A Step Backward for Women's Health Care?
by: Maya Schenwar, Editor t r u t h o u t
Editorial: 08 March 2010
Monday evening, after a rousing speech in Philadelphia pushing for health
reform passage, President Obama celebrated International Women's Day
with a White House reception honoring women around the world for their
achievements.
This recognition is important. However, International Women's Day - the
brainchild of a group of predominantly socialist women with revolutionary
dreams of equality and basic human rights for all - presents an opportunity
for a little more expansive thinking on the part of the Obama
administration.
One item that's ripe for rethinking, ASAP: the gender discrimination that is
burning a hole through the Senate health reform bill that's headed for a
House vote next week.
Though the Senate bill lacks the Stupak stamp of shame, it certainly doesn't
come up short in the department of reactionary anti-choice provisions.
Currently, the vast majority of private health plans cover abortion
procedures. The Senate plan endorsed by President Obama would severely
complicate payments for abortion-inclusive plans, requiring individuals
covered by those plans to write two separate checks - one to cover abortion
procedures and one for all other coverage. Insurers then must deposit
abortion payments and everything-else payments into two separate accounts.
Chances are, the new regulations would drive insurance companies to drop
abortion coverage from their plans, according to health policy analysts.
These eliminations would impact millions of Americans: more than one-third
of adult women in the US have had at least one abortion. When it comes to
choice, the health reform plan in its current state marks a dangerous step
backward.
The bill's shortcomings for women don't stop at abortion. Earlier in the
health-care-push season, Obama promised a plan that would eliminate "gender
rating" - the practice of charging more for women's coverage than for men's.
Gender rating is still going strong in 40 states. Insurance companies rally
around the excuse that the policy is "actuarially based"; that women cost
more to insure than men, mostly due to pregnancy- and birth-related medical
care. Beneath that flimsy statistical veil, it's blatant discrimination:
Insurance companies acknowledged that themselves 40 years ago when they
abandoned race as a price-determining factor.
Despite the president's promise, the Senate bill upon which we're pinning
our hopes for health reform would not eradicate gender rating. It would
openly permit the practice for employers of businesses with 100 employees or
more, giving large employers an obvious incentive to hire men over women to
keep down insurance costs. Gender rating also puts businesses with a mostly
female workforce - childcare centers, some school districts and nurse
associations - at a disadvantage. According to the National Women's Law
Center, "One such employer with a predominantly female workforce estimated
that, due to gender rating, her annual premiums were $2,000 higher per
employee."
As the health care debate drags on and on, there's a lot of shushing going
around. Many leading Democrats are hoping to sweep the Senate bill's
discriminatory flaws under the rug. After all, health reform is desperately
needed, and it would be really nice to finally push a passable bill through
before we all lose our sanity (not to mention our insurance).
However, as it stands, the health reform bill would endanger the basic human
rights of many women. This International Women's Day, it's time for Congress
and the president to stop ignoring the bill's consequences for women's
health coverage - and start discussing options for averting them.
Planned Parenthood President Cecile Richards calls for Congress to fix the
legislation's abortion caveats during reconciliation - a move that could
prove very difficult, since reconciliation is designed to address only items
that are relevant to the budget. Jodi Jacobson at RH Reality Check notes
that the only route to a true repair job may be a "future bill aimed at
making technical fixes to health reform."
Either way, the work to protect women's health coverage from these sweeping
restrictions and limitations must begin now. As the International Women's
Day reception festivities wind down at the White House tonight, the
president should do some hard thinking about how to ensure the basic human
right of health care for women here at home.
***
http://www.nytimes.com/2010/03/08/opinion/08krugman.html?th&emc=th
An Irish Mirror
By PAUL KRUGMAN
NY Times Op-Ed: March 7, 2010
Everyone has a theory about the financial crisis. These theories range from
the absurd to the plausible - from claims that liberal Democrats somehow
forced banks to lend to the undeserving poor (even though Republicans
controlled Congress) to the belief that exotic financial instruments
fostered confusion and fraud. But what do we really know?
Well, in a way the sheer scale of the crisis - the way it affected much,
though not all, of the world - is helpful, for research if nothing else. We
can look at countries that avoided the worst, like Canada, and ask what they
did right - such as limiting leverage, protecting consumers and, above all,
avoiding getting caught up in an ideology that denies any need for
regulation. We can also look at countries whose financial institutions and
policies seemed very different from those in the United States, yet which
cracked up just as badly, and try to discern common causes.
So let's talk about Ireland.
As a new research paper by the Irish economists Gregory Connor, Thomas
Flavin and Brian O'Kelly points out, "Almost all the apparent causal factors
of the U.S. crisis are missing in the Irish case," and vice versa. Yet the
shape of Ireland's crisis was very similar: a huge real estate bubble -
prices rose more in Dublin than in Los Angeles or Miami - followed by a
severe banking bust that was contained only via an expensive bailout.
Ireland had none of the American right's favorite villains: there was no
Community Reinvestment Act, no Fannie Mae or Freddie Mac. More surprising,
perhaps, was the unimportance of exotic finance: Ireland's bust wasn't a
tale of collateralized debt obligations and credit default swaps; it was an
old-fashioned, plain-vanilla case of excess, in which banks made big loans
to questionable borrowers, and taxpayers ended up holding the bag.
So what did we have in common? The authors of the new study suggest four "
'deep' causal factors."
First, there was irrational exuberance: in both countries buyers and lenders
convinced themselves that real estate prices, although sky-high by
historical standards, would continue to rise.
Second, there was a huge inflow of cheap money. In America's case, much of
the cheap money came from China; in Ireland's case, it came mainly from the
rest of the euro zone, where Germany became a gigantic capital exporter.
Third, key players had an incentive to take big risks, because it was heads
they win, tails someone else loses. In Ireland this moral hazard was largely
personal: "Rogue-bank heads retired with their large fortunes intact." There
was a lot of this in the United States, too: as Harvard's Lucian Bebchuk and
others have pointed out, top executives at failed U.S. financial companies
received billions in "performance related" pay before their firms went
belly-up.
But the most striking similarity between Ireland and America was "regulatory
imprudence": the people charged with keeping banks safe didn't do their
jobs. In Ireland, regulators looked the other way in part because the
country was trying to attract foreign business, in part because of cronyism:
bankers and property developers had close ties to the ruling party.
There was a lot of that here too, but the bigger issue was ideology.
Actually, the authors of the Irish paper get this wrong, stressing the way
U.S. politicians celebrated the ideal of homeownership; yes, they made
speeches along those lines, but this didn't have much effect on lenders'
incentives.
What really mattered was free-market fundamentalism. This is what led Ronald
Reagan to declare that deregulation would solve the problems of thrift
institutions - the actual result was huge losses, followed by a gigantic
taxpayer bailout - and Alan Greenspan to insist that the proliferation of
derivatives had actually strengthened the financial system. It was largely
thanks to this ideology that regulators ignored the mounting risks.
So what can we learn from the way Ireland had a U.S.-type financial crisis
with very different institutions? Mainly, that we have to focus as much on
the regulators as on the regulations. By all means, let's limit both
leverage and the use of securitization - which were part of what Canada did
right. But such measures won't matter unless they're enforced by people who
see it as their duty to say no to powerful bankers.
That's why we need an independent agency protecting financial consumers -
again, something Canada did right - rather than leaving the job to agencies
that have other priorities. And beyond that, we need a sea change in
attitudes, a recognition that letting bankers do what they want is a recipe
for disaster. If that doesn't happen, we will have failed to learn from
recent history - and we'll be doomed to repeat it.
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