million more people than currently, compared with 18 million more people under Obama's plan. Neither plan insures everyone, but the difference is striking.

McCain's plan proposes offering every family a $5,000 health insurance tax credit ($2,500 for individuals) to buy coverage on the open market regardless of where you live. Putting health care in your hands, cash to pay for it and the freedom to choose coverage across state lines - sounds appealing, right? It's not as it appears.

The New McCain Health Tax

McCain's is the plan that giveth with one hand while the other hand taketh away. While he disingenuously refers to Obama as someone who will "raise your taxes," it is actually McCain who is proposing the largest tax increase in my memory - the McCain Health Tax.

In my own case, the new tax on my employer-provided family health coverage at NOW would be nearly $5,000 per year, which is a breathtaking tax increase. It would be covered (barely) by the promised $5,000 tax credit, but within a few years the McCain Health Tax would be greater than the credit. Even given the tax credit, the average person will likely only break even under this plan and would actually lose ground with inflation.

No More Drive-By Mastectomies

A key component of McCain's plan is that he wants to give people the option of buying health care across state lines. Yet this can undermine existing state insurance requirements - many of which women fought to win - like state laws requiring insurers to cover contraceptives and mammograms and preventing outrageous limits on hospital stays (like the 24-hour "drive-by mastectomies" for breast cancer). Under McCain's plan, insurance companies will just set up shop in states with the weakest consumer protection and coverage laws, so in the end insurance companies make even money while our hard-won coverage rights are lost.

The kind of coverage, not just the fact of coverage, is also critical for women, particularly in the area of reproductive coverage. Comprehensive health care should recognize that reproductive health care is primary care for women, and the Obama plan is the only one to guarantee affordable coverage for maternity care, reproductive care, cancer screening, mental health care and much more -- the kinds of gaps in current insurance coverage that impact women disproportionately.

There are no easy answers for reforming our health care, but Obama's plan takes many steps in the right direction, while McCain's plan takes us backward, virtually guaranteeing less coverage for fewer people. Neither offers a full cure for what ails us, but McCain's plan isn't even a Band-Aid, while Obama's is at least a shot in the arm.

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