Thesis: Women Discrimination

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Discrimination Against Women in California Health & Medical Contexts

Gender Discrimination: "ED medications are for men only; prescription birth control is for women only. Legislators who permit health plans to operate under a double standard are engaging in gender discrimination against women."

Gender Inequality in California Health Issues

In how many areas of healthcare in California are there disturbing injustices for women? The answer will be the basis for this research effort. This paper will review and analyze several of examples of unfairness to California women in healthcare matters, and reference critics who have challenged the policies that lead to a lack of fairness.

Insurance discrepancies give women the shaft: The California National Organization for Women (CANOW) sites the fact that "women pay much more than men of the same age for individual [health] insurance policies providing identical coverage" (www.canow.org).Writing in the New York Times, Robert Pear echoes the claim by California NOW: "Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age..." (Pear, 2008). U.S. Representative Xavier Becerra, Democrat of California, is quoted in the article, "If men could have kids' such disparities would probably not exist."

Blue Shield of California has decided that women, "as a general rule, are more expensive to insure than men," reports David Lazarus in the Los Angeles Times (Lazarus, 2008). Tova Hack in Valencia, California, needs insurance because her employer does not provide it; so, according to Lazarus' article, she pays Blue Shield of California $99 a month. Or she did until June 2008, when Blue Shield raised her "bare-bones, high-deductible" plan to $119 a month. Blue Shield flatly admitted that "men and women will now be charged different rates" for the same policies.

Why? Lazarus reports that in the eyes and data sheets of Blue Shield, Ms. Hack "and all other women are somehow more accident-prone, or more likely to break a bone, or more susceptible to costly ailments." Tom Epstein, a spokesman for Blue Shield, told Lazarus, "Our egghead actuaries crunched the numbers based on all the data we have about healthcare... [and] this is what they found. it's all about the statistics," Epstein said. Blue Shield can get away with this discrimination because there are "no regulations preventing gender-based pricing for individual policies" (according to the California Department of Insurance, quoted by Lazarus).

Lazarus crunched some numbers and discovered that on average, by age 20, women are paying $119 monthly (for rock-bottom basic health insurance), and men are charged $110. By the age of 35, women pay $174 a month and men pay $162. By age 45, Lazarus' numbers indicate, women pay $271 monthly and men pay $246. The article also reveals that Aetna uses the same discriminatory practices as Blue Shield, and "has used gender to set rates" since 2005.

The UCLA Health Policy Fact Sheet (August 2008) reports that when it comes to employment-based insurance "...women are less likely than men to be covered as the primary policyholder" (36% of working woman covered by employment insurance are primary policyholders; 50.5% of working men covered by employment insurance are the primary policyholder).

The Executive Director of Health Access California, Anthony Wright, explains that women are discriminated against in the individual insurance market by having to pay "significant surcharges for maternity coverage" (Wright, 2008). Also, Wright claims, a C-section can be classified "as a pre-existing condition that leads to higher premiums or a denial of coverage." Moreover, since the California insurance companies have determined that women are more expensive to cover than men, legislation should be passed to require "maternity as a basic benefit" and the legislature should pass a bill to guarantee that those with "pre-existing conditions" can get coverage" (Wright, 2008).

Questions of fairness in reproductive rights: Viagra is often covered but not birth control - why? Another gender inequality issue in California is the fact that not all insurance companies cover prescription birth control medications for women, but many of those same companies do cover Viagra (erectile dysfunction) prescriptions for men. The National Association for the Repeal of Abortion Laws (NARAL) urges the U.S. Senate to pass the "Equity in Prescription Insurance and Contraceptive Coverage Act" (H.R. 4651) because "women deserve equal treatment for health needs..." (www.thepetitionsite.com).

But Fox News conservative commentator Bill O'Reilly insists women should not be paid by insurance companies for prescription drugs for birth control because "Birth control is not a medical condition, it is a choice" (MediaMatters, 2008). "Viagra is used to help a medical condition," O'Reilly asserts. MediaMatters quoted Dr. Luella Klein, past president of the American College of Obstetricians and Gynecologists: "Pregnancy is a medical condition, just like impotence. And the cost benefit of preventing pregnancy is much greater than treating impotence" (MediaMatters, 2008).

ABC News ("Erections Get Insurance; Why not the Pill?") in 2002 noted that since the pill "can be relatively expensive for some [average $30 a month], a lack of insurance coverage can put contraception out of reach for some" (Sealey, 2002). The article also mentions that for "...every $1 of public funds invested in family planning, $4 to $14 of public funds is saved in pregnancy and health-care related costs" (Sealey).

California however is one of 27 states that have enacted legislation to "mandate that insurers which cover prescription drugs also provide coverage for any Food and Drug Administration (FDA)-approved contraceptive" (National Conference of State Legislatures, 2008) (NCSL). The report from the NCSL asserts that employer-based coverage is the primary form of health insurance "for 64% of women of reproductive age"; the report also states that while federal law requires insurance coverage of contraceptives for federal employees and their dependents, there are "a few religious insurers" that are exempted from that law (NCSL, 2008).

The Guttmacher Institute ("State Policies in Brief: Insurance Coverage of Contraceptives") delves deeper into the issue. For example of the 27 states requiring insurers to provide contraceptive prescriptions, 18 "specifically require coverage of related outpatient services" (Guttmacher, 2008). Meanwhile 19 other states "allow certain employers and insurers to refuse to comply" with the laws; in fact, 15 of the 19 aforementioned states "permit religious employers to refuse to provide the coverage." So, if you are a woman who is of reproductive age and sexually active, but your employer is against birth control, he or she can in effect force you to pay for your own contraceptive prescriptions (Guttmacher, 2008).

The Center for Reproductive Rights (CRR) explains that "almost 50% of pregnancies are unintended," which makes it all the more important that insurers offer prescriptions for contraceptives (CCR, 2005). Moreover, women of reproductive age "...spend 68% more than men on out-of-pocket health care costs, largely on reproductive health care services." And although about two-thirds of U.S. women of childbearing age rely on private, employer-related plans for their health coverage, "...yet 49% of large group plans do not routinely cover any contraceptive method" (CCR, 2005).

Questions of fairness in reproductive rights: Abortion rights: California's voters took on another gender in healthcare issue on November 4 when they were faced with a decision on "Sarah's Law" (Proposition #4). The proposition did not pass, but had it been successful, it would have prohibited underage girls in California from getting an abortion until 48 hours after a physician notifies parents or guardians of the girl. In the required public hearing prior to the November 4 vote Planned Parenthood President Kathy Kneer pointed to "the dangerous effect...on California's teens" (Linden, 2008) due to the fact that many teens do not have open relationships with their parents and they may turn to illegal, unhealthy methods of abortion if this became law. "Proposition 4 would force those vulnerable teens, the ones who can't talk to their parents, to delay medical care or tune to self-induced or illegal back-alley abortions...some may even consider suicide" (Bellasalma, 2008).

Breastfeeding (gender) discrimination: In another gender-related discriminatory policy, it is a known fact that men don't breastfeed infants and that men never give birth to infants who benefit from the nourishing milk from a mother's breast. That said, women are nonetheless still harassed for breastfeeding their infants. The California Women's Law Center (CWLC) recently handled a case in which a California woman was breastfeeding her infant at the Treasure Island Casino in Las Vegas and was asked by a wait staff to "go somewhere more private." The case was quickly settled as the CWLC reminded Treasure Island executives that Nevada Statute 201.232 makes breastfeeding in public legal (CWLC, 2003). In California not only is it perfectly legal for a woman to breastfeed her child in public, a law went into effect in January 2002, that "...requires employers to provide time and space...other than a toilet stall...for employees to express breast milk at work" (CWLC, 2004).

Male violence against women - the ultimate health-related issue in which women are discriminated against: Women are nearly always on the receiving end when it comes to health issues related to domestic violence. In… [END OF PREVIEW]

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