The Affordable Care Act (ACA) is here. For those of us that have been at the mercy of private insurance on the individual market, this is a long awaited welcomed relief. If you currently don’t have insurance with an employer, you may be signing up through a state run exchange or through one handled by the federal government – depending on your state. Sign-ups begin on Tuesday, October 1, 2013 through March 2014, with coverage to begin on January 1, 2014.
Since signed into law in March 2010, there has been a shift in how and what insurance companies must offer in policies. Many services must be covered without deductibles or co-insurance, while the out-of-pocket costs are tempered by limits on deductibles and co-pays. This has bothered opponents of the ACA, claiming that it will cost more for people to be insured, even though that is proving to be false in the majority of cases. Not to mention, insurance premiums have reflected the costs of the uninsured for years.
If they aren’t worried about costs, they are worried that some people will be using up all the health care available. People like women.
Dr. David Samadi is a board certified urologist who treats prostate cancer patients. His expertise is men’s health. So naturally the Fox News contributor felt he needed to share his views about the ACA, focusing in particular on women’s health. Dr. Samadi feels that the ACA is unfair because it makes men and women pay the same amount for the same policy. Women have breasts and other stuff that men don’t have and that costs more, he says. Men shouldn’t have to pay for that.
He’s against gender equality – even in healthcare.
Dr. Samadi is correct that women and men are charged the same rate for the same coverage – now. Women are more likely than men to go to the doctor, much of which is required in order to ensure that they can have children, should they desire, and otherwise be around for their families. This may also contribute to their longevity, as women have a greater life expectancy then men.
Insurers found all of these to be risk factors – meaning they would have to pay out more in claims – and charged women more for the same policies. This claim was deemed dubious, since the costs of the healthcare services didn’t justify the increases in premium prices, which could range anywhere from 10 percent to 80 percent more than what a man would pay.
In other words, being a woman was a pre-existing condition.
This gender gap in premium costs penalized women for, well, being women, while rewarding men for being more cavalier about their health. Men tend to not go to the doctor until something is wrong, increasing the chances that care will be more costly in the long run. It also allowed them to not share in the costs of birth control, pregnancy, and birth – at least not in insurance premiums.
Dr. Samadi, and those who oppose the ACA, feels this is exactly the way it should be.
He also thinks that people should pay for their own healthcare with cash or credit cards if you don’t have enough. If you need a chest x-ray to see what that nasty cough is all about, shop around for the best price so you can stay within budget for your unexpected medical costs. This is a great plan unless, of course, you’re like the average American and can’t afford to shop around for the best price for medical care.
One of the key purposes of the ACA is to level the playing field. Preventive maintenance – such as annual exams – is covered without co-pays or co-insurance. There is also no extra charge for pre-existing conditions – something that could more than triple the cost of a premium – if coverage could be obtained at all. Most of all, for millions of Americans who were at the mercy of the “free” market, they now have to opportunity to access coverage whether it’s through the expansion of Medicare or subsidized premiums.
So, yes, the ACA is a huge step forward in equalizing access to healthcare and putting us on a path to better health outcomes for everyone, even men.
It’s far from perfect – but it’s a start.