Search Smart Spending:

Women pay higher rates for private health insurance

Posted Nov 05 2008, 03:51 PM by Karen Datko
Rating:

If you're one of those people who buy individual health insurance because your employer doesn't provide coverage or you work for yourself, this news may come as a shock: Women pay much more for individual health insurance than do men of the same age.

A New York Times story reported that the gap is often more than 30% and in some cases almost 50%. We're talking about identical coverage, not including the extra women have to pay for maternity care. We're comparing apples to apples.

"F.F." wrote in a thoughtful post at Feminist Finance, "And no one seems to have a very good explanation of why that might be."

F.F. shared her thoughts after reading the New York Times story examining the discrepancy. For those of you who aren't familiar with the individual health insurance market, this excerpt from the story will quickly bring you up to speed.

The individual insurance market is notoriously unstable. Adults often find it difficult or impossible to get affordable coverage in this market. In most states, insurers can charge higher premiums or deny coverage to people with health problems.

(Full disclosure: We're one of those people who don't have health insurance because of those facts.)

Laws are in place to prevent sex discrimination against workers who have group insurance. Not so in the individual market, except in a few states.

What's the justification for charging women so much more? Most of the insurance people the NYT interviewed said that women use health care more often. "They are more likely to visit doctors, to get regular checkups, to take prescription medications and to have certain chronic illnesses," the story said.

Holes can be poked in that explanation.

    • For plans with high deductibles, women are paying for many of those costs out-of-pocket.

    • F.F. argued that those doctor visits are often for preventive care, which would mean eventual savings for health insurers.

    • Marcia Greenberger, co-president of the National Women's Law Center, told The New York Times, "The wide variation in premiums could not possibly be justified by actuarial principles."

    F.F. predicted in her pre-election post that John McCain's health plan would force more people out of employer-provided group health care and into the individual market. Regardless of how America's health care evolves, it's an issue that should be addressed.

    "It would be swell if this sort of discrimination was prohibited," she wrote. "But right now, it's A-OK."

    Comments

     

    Hey I don't care if you're fat or skinny, the only points I made here are that: 1. The thought that everybody needs to go for any type of "annual check-up" for anything is ridiculous. And 2. It's a load of crap that I have a difficult time getting a script for thyroid replacement because health care providers don't want to take anyone who can afford to pay with cash at the time of service.

    That is correct, A.pend.. I checked every EOB, found and reported any duplicate bills...I have become very well educated in health care from personal experience.. and I was even denied care by Mayo in Florida and had to use Cleveland Clinic..as things locally could not be resolved.. I am very familiar with CAT cases as Jay discusses.. and when you get one, you can be KNOCKED out of your insurance in the future.. as I have been denied.. I plan on filing an appeal to the process if I don't get group coverage soon with now trying to return to work, and I have plenty of job experience as a former educator/trainer.. etc.

    Insurance doesn't like to pay, and I had to FIGHT for many things that were done to my body to be paid for..

    I can tell you, insurance in this country is about to see some major issues.. and I fear what those might be in the end.. EVERYONE needs to take accountability to research your plans, compare your needs, your age, your LTC, STD, etc. because this is something that can MAKE or BREAK your total household income, your 401k..

    Just be taken or go to an emergency room visit now, and the cost is anywhere between 4-8 grand.. for 24 hour stay.. average hospital a day, NOT in ICU, is now about 10 grand a day.. sometimes.

    It has become overwhelming and I can tell you this next generation is going to be in for some rude awakenings in this area.. I keep tellng my sons, get a decent job but a great benefit plan when they both finish college.. It is also be known, easier to GET health insurance while you have it, then when you DON'T  Any agent will tell you that..

    I hope this information has helped someone.. and yes, flexible reimbursements are great for growing younger families as well.. Also, people need to know, there are a number of tax deductions you can claim if you get into a CAT case, you easily can meet 7.5% medical tax issues on filing.. KEEP all reciepts and docs...

    My post wasn't directed at you a.pend! I think it was the post before yours that it was directed at! For the most part people (skinny people that is) always have such hatred for fat people because they aren't asteticaly pleasing to look at, and that's it! Then they will find any other way to put them down! They would show more respect to a child molester then to a fat person! Like I said, my life is just as important as theirs! How I choose to live it is my buisness, as long as I'm not hurting anybody!

    Like I've already said, but felt I needed to reiterate. Take responsibility for your own health, and realize that b/c everyone rushes to the doctor with every sniffle is the reason our insurance is so high. Insurance costs are spread out among many even when it comes to individual plans, so if you don't want to be paying alot get on your not so healthy friends to take better  care of themselves.

    As for pre-existing from birth costs. I'm sorry you're right you can't control it, but it doesn't mean you should get a free ride either. Like it or not those problems catch up to you and make more problems in the future, so you're insurance should be higher!

    To Ryan:

     You're awful close-minded. There are plenty of overweight men as well, so I would consider backing off when you presume to think (and state) that all women are fat. Just because you hit the gym 3-5 times a week doesn't mean that you can't catch a serious illness. What happens when you're doing your squats and you tear a muscle... you gonna go to the doctor, or go hit the bench, because frankly it sounds like you think the gym must solve everything...

    To "man":

     Birth control is perscribed for more than just keep a woman from getting pregnant. I have a condition called endometriosis which causes excruciating pains during menstration (used to take me down & out for the first three days - couldn't move without vomiting... this is NOT something to play around with). The pill lessens the severity and length of my cycle, and even the frequency (4 times a year instead of 12). Condoms only serve 1 purpose that I know of, so until the condom checks for prostate cancer or blood disorders I think you're s.o.l.

    (Hey... maybe if I go to the gym my endometriosis will go away - HA!!)

    As for the "well men pay more for car insurance" arguement, please do some reading people. Studies have shown again and again that men are more agressive behind the wheel and tend to take more risks than women - though that demographic is changing and as such, so are the rates. On top of that, car insurance is something that no company provides, so each individual makes the choice on their provider. Some of us with company sponsored insurance don't have that luxury. We can't exactly "shop around" so all we can do is suggest that our boss go and do the same. Cheaper than privatized care which is our other option, but still...

    Fat, skinny, tall, short, black, white, and everything in between - it comes down to this. Health is a practice, not a science. Some of us wait until it's too late to go get checked out, while others go everytime they get a papercut. What needs to happen is this (in addition to a few suggestions that I believe Beverly brought up):

    Ending the sensationalism associated with health - make information available but don't cram crap down peoples throats, there are enough hypochondriacs as it is. Let people be responsible for themselves - big brother does not need to regulate every little thing in our lives, and frankly with their dismal performance recently I wouldn't want them running that much of my life anyway.

    Pay attention to what you do to yourself - if you smoke, expect cancer. If you eat junk/fried foods, expect diabetes/high cholesterol, etc. Yes, things will happen that will be outside of your control, this is life people. At the end of the day we all must learn to take preventative steps - eat right, get at least 15-20 minutes of moderate walking done a day, and when you go home don't sit in front of the tube. Clean a bathroom... go to the playground with your kids... walk around the mall with your significant other. Something, ANYTHING, is better than doing nothing. Wellness people, wellness.

    *steps off the soapbox*

    People will go to the doctors for the slightest thing! If I don't have a fever of at least 101 I don't even call the doctor! They prescribe, prescribe, prescribe, then your body ends up building up antibodies against the antibiotics! Colds will go away without medical intervention! Sports injuries are going to happen! Hey don't play sports then! You don't need to dive 10 feet in the air to catch that pop up ball! Should my insurence premiums go up cause somebody wanted to be the hero of the game! I don't think so! My point is, people get sick no matter what they weigh and from the same illnesses as fat people!Aaccidents happen due to things like sports, We don't have to play sports, but is that the way we really want to llive! I don't think so! My whole point is don't blame one group of people because you don't like the way they look! I have a friend who has high cholesterol, and high blood pressure. She also weighs about 120 pounds and works out and eats healthy she gets so upset that she's been on medicine for this for 10 years and I have no medical problems and am obviously much hevier the she is! She states it's not fair! Why does God allow me to be sick with this and you to gon living and eating what ever you want! Well I just gotta laugh at her cause I'm not particuliarly relgious so I tell her maybe God doesn't appreiciate you dictating whom should live and whom should die!!!  She don't like that to much!! I also have another friend who could eat anything she wants and as much and never gain a pound!! Should I wish death on her cause she can eat and eat and eat, but if I so much as look at a potatochip I gain 10 pounds!!! LOL   Of course not!

    Sorry for the rant, but I obviously get upset about this! I guess my point is don't judge a book by it's cover! You might be missing out on a great story!!!!

    No more rants from me!  LOL

    State mandates are out there that cover birth control.  

    Men are charged more once they get past 55 - they start having more heart attacks and strokes.  

    Employer funded health care is regulated by state.  They cannot discriminate against overweight smokers with bad lifestyle habits.  So the young healthy workers are subsidizing the old fat smokers.  

    Individual is also regulated by state.  Each state sets their own rules.  Cherry picking states that underwrite risks charge much less.  States that guarantee coverage to all residents have to hope for the best and charge enough to keep the plan afloat for another year.  

    Healthcare is expensive. Someone has to pay for it.  Whether it is the insurance company, your premiums and out of pocket costs, the state or feds, it all costs the same.  Doctors charge $200 to see you for 5 minutes.  They send you for diagnostic tests that cost thousands (how much do you think MRI's are???).  They give you drugs that costs hundreds.  No one gets that the costs all start at the providers.  The insurance companies and the medicaid plans all chip away at these costs (that $200 doctor visit is generally allowed about $50 for a medicaid plan, a bit higher for network negotiated rates).  So who pays after that?  Should the doctor eat the balance, or the patient?

    The problem is systemic.  Its not just the big bad insurance companies - they have their problems no doubt - but it is a problem through out.    

    For every insurance company that denys a claim, there is a doctor that orders a needless test or prescription, and there is a patient that demands a drug because they saw their favorite talk show host or actor or sports hero on tv saying how great it is.  

    What about all the advances in preventive medicine?  They are only available to the wealthy and the poor.  I pay taxes so that low-income people can get the best health care in the State.  Who can afford to pay for a Colonoscopy out of pocket?  Middle income people just get cancer and die while the poor and the wealthy get all the early detection money can buy.  I think if health care is offered to all children, it ought to be offered to everyone, Men, women, and children.  What is wrong with this country when hard working tax payers who are trying to take care of themselve and don't have their hand out to get that government check every month can't even afford minimum basic care?  I tried to get on a waiting list for a reduced fee screening - was told if something changes in the near future, I could reapply.  I said you mean if I lose my job in the next few months to give you a call.  She said "I'm sorry".

    Yes, I'm sorry too.  After all the middle-income baby boomers die of preventable diseases, who'se going to pay for health insurance for the poor? Socialized medicine would not be so bad.  What would be so bad about being on a waiting list in order of need instead of income level?  I would be all for it.  This isn't about men vs. women, it's about what our own government has done to us while they've been in bed with the drug companies and the insurance industry.  

    As one who came from a country with socialized health care let me tell you what's bad. You have no say in what treatment you get the government tells you what when and how. Even if you can afford to pay out of pocket for the care you want and need you have to wait until you are told "it's your turn". Sometimes you are told that you can not qualify for the care you need because your expectations of living are below standards so you don't get the treatment. A ggod friend of mine contracted a rare bone disease through dental surgery, even though there are treatments available to cure the disease and reconstruct the damage she was told no. That's what is wrong with socialized health care. Trust me when I tell you, it sounds good up front, everyone has the same access to care, but when it comes to real life practice it's horrible, dangerous and wrong. Americans have a great health care system, whether you believe it or not. Yes it can be expensive but it is better than the alternative.

    In Calif., Insurers have come up with plans that do Not cover Maternity, in an effort to reduce premiums and costs.

    Actually the premiums keep going up and the benefits go down every year.  The new plans are the same plans, but have a new name and the beneifts have been spread out across the board of the various plans.

    Send a Comment

    Comments must be directly related to the blog entry. Comments with offensive language will be deleted. Your e-mail address won't be displayed.

    (please, no HTML tags. Web addresses will be hyperlinked):