Journal of Gender, Race, and Justice
Women; Poverty; Access to Health Care; Reform
The authors analyze the effect of unintended consequences and unconscious gender-based bias on attempts at health policy reform in the United States. Recent reforms in national health policy that would seem to address issues particularly relevant to women have been more symbolic than substantive in scope and impact. Part I begins by analyzing data on health care status, treatment, and outcomes for men and women. The data on health care status is intriguing because women have a longer average life expectancy than men. Part II then reviews the conflicting evidence about gender-related differences in health care treatments and outcomes. Part III carries these themes forward by emphasizing the connection between access to care and access to health insurance. The authors explore the data on access to health insurance for women and conclude that women and men are insured at similar rates. Women are more likely, however, to be covered by public health insurance programs. In Part IV, the article analyzes the role of gender in the private and public insurance markets. The authors argue that women's increasing political power has resulted in greater regulation of the private insurance market in ways that, at least symbolically, benefit women covered by the private market. Part IV also explores the negative impact of the politicization of public health insurance, focusing on the impact of symbolic reforms in the public provision of health benefits. The authors note that women are disproportionately at risk for governmental intrusion into personal health decisions because they are more likely to be poor or old and, therefore, are more likely to be covered by public insurance programs. The authors conclude that women appear to be at risk for unconscious bias in treatment or in the design of health care systems but that further research is needed on the relationship between gender, health care treatment, and health care outcomes.
Mary Anne Bobinski & Phyllis Griffin Epps, "Women, Poverty, Access to Health Care, and the Perils of Symbolic Reform" (2002) 5:2 J Gender Race & Just 233.