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Terry O'Neill: Women and health care

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By Terry O'Neill
Wednesday, November 4, 2009; 5:39 PM

Women have far different interactions with the health-care system than men. Profit-driven insurance companies are allowed to charge women higher premiums than men because women's reproductive health-care needs are more costly. Even women who never experience pregnancy or childbirth may pay higher premiums.

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Insurers also avoid paying for women's health care (even though we pay higher premiums for just that reason) by an ingenious use of the concept of "pre-existing conditions." Having had a c-section birth, for example, can be a pre-existing condition, so the next pregnancy isn't covered. If you're pregnant when you get that job with health benefits, the pregnancy is pre-existing and may not be covered.

In a half-dozen or so states, insurance companies are allowed to call domestic violence a pre-existing condition and refuse to provide any health coverage to women who are or have been abused. It makes you wonder if insurance companies think just being a woman is a "pre-existing condition."

We've been promised that insurers won't be able to deny coverage for "pre-existing conditions" under reform. But will that stop them from just raising costs for the reproductive health care we need -- often to save our lives, and the lives of our children? And will a reform package ensure that women have access to the full range of reproductive health services, including birth control and abortion? If some in Congress have their way, women with the least resources -- the most vulnerable of us -- could be denied desperately needed abortion or contraceptive care.

Also vulnerable are the unpaid family members who are increasingly taking on providing care formerly provided by paid employees.

Women are providing more health-care services, unpaid, to their family members and receiving fewer health-care services themselves under the current system. A new paradigm for health care that doesn't address this disparity won't be any fairer to women than the failed system we have now.

Terry O'Neill is president of the National Organization for Women.

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