A singular solution for healthcare (best for women)

[clear eye]

http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/06/15/a_singular_solution_for_healthcare/">An Op-Ed from the Boston Globe

By Judy Norsigian and Jennifer Potter
Judy Norsigian is executive director of Our Bodies Ourselves. Jennifer Potter, MD, is director of the Women's Health Center at Beth Israel Deaconess Medical Center and director of women's health at Fenway Health.
June 15, 2009

A single-payer healthcare system would more effectively control costs than any other plan that Congress is considering as it moves toward a reform bill. And by controlling costs, existing resources could be allocated more equitably, especially for the benefit of women.

First, single-payer plans eliminate the $300 billion to $400 billion that insurance companies spend annually in administrative overhead and waste. Second, single-payer plans are best positioned to take on the enormous challenge of reducing or eliminating the financial incentives that have led to so much overtreatment and undertreatment.

Maternity care illustrates this phenomenon: We spend far more per capita than any other industrialized country and yet do worse on most birth outcome measures than most of these other countries....

Coverage with a single-payer plan is independent from employment. Because women are more likely to be self-employed, to work part time, and to move in and out of employment outside the home, they are now more likely either to lack coverage through work or to lose insurance when changing jobs.

Medical debt is an enormous concern for many women, and single-payer plans effectively address the cost issues that send women into debt and even bankruptcy. A 2009 Commonwealth Fund study found that 45 percent of women accrued medical debt or reported problems with medical bills in 2007 compared with 36 percent of men. Under Rep. John Conyers' single-payer bill, a family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs - with no deductibles or copays or concerns about catastrophic costs.

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[Oregone]

1. We just had a child with single-payer insurance

(and I was self-employed and my wife was part time, so her employer didn't cover her costs)

So, monthly appointments (bi-weekly/weekly at the end), diagostic screenings, ultrasounds, birth, post-birth meetings/checkups/tests and even mental help if needed were all covered. The final bill was: $108 a month, period, end of story. My wife doesn't have to go back to work to continue this coverage at all. She has 55% paid leave for a year too

I cannot express in words how grateful I am for this coverage.

[clear eye]

2. For the readers, the author of this reply lives in Canada. n/t

[iverglas]

3. and specifically, I'd guess, in BC? ;)

In most other provinces, we don't pay separate premiums for the health insurance plan -- it's tax-funded. I think Oregone is paying the max on BC's sliding scale.

I did raise the issue of parental leave (the year can be divided between parents pretty much as they choose, with a separate few weeks specifically for late pregnancy/post-delivery - provided both are in regular employment paying premiums into the fund, of course) in a thread here at DU a while back. How it is in women's interests for there to be paid paternity leave, so that if a couple wants someone at home with an infant for the first few months or year, it doesn't have to be the woman sacrificing the benefits of continuous employment. The response was somewhat hostile.

My mum is in treatment for lymphoma: chemo and radiation, with all the attendant scans and whatnot, including a daily free shuttle bus from her local hospital to the big city hospital for the radiation. My sister is in treatment for advanced colorectal surgery: chemo, radiation, surgery, more chemo, home nursing visits. My partner had two episodes of diabetic ketoacidosis last month (subsequent to flu, a danger we didn't actually know about, him having developed diabetes, type I, only at the age of 50), and spent many hours in the ER both times, a night in ICU, a couple more nights in acute monitoring and a regular ward. And is now back to frequent visits to the endocrinology department. I've just seen a retinal surgeon and scheduled surgery to repair a botched cataract surgery two years ago. That's not anything to do with public health insurance, it's just me. If there's a minute risk of something going wrong -- a small percentage of cataract surgeries have complications -- it will.

Anyhow, for all this and more (my dad's six weeks in hospital and late-stage home care before dying 6 years ago ...), we end up being out of pocket for parking and taxis.

Other than drugs. People with jobs generally have employer-based supplemental insurance for drugs (only a couple of provincial plans cover drugs, or any dental). I'm self-employed. Ontario has a public plan we could join, but coverage is for percentage of income spent on meds and we'd have to spend a fortune to get any rebate. But the partner's about to enrol in a separate provincial prevention program for diabetics that has no premium and is not means-tested and will cover more than half the cost of his testing supplies.

I have no idea what life would be like if we lived on the other side of the border. I'd be spending a fortune on private medical insurance, I guess. Or I'd have lost my house by now.

I may be the exception in that I'm self-employed and make quite a bit of money, but my income is still "precarious", as growing numbers of people's is in our new economy. And women certainly loom large in those numbers.