To some, it’s a moral imperative; to others, it’s an important path out of the economic crisis. To all, health-care reform is a notion whose time has come now.
By DELTHIA RICKS
Melanie Victor-Taylor waxes nostalgic about “the good old days” when she had a full-time job as an administrative assistant at a major university in Southern California. But an unexpected staff layoff two years ago set the 53-year-old on an odyssey of job searches that have mostly turned up empty. For now, temporary jobs fill the void, but the temp world comes with few guarantees and no benefits.
And that has meant that, since losing her job, Victor-Taylor has not seen a physician for any reason. “I am too young for Medicare and too rich for Medi-Cal [California’s version of Medicaid, the state and federal health insurance program for low-income residents],” she says. She did see a dentist recently, but had to borrow money for a much-needed root canal. Having deferred other preventive care, she hopes her lifelong streak of good health holds out.
During his presidential campaign, candidate Barack Obama promised health care for everyone. And now, President Obama has laid the groundwork for a massive health-care reform effort to help Victor-Taylor and the legions of uninsured like her, now estimated at 47 million. The president proposed in February a $634 billion reserve fund to finance an overhaul of the U.S. health-care delivery system, an effort he estimates will take about 10 years to complete.
Whatever reforms are made in health delivery, the change will have a profound impact on women, who as a group spend more on medical care than their male counterparts, explains Dr. Steffie Woolhandler, a veteran advocate for health-care reform. “Women [seek] more routine health care than men,” she says. “It starts in the late teens and continues into the elderly categories: There are Pap smears, maternity care and mammograms. Women will pay about $1,000 a year more than the average healthy man, although it levels out as people get into their 60s and 70s. But the co-payments and deductibles really do penalize women,” Woolhandler says, because of lower earnings and more frequent use of routine health-care services.
Key players who will structure the measure have already lined up in the House and Senate. In February, Jan Schakowsky (D-Ill), co-chair of the Caucus on Women’s Issues in the House, introduced a Health Care for Women resolution designed to ensure that a revamped health-care system addresses the particular concerns of women and families. She describes women as “gatekeepers” of their family’s health—the ones who usually research doctors, treatments and health-care facilities. Her resolution, introduced simultaneously in the Senate and cosponsored by Sens. Barbara Mikulski (D-Md.), Bernie Sanders (I-Vt.), Debbie Stabenow (D-Mich.) and Patty Murray (D-Wash.), opens the reform debate on a note that assures disparities in women’s health care will no longer be tolerated.
“When I came to Congress, women’s health care wasn’t a national priority,” says Mikulski, who was first elected to the House in 1976 and won a Senate seat 10 years later. “There was that famous aspirin study—10,000 men were included in clinical trials, and not one woman,” she says, remembering research two decades ago that laid the foundation for heart-attack prevention. Even though the study involved only men, its results were automatically considered applicable to both genders.
Obama is specific about what he wants to create: a health-care system that is streamlined throughout, incorporates electronic databases for medical records and drug prescribing, emphasizes prevention and eliminates the use of emergency rooms for primary care. The centerpiece of the system is affordable access for everybody. That strikes a note of optimism for Victor-Taylor. “The main reason I am looking for a job is to have health-care benefits,” she says. “I’ll get a small pension when I am 65 so I am not as worried about retirement. I am most concerned about what happens if I got sick.”
While the U.S. leads the world in health-care spending, it remains among the only industrialized nations where a vast proportion of the population is chronically uninsured. Economists in the Office of Management and Budget estimate health-care costs, public and private, run up to $2.4 trillion annually and are on the rise, consuming 17 percent of the nation’s gross national product.
Medical costs have grown so high that it’s no longer just catastrophic care that worries families. Many are cutting back on lower-budget medical needs as well. A Kaiser Family Foundation study released in February found that in the previous 12 months Americans were more likely to avoid getting prescriptions filled because they considered medication costs too high. Those who did fill prescriptions were more likely to split pills or skip doses to make the medicine last longer. Others shied away from needed dental care because of costs, and still others treated themselves with folk remedies and drugstore preparations because the cost of seeing a physician was too expensive.
Unless reform happens now, adds Julie Pinkham, executive director of the Massachusetts Nurses Association, America will have failed its citizens on the most important aspect of life: the right to good health. Pleased that healthcare reform has garnered a bright spotlight, Pinkham warns, “Now it’s up to our generation, and if we can’t figure it out we really should be embarrassed.”
DELTHIA RICKS is a staff writer for Newsday specializing in health and science issues.
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