TELL ME MORE from NPR News April 7, 2010
MICHEL MARTIN
With the NPR health care bill now turned into law, people are starting to get a grasp on the details of the legislation. Women are said to be some of the biggest winners, with health coverage discrepancies appearing to have disappeared. But not all women are on board with this change. Host Michel Martin talks to Sabrina Schaeffer, senior fellow of the Independent Women’s Forum, who says the new health care reform law is actually bad for women.
MICHEL MARTIN, host:
I’m Michel Martin, and this is TELL ME MORE from NPR News.
Marcia Greenberger, the founder of the National Women’s Law Center was our guest.
Ms. MARCIA GREENBERGER (Founder, National Women’s Law Center): It’s probably more important for women than any other group, not only because women, of course, take care not only of their own health, but also their family’s health, but because the health care system has been especially discriminatory and it has not treated women well.
MARTIN: Today, we decided to hear a different perspective on how the health care plan or the health care law will affect women. Joining us now is Sabrina Schaeffer. She’s a senior fellow with the Independent Women’s Forum. That’s a think tank that addresses issues that affect women, but from a free market perspective, and she’s with us now. Welcome, thanks for joining us.
Ms. SABRINA SCHAEFFER (Senior Fellow, Independent Women’s Forum): Thanks for having me.
MARTIN: Now, we heard Marcia Greenberger tell us about some specific issues like gender rating. She said the data shows that even if women use more medical services on average than men, that the fees that they’re actually charged by insurance companies far outstrip that differential in the usage, and the law will stop that practice. What’s wrong with that?
Ms. SCHAEFFER: I think gender-based pricing makes people uncomfortable. But I think we need to be a little bit more clear about what we’re talking about. This is not baseless gender discrimination in the sense that we say: You broke your arm and you broke your arm, you’re a woman, therefore it’s going to cost you twice the amount.
What we’re talking about are actual business actuarial accounting realities. And just because the government says that you have to pay for something like maternity care, it doesn’t make the actual cost go away. It simply means that insurance companies are going to shift those costs to other consumers who don’t necessarily need those services.
And in an economic downturn, the idea of charging, let’s say young, healthy 20-something, you know, men who maybe are dealing with college debt and looking for a new job, suddenly they have to pay for me to have my baby, it doesn’t seem fair and it doesn’t seem right.
MARTIN: What about the ban on dropping people because of preexisting conditions? She pointed out that women have been dropped because they’re victims of domestic violence. You think that’s an acceptable practice?
Ms. SCHAEFFER: You know, I think, again, we recoil from this idea. It’s very disturbing. But, unfortunately, this is a kind of business practice that goes on in insurance in general. We don’t really blink an eye when we talk about car insurance, for instance, or home insurance, life insurance. Life insurance, for instance, somebody could choose to be a missionary in all sorts of areas of the world that are very dangerous, they’re doing wonderful work, for instance. But they’re putting themselves into a position that they’re a high risk for their life insurance companies.
And we don’t say, well, you know, someone who’s living in a safe suburb should pay for them. They made the decision to do that. And, unfortunately, when it comes to domestic violence, it’s very uncomfortable, we recoil from this idea of burdening, but we can’t just get rid of the actual economics behind this.
MARTIN: You have a specific objection to the way the new law handles mammograms. Can you talk about your concerns there?
Ms. SCHAEFFER: Well, what I was concerned about is during the discussion of health care reform, we sort of - coincidentally, this government panel made up of statisticians, not of physicians, came up with a sort of recommendation that mammograms should be put off for a little longer. Well, what comes, you know, to my mind is not whether or not it’s worth it or not worth it. And then there were arguments on both sides of when you should have a mammogram, but this is an issue of risk and of choice.
And the fact is, women need the greatest amount of choice. And they need to be able to have those discussions with their doctors and not have someone in Washington making those decisions for them.
MARTIN: I think your characterization of that panel is completely inaccurate. This is a panel that was comprised both of medical professionals and of statisticians. It’s an advisory recommendation, it’s not compulsory, it’s not binding.
Ms. SCHAEFFER: It’s not binding, you’re right.
MARTIN: And so it seems to me from a free market perspective, you ought to be applauding that result because what they’re saying if you shouldn’t have to have one at a certain age, that you can wait a couple of years. So, why isn’t that exactly the kind of reform that a group like yours would support?
Ms. SCHAEFFER: I think what it suggests is this is the kind of recommendation that we might see with this new law in which we have government panels that are suggesting how medical services, how prescription drugs, when they should be allotted and to whom. And right now cost is not part of this conversation, but you can be sure that we’re providing a service or a good to everybody in this country, we are going to have to ration, and this is the way it will be done.
MARTIN: So, insurance companies should do that. You’re saying insurance companies…
Ms. SCHAEFFER: No, well, insurance companies do ration.
MARTIN: The insurance companies are doing that now. So, you’re saying private insurance companies are the ones who should ration care, the government.
Ms. SCHAEFFER: They can do it through price. The government can do it through force. And I think that this is what we can expect. In a private market there are ways, and we should talk a little bit about what some of those reforms could have been. We didn’t try to expand health savings accounts or high deductible insurance plans, so it’ll allow people more choice and control over the way they’re spending their money.
These are ways that we could have, you know, sort of kept a fantastic health care system. We have wonderful, top-notch health care in this country, and we could have expanded it to many more people and driven down costs.
MARTIN: And, finally, I did want to ask you, because I asked Marcia Greenberger this, the question about access to abortion services. And I just wanted to ask, what’s your perspective on it? Marcia Greenberger’s perspective is that this law is actually more restrictive for abortion services. She says it has the effect of perhaps even keeping people who have from getting the services with their own money. And I’d like to ask your perspective on that.
Ms. SCHAEFFER: Sure. I think the question of allowing the government to determine a lot of serious moral issues like abortion, like assisted suicide or other end-of-life decisions is very touchy. And as we saw, it raised all sorts of emotions. I think it’s very dangerous when the government gets into the business of having to make those decisions.
And I just want to add that because abortion is usually considered a woman’s issue, I think that when we try to negotiate a policy to give women everything they want and we’re focused so much on allowing their birth control, for instance, be covered in insurance, we forget the larger picture. That is that this is going to cost us $940 billion. This is going to cost $2.25 trillion over the next 10 years.
What does that mean for women in this economy? What does that mean for job creation and growth? I think that when you really ask women, would you rather have your birth control covered and your health insurance, or would you rather make sure that you can stay at home with your children if you choose so because you want to, you know, have that time and you want to live on one income. Which is more important to you? I think we would find that a lot of people are opposed to this law.
MARTIN: Sabrina Schaeffer is a senior fellow with the Independent Women’s Forum. That’s a think tank that addresses issues that affect women, but from a free market perspective, as you heard. She’s also the managing partner for Evolving Strategies. That’s a communications consulting firm. She was here with us in our Washington, D.C. studio. Sabrina, thank you for joining us.
Ms. SCHAEFFER: Thank you for having me.
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