Posted by: Emma Carys Dixon | March 26, 2020

Women, Pre-existing medical conditions & health care

One thing that I have thought about in the back of my mind this whole semester is the differences between men and women when it comes to medical care. We’ve talked about how women face certain disadvantages when it comes to getting top positions and double binds placed upon them. But what about the health sector?

As someone with multiple pre-existing medical conditions, it got me thinking if there were any differences between how men and women receive medical care. It also got me thinking about if men and women have different access to health care coverage due to pre-existing medical conditions.

I found an article by Planned Parenthood that first explained what a pre-existing condition is. Essentially, a pre-existing condition is anything in someone’s medical history that would allow health insurance companies to charge that person more for coverage or deny them coverage outright. Pre-existing conditions can also be that your family has a history of a health condition even if you do not have that condition yourself. 

What was most shocking to me was that there are so many things labeled as a pre-existing medical condition that are not chronic illnesses like asthma, high blood pressure, and allergies. If you have anything deemed as a pre-existing condition you can be denied health coverage altogether or could face higher premiums than most. 

Now, how do women tie into this?

The article talked about how just the act of being a woman is almost considered a pre-existing condition. Now, what does this mean? It means millions of women were denied coverage because of things the health insurance companies labeled as pre-existing conditions. Pregnancy and irregular periods were considered pre-existing conditions for women. 

This caused a huge gap between women who were labeled as having pre-existing medical conditions and men who had pre-existing conditions. There were 29.4 million women who were deemed as having a pre-existing condition compared to only 22.8 million men. 

This large discrepancy is due to the fact that there are many bodily functions women go through that men do not. For example, if you had been pregnant or wanted to become pregnant that is considered a pre-existing medical condition. If you had a C-section or have irregular periods, this is grounds for a health insurance company to deny you coverage or charge you higher premiums. 

Another thing I found shocking was mental health needs are also a pre-existing condition, and women are 40 percent more likely than men to develop mental health needs. This means women were paying $8,490 more each year than men in order to get the same mental health treatment.

Okay now I know what you’re thinking. What does all of this have to do with women and leadership? 

I think this is an important topic related to women and leadership because all of this can affect the development of women leaders.

Women who are denied or can’t afford the higher premiums because there are more factors that allow them to be labeled as having a pre-existing medical condition have less access to health care than men. Not having access to or having to pay more for basic health coverage than men puts women at a disadvantage in the health industry as well. 

If women can not get or afford access to health coverage because they have more ways to be deemed a pre-existing condition than men then they cannot take care of themselves physically or mentally which are both important to develop into a leader. Women are expected in society to have children and start a family yet they are denied health insurance or charged for more coverage when they do have children. It is yet another double bind that women face. 

Because women can get pregnant and have periods, they are discriminated against when it comes to getting health insurance from insurance. It is another, often less talked about, obstacle in the labyrinth women have to face and overcome in order to be successful.


Responses

  1. I think this topic is extremely interesting and very discriminatory for women. I’m honestly very surprised by these findings and never even thought about whether women were treated differently in the health care system. I think its completely unfair for pre-existing conditions to include having a C-section or irregular periods. Both of those “conditions” are completely uncontrollable. Having a C-section is usually not a choice, it is usually because the baby did not turn and is unable to come out any other way, and that is not the fault of the mother. Irregular periods are also uncontrollable, most of us don’t even want to deal with them in the first place. I did a little google searching and found a cool podcast and a disturbing article on the topic.

    The podcast includes a conversation between three women that worked on a report about women’s medical care. They discuss that when the Affordable Care Act (ACA) was put into place there were many improvements for women’s care. One of those improvements included that maternity coverage needed to be covered as part of your care, before this you could be denied because of pregnancy. However, this was surprising to the women because many of the ACA changes are things that other countries have had for much longer. One of the women graduated from Harvard with a master’s in public health and it was the first time she had been uninsured. In other countries, she was assigned a national health insurance patient number and did not need to worry about how much the service was going to cost her. The fear of medical costs is unique to the U.S. in the developed world. One woman discussed the struggle she had to find an OB/GYN that was both accepting patients and covered through her insurance, and she was still afraid of receiving a large medical bill. She and her husband had also discussed that she would only receive a C-section if it was a true medical emergency. The podcast includes many other fascinating facts from their conversation that I highly recommend you listen to or skim through the transcript (I found it very interesting and educational).

    The article I found opened with the story of Joyce Sasser, who was born in 1970 with no bones in her thumbs. Her doctors had blamed thalidomide, a drug that used to be used for morning sickness, even though her mother swore she had never taken it. The doctors did not listen to her and continued to treat Joyce according to their theory, including one that permanently stunted her arms. When she was 20 and pregnant with her first child, the doctors found that she had Diamond-Blackfan anemia. The article continued with some interesting facts about the differences between men and women’s health care. In a 2008 study of about 1,000 patients in an emergency room found that women waited an average of 16 minutes longer than men. In 2000, a study found that because women have different cardiac symptoms than men’s, women are 7 times more likely to be misdiagnosed and discharged during a heart attack. One doctor even had a woman tested twice, blamed the machine, had himself tested and when his results came back normal, he finally admitted her. In a 2014 survey, more than 2,400 U.S. women with chronic pain conditions were told that the pain was all in their heads.

    I find these women’s stories and the studies findings very concerning. If women already struggle to get medical care, it doesn’t help if they don’t receive the care they need. The article blames the lack of women doctors and the lack of focus on women’s diseases in medical school. Do you think their are other reasons that could cause women to be discriminated? Why is being a woman considered a pre-existing condition?

    Podcast: https://www.commonwealthfund.org/publications/podcast/2019/jan/how-us-fails-women-when-it-comes-health

    Article:
    https://www.voanews.com/usa/women-minorities-work-harder-get-good-health-care

  2. This is such an interesting topic and I learned so much from your post. Before your post I was aware of what a preexisting condition was and how these affect rates and coverage of health insurance, but I had no idea that pregnancy was a preexisting health condition. I know that giving birth in a hospital is very expensive and the fact that health insurance companies make this process even more expensive for women is infuriating. I also did not know that mental health needs are also considered a preexisting condition. Not only did you mention that women are 40% more likely to develop a mental health condition, but when I was researching my annotated bibliography topic on the discrimination and obstacles faced by female police officers, I found that female officers were also more likely to actively cope with the stress and burnout that they faced than male officers, meaning that they would participate in measures such as counseling or support groups to cope with the stress and treatment they received in their job. Having said this, I think it is so incredibly unfair and unhealthy to penalize women for their mental health or their choice to receive help in coping.

    I completely agree with you that this is most certainly another double bind for women as women are almost expected to become mothers, yet this is deemed as a preexisting condition for health care, making it more financially difficult for women. I think this should be something that is reformed in our healthcare system.

  3. Unequal access to healthcare for women adds to the labyrinth that is women’s leadership. It is another thing that women have to think about that men do not. Unequal access to healthcare causes people to live in poverty, unable to pay their medical bills. In addition to having to pay medical bills because their healthcare may not cover it women have to buy feminine products monthly. Just buying tampons a woman will spend around $1,773.33 according to Huffington Post. These are expenses that men simply do not have to think about.

    Preexisting conditions are also interesting at a time like this. With the pandemic, there are not enough ventilators in the United States to care for all patients. Doctors are being forced to choose who will live and who will die. As the article Emma founds suggests, women are more likely to have preexisting conditions. These preexisting conditions could be the reason the doctors decide they should not get a ventilator. After this pandemic is over I will be interested to see the statistics of who recovered and who died in relation to gender.

  4. Wow, I didn’t know that there was such a stark difference in pre-existing conditions and health insurance. I don’t know much about what defines a pre-existing condition, but family history and current or future medical needs makes sense to me. Women are expected to pay more because of pregnancy and irregular periods. With these added ‘symptoms’ of being a woman, rates are sure to go up. But this makes sense to me. I understand how pre-existing conditions could be used to justify charging someone more or denying coverage. What is discriminatory about this for women is that pregnancy and periods are part of every woman’s potential life. High blood pressure, asthma, allergies etc, are not. I understand that irregular periods and potential pregnancy are more collateral. Maybe women should be charged more? We biologically have a higher level of need for health coverage due to pregnancy/irregular periods. Just as if a man has a history of testicular or penile cancer in their families, they should also be charged more (given the current method of health coverage decisions). What I do not agree with is the denying of coverage because of pregnancy. Pregnancy is a choice (usually). Allergies, history of cancer, high-blood pressure (usually), irregular periods, are not. So to deny coverage because a woman plans to have a family one day is wrong – that is where the true discrimination in this process lies. You are offering an ultimatum on a woman’s choice to become pregnant one day if you are willing to deny coverage with pregnancy as a contributing factor. I also really like your leadership tie-in here. I think the connections between health coverage rates, mental health, and women’s leadership are not uncorrelated.

  5. I absolutely love this post, because it is extremely true. My mother is employed by the state of Connecticut, which should be supplying some of the most optimal coverage, but she has complained to me many times about the differences in medical expenses between us and my brother and father. I think it is incredibly unfair that insurance companies are able to claim that certain conditions that afflict women over men should be charged. Women should not be hindered because of predisposed medical conditions. I think that it is very interesting that you related this to how it can affect women in leadership. Even down to menstruation, some women experience such severe cramping that it restricts movement. Although this can be medicated, if an insurance company refuses a patient because of this condition, or up-charges the medication to an unreasonable amount, it could be near impossible for some women to work under this condition. This is just one example of how women can be affected by insurance companies downplaying their predisposed conditions, but mental health is a big aspect as well, as you mentioned.

  6. This is a super interesting post. I immediately thought of how this might effect women of lower socioeconomic class and women of more interestingly backgrounds more profoundly than the standard woman. Just as being a woman is almost a pre-existing condition so is being a poor, black, Hispanic, queer, etc woman. Each of the layered identities of a minority woman brings more and more heath issues or risks. The less privilege a woman has the more likely she is to have a preexisting condition and the less likely she would be able afford health coverage on her own. This adds more hidden corridors, traps, and tricks to her labyrinth. This institutional bias is deeply rooted in our society and more likely than not the only way we are going to see change is if a female legislator decides to bring attention to this discrepancy.

  7. I hate that this is true as I agree with you, it is definitely a double bind for women. To me, it seems almost like the insurance agencies are discouraging women from utilizing health services. I think it is unfair what is considered a preexisting condition, such as simply desiring to be pregnant. It is ironic to me that while it is considered a health condition, based on previous blog posts, it is extremely difficult to get proper leave from work for the birth of children. More unfairly, some men get more leave than women. If this is the case, why are women charged more due to their preexisting condition of pregnancy, but men get more benefits? However, I wonder if this is balanced out by the fact that men pay higher car insurance as they are statistically found to drive more recklessly. I understand that women and men have different health criteria, but I honestly do not understand the large price differences. I agree that it does largely hold women back in leadership.

  8. I had truly never considered this aspect to the labyrinth for women leaders, but this seems like such an important thing to point out. I think a topic like this might seem unrelated to women obtaining leadership, but it’s the increased inequality between men and women occurring over and over again in basically every corner of life that compounds and affects what women as a whole can achieve. I like how you brought up implications for emotional health care not just physical. If as a person you cannot afford get the care you need to be mentally and physically your best self, how can you be expected to continue moving through the labyrinth and obtaining fulfilling leadership? In addition, the double bind of having societal expectations on having children placed on women and the inequality of health coverage for the potential to have children is crazy to me. Women are punished for having children, they’re punished for not, and they’re even punished for having a uterus making it a potential for them to have children – this does not make any sense and until health insurance companies face backlash for this, it probably won’t change.

  9. I really liked this post because health care and pre-existing conditions within males and females is truly something I have never considered before, and this is the first time in a long time I have been genuinely shocked by a post. It is not surprising to me that women are treated differently when it comes to health care coverage, however I cannot believe that it is due to irregular periods. I genuinely can’t even wrap my mind around the fact that pregnancy or future pregnancies, C-sections, and irregular periods qualify as pre-existing health conditions, meaning coverage can be defined or expensive fees can be charged to women. I don do not even understand how these things are applicable, and I would be interested to hear the justification behind these things.

    From the basic understanding I have of healthcare and pre-exisintg health conditions, I understand that certain plans do not like to cover those that have many and extreme pre-existing health conditions because they are at a higher risk of experiencing things that health insurance will be forced to cover even though they are aware of the possibility of them occurring. Therefore, those who have these conditions often do not receive as much coverage because they are at a high risk for these conditions and it is not random, it can be expected. Things like high blood pressure makes sense to me because of the negative health implications it can have on someone, however I would be curios to see what people think irregular periods and pregnancy could cause. This reminds me of the stereotypical idea that all men are scared and uncomfortable of women’s periods, which is entirely absurd.

    I also agree with the point you made that this absolutely impacts women and leadership. I think it is incredibly difficult for a woman to be able to accept herself and her bodies’ regular functions when the healthcare system refuses to recognize them as normal. Women are placed at such a disadvantage for so many things, but I never thought that they would actually be charged for health insurance because their bodies are functioning as they are supposed to.

  10. This is so interesting and something I had never really considered. In another gender studies class I was in, we discussed at length the disparity in treatment of men and women in terms of how doctors and other health care professionals actually treat and believe/ listen to the needs and concerns of their patients, including the increased disparity in dismissal of concerns of people of color and queer persons, but I had genuinely never thought about the issue insurance. I really appreciate your post because it has made me think of a number of problems for women and other marginalized people that are likely very salient in the midst of the covid19 pandemic. Although not directly related to your post, it has made me curious and concerned with how those suffering from covid symptoms are being treated. It feels very obvious with everything in the media that people without health insurance are at an enormous disadvantage currently, which disproportionately has impacted women and people of color.
    I find it so outrageous that women are expected to have children (at least in order to “have it all”) but that they are still punished for this in a way? If potential pregnancy is a preexisting condition that causes insurance to be more expensive, how does it make any sense that women also are in a way expected to work less intensive jobs/take time off if they do end up having children?

  11. This is super important in a time like this where for most Americans their health insurance is tied to their jobs. Now, due to COVID-19, a medical crisis, so many people have lost their jobs and therefore their access to health insurance. These people are going to be seeking health insurance outside of their workplace, which is already typically more expensive, on top of the uncertainty of not having an income and needing to pay high insurance premiums due to “pre-existing” conditions. Or, they could just not have health care… in a pandemic… . This reminds me of the olden days, or how it is in other less developed countries, where if you are a women you don’t receive any form of medical treatment at all, or only if your husband allows it.

    Lack of access to health care, whether due to a cultural situation, or lack of health insurance, or any other way, is a violation of human rights. All people should be able to access the proper care that they need. This prevents so many women and children dying in childbirth. So many young children from dying of a preventable or curable illness. These people who are dying have a future, and could be the ones to go off and be our next great leaders, but they died too young for a purely preventable reason.


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