Sicko

I have no real desire to go and see Sicko. I have, however, read a large number of reviews, reactions and responses to the documentary, which almost inevitably get caught up in the Michael Moore aspect, and his deliberately provocative visit to Cuba (flaws as to which are featured in the Onion review, I think - his failure to state that Cuba actually ranks below the U.S. is disingenuous, not entirely unexpected - yet who else but Cuba deliberately trains too many doctors to go to Africa and provide healthcare there, as I've heard from British doctors doing internships out there?). I have elsewhere detailed my own limited (and terrified) experience with the healthcare system here, and I do not want to revisit it.

However, I was pushed into doing more serious posting, and not so frivolous, by this notice I got from Kaiser's Daily Women's Health roundup.*

Although "little research" has been conducted on the effects of high-deductible health plans on women, "several studies point to potentially higher costs, ... especially where maternity care is concerned," MarketWatch reports. Under high-deductible plans, an individual is responsible for at least the first $1,100 of out-of-pocket medical costs, and out-of-pocket costs for family plans start at $2,200, "though deductibles often run much higher," according to MarketWatch.An April Harvard Medical School study on high-deductible plans found that in 2006, health costs for working-age women averaged about $1,844, compared with $847 for men. Among people ages 18 to 44, women's median outlays were about $1,266 for high-deductible plans, compared with $463 for men (Gerencher, MarketWatch, 7/5).

A June study conducted by researchers at the Kaiser Family Foundation and the Georgetown University Health Policy Institute found that consumer-driven health plans generally require families to pay higher out-of-pocket costs for maternity care than traditional insurance plans (Kaiser Daily Women's Health Policy Report, 6/13).

This is scary on many, many levels. Our average health costs are seriously a thousand dollars more than those of men? We pay $800 more for receiving treatment? Oh yes, it's because we have all those complicated tubes and scary things like ovaries and periods and, shockingly, not wanting to be pregnant when we do not want to be. And so we have to do that, and suffer the ignominies of the pay gap (as of 2004 Government data, 75.5 cents of every male dollar) and, until Congress sorts itself out, not being allowed to sue for unequal pay after six months.**

I wonder what percentage of these women's partners actually share the costs of not having to have a baby. I try to be fair about the US system in comparison to Britain, and I think that Michael Moore might want to show the horrendous waiting lists for elderly patients to get hip replacements, for the time to get physiotherapy and so on. However, when it comes to contraception, the British system genuinely kicks the US's sorry behind, particularly now that students are now going to have to pay more for contraception.

* If you don't subscribe to this and care even a teeny weeny fraction of an ounce about gender issues, I urge you to sign up here - it's an excellent distillation of news about health, with a firm dose of politics and eye-opening horrors.

** That link is to a fantastic article about the Supreme Court's jurisprudence having fallen into the trap that illegal discrimination is all about the intent to discriminate, and not the actual action of discriminating, which Lily Ledbetter's employers did every single time they paid her less than her male counterparts. It's excellent, and well worth the read, even for non-law geeks.