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Affordable Care Act Puts Men and Women on an Equal Playing Field

Affordable Care Act Puts Men and Women on an Equal Playing Field

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.

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106 comments

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8:36PM PST on Nov 10, 2013

Here is a well-informed statement from Kaiser Family Foundation Health News about the gaps in Men's care resulting from the ACA:

http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2012/health-law-men-michelle-andrews-082812.aspx

6:33AM PDT on Oct 2, 2013

TY.

11:18AM PDT on Oct 1, 2013

ty

10:54AM PDT on Oct 1, 2013

@ David F first off you need to stop listening to Fox news or Texas needs to clean the water you all are drinking from because Death Panels is a moronic statement.Those who want to keep their health insurance can,and those who want to get health care can now for competitive rates another point is those who do have a medical conditions will not be denied coverage ever. So where is the doom and gloom in all this.

6:51PM PDT on Sep 30, 2013

"...shop around for the best price so you can stay within budget for your unexpected medical costs."

The only problem with that is the medical community doesn't have prices listed for anything. TIME Magazine did a story called "Bitter Pill" by Steven Brill March 4th, 2013. His quote or subtitle was "How outrageous pricing and egregious profits are destroying our health care."

"Hospitals arbitrarily set prices based on a mysterious internal list known as the “chargemaster.” These prices vary from hospital to hospital and are often ten times the actual cost of an item."

Read more: http://healthland.time.com/2013/02/20/bitter-pill-inside-times-cover-story-on-medical-bills/#ixzz2gQknLN3p (This is the free source.)

I didn't read all of it, too depressing. What is sad and frustrating is that it should have infuriated everyone and the masses should have risen up. But nothing happened. I didn't hear anything from other media sources on the subject.

I didn't become an internet protester/armchair protester until this year. This story may have pushed me into this new direction of speaking up.

3:27PM PDT on Sep 30, 2013

Darryll G ..... If the USA doesn't go for "change" you and the others in Florida (not to mention all the other states) will be stuck in the "stranglehold" of the insurance companies forever .... can't you look just a little further than the end of your nose ????

There are much better systems (in other countries, for example) and ACA is just the first step !!

12:49PM PDT on Sep 30, 2013

Tell that to the more than 1 million people in florida who have an income to low to afford insurence yet don't qualify for subsidie help from the government, this was said on the local A B C news channel last night, how many other millions wont qualify in other states and do they still have to pay the tax if they don't get insurence, just because they can't afford it

12:27PM PDT on Sep 30, 2013

Oh David you really are funny. Check your facts Canadian have a longer life expetancy than the US and a lower infant mortality rate. And it's not because everyone is jumping across the border for treatment.
Quit taking your "fantasy pills" and maybe your brain will start to work again.

8:33AM PDT on Sep 30, 2013

David F ......... 3:24PM PDT on Sep 29, 2013
" .............. No doubt this will quickly drive the private insurers out of business and result in a dreaded and proven disastrous single payer system." .........

You seem to be so insistent about what you call a "single payer system" being so bad, I'm beginning to wonder what you actually understand this type of system to be ...... could it be that your "picture" is not what the rest of us are talking about at all ?

Please try and describe what YOU mean by "single payer system" for us David - that might clarify things a bit .............

7:32AM PDT on Sep 30, 2013

I challenge everyone reading this today to email your congressmen and tell them to approve a budget that includes Obamacare. I just did!

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