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Most older women's healthcare prospects grim

By Morgan Currie

Wanda Mae Schindler has serious reasons to worry about her future. At 62 years old she suffers from depression, thyroid problems, and a joint syndrome that causes her to clench her teeth at night, giving her headaches. With only $320 a month from Social Security, she has the impossible task of stretching this over a $297 rent, her food and utilities, and, starting in July, her expensive healthcare. She is one of the casualties of Measure 30, which raises the bar on who is eligible for the Oregon Standard Health Plan starting this summer. The questions she now asks herself are who will pay when she goes to the doctor, and will they even accept her now that she doesn’t have insurance?

“Come August,” she fears, “I will be without anything.”

Schindler is typical of the escalating crisis for midlife women who fall through the cracks of Medicare and employer-based insurance. A new report released by the Older Women’s League (OWL), called the Mother’s Day Report, details this crisis with a sobering study on healthcare cost and how it affects the aging female population. Produced by the only grassroots organization to focus on elderly women’s health issues, the report reveals that more Americans are lacking health insurance than ever before, at the same time that health care costs are soaring. Aging women are particularly prone to fall through the gaps of our healthcare system.

The report shows how midlife and elderly women are uniquely at risk of not receiving the coverage they need. In 2001, 15 percent of women age 60-64 — one in seven — had no health insurance at all, compared to 12.7 percent of men without insurance. Many women in this age group are married to older men and may rely on their husband’s Medicare coverage or Social Security benefits. Yet when their husbands die — and women outlive men by an average of six years — their husband’s coverage will only last another 18 months (through COBRA). Afterward a woman must find a job or cross her fingers and hope that no serious health problem befalls her before age 65.

Medicare is then available to women 65 and older, yet women are less likely than men to afford augmenting their basic coverage with private insurance. Reasons for this include the wage gap — women still make 75 cents to a man’s dollar — and the fact that women are primary caregivers of children and the elderly, averaging 14 years out of the workforce to perform unpaid work. This sets them up for economic insecurity in retirement.

Those at the official poverty level can qualify for much-needed Medicaid to pay for prescription drugs and healthcare costs Medicare doesn’t cover. Yet millions of seniors are forced to scrape by on very modest means without ever qualifying for Medicaid. The majority of these are women. In fact, two-thirds of all seniors with household incomes just above the poverty level, at 125 to 200 percent of poverty, are women. Many of these are widows or unmarried women who depend far more on Social Security than men do and and have an annual income about half that of a man their age. Poignantly, the average woman on Medicare who also lives alone is more likely to spend her out-of-pocket money on healthcare than on food.

The OWL report attributes these issues to the overall flaws in America’s healthcare system. The report shows that as of 2002, the majority of those lacking insurance are workers in private industry, where less than half of American workers carried health insurance through their own jobs as compared to nearly two-thirds in 1993. Moreover, costs have soared to a record amount, up 47 percent from five years ago. And the future looks bleak as the service-producing sector balloons, where only 42 percent of workers in these industries have health benefits. Wal-Mart best embodies this pernicious cycle, since the conglomerate offers either no benefits at all or offers them at costs that few can afford.

In Oregon, where 20 percent of the population is uninsured, the effects are palpable.

“It’s a screwed-up system and unfair,” says Liz Stevenson from Oregon Health and Policy Research. “Employment-based insurance means if you’re not a part of the mainstream system, you’re excluded. People fall through the cracks, and it’s growing. When the number of uninsured increase, everyone pays for that.”

Stevenson explains that as the economy collapsed in 2001, the state government began their cutbacks in the Oregon Health Plan. “It’s heartbreaking for state and local governments who built plans over the past decade to watch them being dismantled.”

Tim Miller runs the hotline for the Oregon Health Action Campaign, whose mission is to enable people to enter the Oregon Health Plan. These days his phone doesn’t stop ringing.

“If you’re not pregnant or a guy, you’re valued less,” he claims. “You have to qualify at or under 100 percent of poverty to join OHP, and that’s making $776 a month, and you still don’t get dental or mental health coverage. There used to be 110,000 people covered two years ago; now it’s dropped to between 42,000-48,000.”

To remedy these problems, the OWL report advocates a single-payer system of universal healthcare. To pave the way for this single-payer system, it recommends a “buy-in” option for people ages 55-65 to pay a reasonable premium and receive Medicare part A and B benefits in the precarious years preceding the full Medicare package. The report also calls for increased benefits under Medicare and the repealing of the Medicare Prescription Drug and Modernization Act of 2003, to end the privatization of Medicare.

Pushing for universal healthcare for all, says OWL, would finish the job begun in 1965, when Medicare was first enacted by the government as a way to take responsibility for those most vulnerable in our population. A single-payer system would ensure that people who now fall through the cracks, like Wanda Schindler, would receive the care that they desperately need.

Morgan Currie is a writer and filmmaker living in Portland. She currently works as an associate producer at Oregon Public Broadcasting.

 

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Last Updated: June 7, 2004