New age of healthcare calls for gender equality

December 1, 2008

Health coverage is typically gender-balanced, but in some states, women are paying higher premiums that simply cannot be justified actuarially, according women's groups and some Congressional leaders.

This nation is becoming more diverse at a faster rate than ever. Racial equality and cultural sensitivity-while always an issue-seem to be reaching a new point of activation similar to what gender equality witnessed a few decades ago. Most agree it is still slow-going in politics, employment, healthcare and in other critical quality-of-life contexts.

Even for gender equality with all its high-profile achievements, the work still isn't done. Women continue to experience new milestones I mistakenly thought they had passed years ago.

The recent election season provides perfect evidence of the groundbreaking ambitions of women in politics, and Sarah Palin and Hillary Clinton aren't the only examples.

The stage is set for more milestones to come. According to last year's census numbers, there are more women living in the United States than men. In Washington, D.C.'s population, women have a 6% advantage. Seven states have equal populations of each gender, but only one state, Nevada, actually has more men.

The bottom line is that 49 states have at least as many or more women, but only one state senate has a female majority. Yes, there is still work to be done.

WOMEN EARN LESS, PAY MORE

Men routinely fare better than women financially too-and I'm not talking about their investment prowess. There are millions of women in this country who are not only being paid less than their male counterparts, they are also supporting children on their own without the financial help of the absent fathers.

Women's earnings as a percentage of men's hit a low of 56.6% in 1973 and slowly rambled along to a high of 77.8% last year, according to the U.S. Women's Bureau. Also, according to the Association for the Enforcement of Child Support, approximately 30 million children are owed more than $41 billion in unpaid child support.

And it's pretty much always the mothers-the women-who are bearing that $41-billion burden of caring for those children while also making less money, regardless of the fact that every child has a mother and a father.

Health coverage is fairly gender-balanced overall, but there is still one sticking point: Women pay significantly higher premiums in the individual insurance market in most states-sometimes as much as 49% more.

Senate Finance Committee Chairman Max Baucus and other members of Congress are starting to question actuarial justifications for the dramatic premium differences for women. Surely a 49% variation can't be attributed to maternity care. There are other utilization concerns, I know, but maternity care tends to be singled out first. Men, who are equally responsible for pregnancies, should probably be paying their share of it anyway.

I'm not suggesting that health insurers throw out their data and become the saints that right the wrongs of employers and deadbeat dads. As legislators, AHIP, the Blue Cross and Blue Shield Assn., and others drive their proposals for individual mandates, however, expect to hear the voices of women demanding the best care and the best premium prices.

Julie Miller is editor-in-chief of Managed Healthcare Executive. She can be reached at julie.miller@advanstar.com