With healthcare reform efforts reaching a critical stage, the stakes couldn't be higher for women. Women are the victims of a healthcare system that treats most people badly at one point or another, but that treats women badly all the time.

Women suffer the double blow of both legalized insurance discrimination and lack of affordable access to needed healthcare. According to the National Women's Law Center, seven in 10 women are either uninsured or underinsured, struggling to pay a medical bill or experiencing another cost-related problem in accessing needed care. More than half have been unable to get care because of cost. They haven't filled a prescription; they skipped a medical test; or they failed to see a doctor when they had a medical problem. The situation is most dire for African-American, Hispanic, and Native-American women, who suffer such problems two to three times as often as white women.

Women are less likely than men to qualify for their employer's insurance program, because they are more likely to work part-time and to have lower-wage jobs. Instead, since they are more likely to depend on their spouse's policy than men, they are more susceptible to losing insurance because of divorce or widowhood.

In 38 states, it is legal to discriminate on the basis of gender when selling insurance. Policies sold to women or their employers can cost 40 percent more than insurance for men -- even when maternity benefits are excluded. Currently permissible practices, such as denying coverage for pre-existing conditions or charging more for those with a history of health problems, disproportionately affect women, who are more likely to seek help from a doctor and to need ongoing care. One of the most egregious current practices allows insurance companies in eight states and the District of Columbia to deem domestic violence a ``pre-existing condition'' and deny coverage to its victims.

For women, healthcare reform must embrace principles and practices that will end gender discrimination and provide affordable quality healthcare for all, including access to the full range of reproductive health options. Tinkering around the edges and adding stopgaps won't be enough. Relying on the insurance industry alone to accomplish what it has been unable or unwilling to do for the last 50 years will only prolong an untenable situation.

New solutions must involve innovation and imagination, including creation of a public health insurance plan option to lower costs and ensure universal affordable coverage. Such an innovation has the support of three-quarters of Americans according to a recent SurveyUSA report -- a result that hasn't changed since 2003. A new poll published in the New England Journal of Medicine finds that 73 percent of all doctors favor a public option. Yet the public option is repeatedly dismissed out of hand in the back rooms on Capitol Hill, even by supposed moderates.

It's up to us to ensure that our elected representatives understand that half-measures won't do. The dire consequences of our patchwork healthcare system are both morally and fiscally indefensible. The 2006 estimate of ``excess deaths'' attributed to being uninsured was between 22,000 and 27,000 among all adults age 25-64. Our system's failures earned us a ranking of 35th among countries with a national healthcare system, while we pay the most for poorer results.

Discrimination against women must be rooted out, and we must insist on a public option. Only then will all of us enjoy a standard of health care that Congress itself takes for granted.

Nancy Ratzan is president of the National Council of Jewish Women, a grassroots organization inspired by Jewish values that strives to improve the quality of life for women, children, and families and to safeguard individual rights and freedoms.

Join the discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. In order to post comments, you must be a registered user of MiamiHerald.com. Your username will show along with the comments you post. Thank you for taking the time to offer your thoughts.

     Showing: Oldest first Newest first Most-recommended first Least-recommended first

@Nyx.AuthorDisplayName@ wrote on @Nyx.PostedAtTime@:

@Nyx.repliedToText@

@Nyx.replyAnswerText@

Reply to this Comment @Nyx.Recommender@ @Nyx.AbuseReporter@