By Molly M. Ginty
Friday, June 26, 2009
As Congress debates at least 10 health care proposals, prominent women's advocates say work and wage issues make the single-payer model the best deal for women. So far, it's mustering little support from lawmakers.
(WOMENSENEWS)--As the battle to reform U.S. health care heats up, Cindy Pearson is staying focused.
"This push is our No. 1 priority now," says Pearson, executive director of the Washington-based National Women's Health Network. "It's an important time because Obama is voicing his concerns about health care and because both houses of Congress are developing legislative language on the issue that women's advocates will have a chance to discuss, review--and possibly change--before it comes up for a vote in the fall of 2009."
Pearson says that her group is encouraging women to educate themselves about health care reform, attend local and national events and lobby representatives for the proposals they want.
She cites women's involvement in shaping other health care legislation--including the Family Medical Leave Act and the Freedom of Access to Clinic Entrances Act, both passed in 1993, as proof that they should get involved now. "Women have affected public health policy in the past and the only way we can do so now is by making our voices heard," she said.
Ten health care proposals are now before Congress.
The three most popular proposals all require that Medicaid be expanded; that most people continue to get insurance coverage through their employers; and that every citizen have health insurance, with government subsidies available to individuals and families to help make that coverage more affordable.
After these common elements, the proposals diverge in some key ways.
The first proposal, which emerged from the May hearings led by Senate Finance Committee Chair Montana Sen. Max Baucus, would create an insurance exchange (an organized market for the purchase of health insurance) through which individuals and small businesses could buy coverage.
The second, introduced June 9 by the Committee on Health, Labor, Exchange and Pensions, which is chaired by Massachusetts Sen. Edward Kennedy, would include the exchange as well. However, it would make subsidies available to more Americans than the Baucus plan, covering more of the nation's 45 million uninsured.
The third plan, drafted by the Obama administration and the House leadership, was unveiled June 19 with the endorsement of three House committees: Ways and Means, Energy and Commerce and Education and Labor. It does not include the type of insurance exchange recommended in the Baucus and Kennedy proposals and is not as wide-reaching as the Kennedy plan.
The Obama "Tri-Committee" plan does require employers to either cover workers or contribute to a government fund. And it fulfills Obama's campaign promise to create a government-sponsored health plan that rivals private plans. "If the private insurance companies have to compete with a public option, it will keep them honest and it will help keep their prices down," Obama said at a June 11 town hall meeting on health reform in Green Bay, Wisc.
One of the ten proposals up for consideration is a single-payer model, in which a publicly financed entity (a "single payer") reimburses providers for their services (instead of private insurers).
Though single-payer legislation is not being considered in the Senate, the House is weighing it in the form of the U.S. National Health Care Act (HR 676), which was introduced January 26 by Michigan Rep. John Conyers, Jr.
Prominent advocates for women's health say the lagging single-payer model would serve women best. The National Women's Health Network, for instance, has endorsed this model since 1978.
"Most of the leading health care proposals on the table would tie insurance coverage to employment in a way that is problematic for women," said Judy Norsigian, executive director of the Boston-based Our Bodies, Ourselves.
Dr. Susan Hasti, a spokesperson for the Chicago-based Physicians for a National Health Program, agrees. "Women are more likely than men to have inadequate coverage because they are self-employed, work part time, have low-paying, no-benefit jobs, rely on their spouses for coverage or lose their insurance when they change jobs," she said.
Reproductive services, including abortion, would likely be covered by single-payer legislation and are also likely to be covered by an 11th plan not yet on the table: the U.S. Universal Health Service Act (HR 3000), which California Rep. Barbara Lee plans to reintroduce during this legislative session. According to Norsigian, none of the other proposals under consideration would cover reproductive services as comprehensively.
As Lee's plan and others come before Congress, the Washington-based Raising Women's Voices, a coalition of social reform groups based in Washington and New York, is encouraging voters to organize "Women's Speak-Outs for Health Reform" in their communities.
National grassroots campaigns are also underway. One became visible on June 25, when thousands of women descended on the U.S. Capitol for a mobilization and rally for affordable, quality health care for all. The rally was sponsored the Washington-based Health Care for America Now.
Norsigian says a single-payer system would save up to $400 billion annually in health care administrative expenses and would help eliminate medical debt, which is 30 percent more common among women than men.
Molly M. Ginty is a freelance writer based in New York City.
National Women's Health Network
Our Bodies, Ourselves
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