When the Golden Rule Insurance Company rejected her application for health coverage last year, Peggy Robertson was mystified.
“It made no sense,” said Ms. Robertson, 39, who lives in Centennial, Colo. “I’m in perfect health.”
She was turned down because she had given birth by Caesarean section. Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it. A letter from the company explained that if she had been sterilized after the Caesarean, or if she were over 40 and had given birth two or more years before applying, she might have qualified.
Ms. Robertson had been shopping around for individual health insurance, the kind that people buy on their own. She already had insurance but was looking for a better rate. After being rejected by Golden Rule, she kept her existing coverage.
With individual insurance, unlike the group coverage usually sponsored by employers, insurance companies in many states are free to pick and choose the people and conditions they cover, and base the price on a person’s medical history. Sometimes, a past Caesarean means higher premiums.
Although it is not known how many women are in Ms. Robertson’s situation, the number seems likely to increase, because the pool of people seeking individual health insurance, now about 18 million, has been growing steadily — and so has the Caesarean rate, which is at an all-time high of 31.1 percent. In 2006, more than 1.2 million Caesareans were performed in the United States, and researchers estimate that each year, half a million women giving birth have had previous Caesareans.
“Obstetricians are rendering large numbers of women uninsurable by overusing this surgery,” said Pamela Udy, president of the International Caesarean Awareness Network, a group whose mission is to prevent unnecessary Caesareans.
Although many women who have had a Caesarean can safely have a normal birth later, something that Ms. Udy’s group advocates, in recent years many doctors and hospitals have refused to allow such births, because they carry a small risk of a potentially fatal complication, uterine rupture. Now, Ms. Udy says, insurers are adding insult to injury. Not only are women feeling pressure to have Caesareans that they do not want and may not need, but they may also be denied coverage for the surgery.
“You have women just caught in the middle of this huge triangle of hospitals, insurance companies and doctors pointing the finger at each other,” Ms. Udy said.
We have health plans that cover Viagra and not contraception. If they cover birth control pills they don't cover diaphragms. They cover in vitro treatments to allow women having difficulty becoming pregnant to conceive, but if you have to have a Caesarean birth, the next time you have your covered in vitro treatment your birth won't be covered.
This is madness. We are living in a society in which the Christofascist Zombie Brigade has disproporationate influence and wants to turn women into nothing but brood mares, but if you DO give birth in a way that costs more, you can't even get medical coverage for the birth they want you to have. I guess they want women to squat in the fields, spew out a baby and go right on picking rice. Why aren't there similar exclusions for conditions that disporportionately affect men?
If you want to talk about sexism, how about first working on dealing with discriminatory activities like this one? How about holding politicians' feet to the fire about their health insurance industry contributions?
There's a very strong likelihood that Hillary Clinton will suspend her campaign tonight and acknowledge the inevitable -- that Barack Obama will be the Democratic nominee this year. Women like Harriet Christian will be angry, and they will pledge to elect John McCain -- as if this is going to somehow "hurt" that "mediocre black man." But before they do, they should realize something: If Barack Obama loses in November because angry women cut off their own noses to spite their faces and elect John McCain, he goes back to the Senate, and continues to work for policies that won't treat his daughters like expendable brood mares who can just go ahead and die after they've had a baby -- as only one of 100 Senators.
But John McCain, the man these women claim they're going to help elect in November, wants everyone to be on their own in the health insurance market, so that EVERYONE is going to be subject to ridiculous insurance industry rules like this. There is a legitimate argument to be made that the employer-based system we have doesn't work well, but the answer is not to put everyone off into individual lifeboats, it's single-payer universal health care. So what are these women going to say when, under President McCain's health plan, ALL women are denied coverage for future births after a Caesarean? What are they going to tell women faced with huge bills after giving birth to their second child? Are they going to tell them it was worth it because after all, Chris Matthews was mean to Hillary Clinton?
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