The perversity of insurance in the United States

A while ago, a friend told me that she was denied life insurance because she'd had an abnormal Pap. For the record, almost every woman in the U.S. will probably have an abnormal Pap at least once in their life -- or at least, the odds are very good that she will. (Purportedly, 80% of Americans have HPV at some point in their lives, though data on this are inconsistent because HPV is a bitch to track for a variety of reasons, some structural (limitations of tests, tracking, etc) and some due to the etiology of the infection.) To add insult to injury, her husband and her insurance broker received the letter declining Mrs. X her coverage, though Mrs. X herself did not get notified. [She would go by Ms. X, but her marital status seems important for the argument here! Apologies, Ms. X.] She could receive coverage after she received a normal Pap. Leaving aside the inanity that Mrs. X was not treated as her own individual, adult person worthy of receiving the information directly, equally disturbing is that she could be denied coverage because of a fairly routine abnormality. True, an abnormal Pap may slightly increase the chance of her developing cervical cancer, but on the other hand, her diligence in getting her Pap and the fact that it was identified by her doctor probably will more likely increase her chance of catching precancerous cells, and being able to get treatment before developing cancer (thereby, saving everyone a lot of time and money -- if we're going to look at this in such a grim way). Basically, penalizing my lovely friend Mrs. X for being careful about her health seems a very ass-backward way to actually increase her longevity. Dumb-asses.

Now, the Sunday The New York Times has an article about how women who've had caesarean sections to deliver their children are being denied insurance coverage when they seek individual health insurance plans. For those who don't follow such things as religiously as I do, caesarean sections have been on the rise -- part of the obsessive medicalization of women's bodies and pregnancy, in general. A number of my friends have had home births lately, and their decisions are not just personal preference, but they are in fact, a form of resistance. I'm a bit agnostic about the home birth vs. the hospital birth (as I've never been pregnant, and prefer not to worry about this issue right now, though I think it's great that my friends have been so determined) -- but the caesarean practice has gotten out of control. And now, to read that women are therefore penalized for the decision, which I suspect is not always "theirs" -- but rather obstetricians, who don't want to be disrupted from their weekend plans, schedule these in order to make life easier. And to be fair to the women who agree to these unnecessary caesareans (there is an important difference between the elective caesarean and the necessary one), child birth is a scary scary unknown, so it's hard to blame these women for choosing a more controlled way of delivery.

I am tempted to write a letter to Obama telling him that health insurance reform and health care reform better damn well be a big part of his platform. I find the constant double standard of insurance in this country so deeply frightening. You really are damned if you do and damned if you don't. I've been thinking a lot about the privatization of health in the United States, and I read an interesting article that made the point that the concept of "confidentiality" is a very American idea when you compare the UK and French socialized health systems -- the consequences of this "confidentiality" is much more far-reaching than simply a notion of the autonomous individual. The ways in which confidentiality taps into capitalist discourses and corporate interests is pretty fascinating. I know I'm not articulating this very well, yet, but I hope to eventually. Anyway, I see this NYT article as really tapping into this morass of conflicting interests -- as I've said before, ultimately, health ought not be on the marketplace.

1 comment:

Anonymous said...

I wonder if there's a disparity between the number of men denied insurance coverage and the number of women denied insurance coverage. Men have a lower life expectancy at almost every stage of life, yet the list of grounds for denying a woman insurance coverage seems to go on and on and on. It does make a girl want to kick herself in the ass for bothering to get preventative care. The reality is that a woman denied coverage has three options when she gets sick--- (a) find the money to pay (ha!), (b) use the ER as your primary care physician (welcome to the cycle of poverty), or (c) get knocked up b/c then you will be eligible for Medicaid (oh but for how long). Them be some sad options.