The Gender Schism In Healthcare Costs
Men and women in the United States think very differently about healthcare costs. When I talk about the topic, it’s common for me to see half of my listeners zoning out — the male half. Why? Well, because women make or influence 90% of the health care decisions in this country, according to a study by the American Academy of Family Physicians.
Women are more in touch with health care pricing and more affected by it than men. Women own reproductive health. Women make pediatricians’ appointments and run elder care. Women nag their spouses, be those spouses husbands or wives or none of the above, to get their cholesterol checked, to pick up a prescription, to go to that physical therapy appointment.
Now don’t get me wrong: I like men. A lot. But by and large, they don’t get this issue.
Beyond the studies, here’s one from my personal experience: When our partners from KQED public radio in San Francisco took the embryonic version of our software to a local coffee shop to test it with real people, we had a telling series of reactions.
Lisa Pickoff-White, the KQED producer, took three sample “explanation of benefit” forms with real reports to the Starbucks, with a handful of Starbucks gift cards. She set up a sign saying “Earn a $10 gift card testing our software.” The task was simple: use the benefits forms, put information into our PriceCheck tool, and help us learn how to make it better.
She had six men and five women volunteer. The six men, to a man, looked at the explanation of benefits and complained bitterly about it — then told her her software didn’t work.
The five women? They wrestled through the E.O.B. and inputted their data. Then they said, to a woman, some variation of this: “I’m so glad you are doing this — it’s really important. Let me tell you what happened to (me, my mom, my daughter, my sister, my girlfriend) with a healthcare bill. Thank you for what you’re doing!”
Women earn less than men: an average of 79 cents for every dollar men make. So high health costs have a disproportionate effect on women: that $1,000 medical bill for a woman is a $790 medical bill for a man. Two-thirds of minimum wage workers are women.
In single-parent families, healthcare costs are a constant threat to economic stability. This is true not just for the poor and uninsured, but also for the middle class and the working poor – for whom a $500 or $2,000 or $6,000 deductible bill can be at the least life-changing and at the worst ruinous.
Women run more single-parent households, and are thus benefiting significantly from the Affordable Care Act — but one salary doesn’t go that far. “While the ACA increased the number of insured people, 12.8 million women remain uninsured. More than a quarter (29%) of women remaining uninsured are not eligible for assistance under the ACA because they are undocumented (16%) or they fall into the Medicaid coverage gap (13%) created by their state’s decision not to expand Medicaid,” the Kaiser Family Foundation said in a report recently.
Of course, many men get this issue of rising health costs: My friend Chapin White at Rand Corp., a healthcare economist, said he does all the healthcare pricing work in his family, partly because he has the expertise. Tom Hudson and John Labonia at WLRN public radio in Miami are great supporters of our work. But they’re the exception, rather than the rule.
What does this mean for us, when we talk about shopping for health care? If I’m talking to a woman, she’s often informed and excited. If I’m talking to a man, I often need to explain the entire landscape, and detail who’s shopping for health care, how the marketplace works, and so on. By the time I’m done explaining the givens, our time is up and he doesn’t get it.
Men think no one shops for health care. Women think everyone does.
Jeanne Pinder is founder of Clear Health Costs. A version of this article originally appeared on The Health Care Blog.
