Private insurers take on women
Gender can cost you in individual health insurance
By David Lazarus
Los Angeles Times
June 22, 2008
When it comes to health insurance, Valencia resident Tova Hack’s first problem is that she works part time and thus needs an individual policy for medical coverage because her employer doesn’t offer one.
Her second problem is that she’s a woman. She just found out that the cost of her bare-bones, high-deductible insurance plan is going up 20%.
But the real surprise — which Blue Shield neglected to point out in its recent letters to individual policyholders but which was apparent from a close reading of an accompanying chart — is that men and women will now be charged different rates.
It’s not about pregnancy, though. Hack’s policy doesn’t even cover pregnancy and maternity care.
No, this is purely a matter of Blue Shield deciding that women, as a general rule, are more expensive to insure than men.
“We’ve done it because our competitors are doing it,” (Blue Shield spokesman Tom) Epstein said. “We don’t want to get a disproportionate share of high-risk people.”
By “high-risk people,” what he means is “women.”
And what Epstein is basically saying is that if women are indeed costlier to insure, and if Blue Shield doesn’t price its policies accordingly, more women will want to be insured by Blue Shield.
Can’t have that.
http://www.latimes.com/business/la-fi-lazarus22-2008jun22,1,3782851,full.column
And…
Health Policy Blog
By John Goodman
National Center for Policy Analysis
How many Americans are overinsured?…. Overinsured?…. Yes, overinsured.
Examples of overinsurance are: a male, or a female past menopause, paying for maternity coverage…
http://www.john-goodman-blog.com/worst-study-award/#more-252
Comment:
By Don McCanne, MD
Isn’t it really about providing all of us with the health care that we need? Doesn’t that mean that we should have an equitable system that removes financial barriers to care by pooling all risks and funding that pool based on ability to pay?
So if it’s about paying for health care, why do we keep talking about an arbitrary construct of private health plans in which premiums are manipulated based on how far we can go in fragmenting risk pools?
We’ve all observed the behavior of the private insurance industry. In order to keep their premiums competitive, they have continued to carve out risks so that those remaining in their insurance pools will have very low health care expenses.
Representatives of the insurance industry contend that they provide consumer value for their very high administrative costs. Foremost are the preventive services that they encourage. But pap smears and mammograms? Their actuarial studies confirm that women actually use those services, and, of course, it is unfair to make men pay for them.
And pregnancy? Men only place the order and receive a child in return, but they don’t go to the doctor for that. It’s women who are running up our health care tab by obtaining prenatal and obstetrical services. They should pay.
So let’s really refine our risk pools. Let’s establish pools more precisely defined by anticipated risks. Since each individual has his or her own risk profile, we should establish 304 million risk pools - one apiece.
Of course, the insurance industry would have much greater underwriting costs, so they would be entitled to maybe a 35 percent surcharge to our medical bills. And aren’t these administrative services worth three-quarters of a trillion dollars? After all, it costs money for the industry to make sure that each one of us pays for precisely the health care that we use.
Come on. Haven’t we had enough? The male-dominated Congress and administration aren’t going to do much based on the signals that we are receiving from Washington. But this time the insurance industry has taken on women.
Women, the guys are wimping out. The insurance industry has put it in your court. It’s your turn, and you can do it!
Having just served as a delegate to the national convention of the League of Women Voters, I am convinced that the women of this nation will bring us the reform that we desperately need. They voted unanimously at their convention to make advocacy for and education on health care reform a priority for the next two years. Watch out! The women are taking charge!