Feminist Currents

A year ago, as the nation heard about "death panels" and misinformation about health reform poisoned civility when "tea party" activists disrupted town hall meetings, I asked, "What stakes do women have as women in the politics of health care?" and I explained, "While scholars have uncovered the workings of gender in the shaping of medical research and delivery, here we want to collect personal experiences and prescriptions for change from feminist perspectives." Though the question was widely circulated, few of you responded. Steve Wilson, however, provided a useful commentary worth pondering: "The depersonalization of the patient seems to cross gender lines." That is, while sex or age discrimination might enter into treatment, the question of medical expertise can make interactions more of a "patient-doctor issue than a woman's issue."

Now, as I put together this "Feminist Currents," six months have passed since President Barack Obama signed the Patient Protection and Affordable Care Act. What does this modest beginning of health care reform mean for women and our families? Recall that during the final negotiations questions of women's access to reproductive services offered a platform to anti-abortion forces trying to stop passage of the bill. Even though many provisions of the bill would fulfill the mission of the Catholic Church to improve the lives of the poor, the bishops encouraged politicians such as Representative Bart Stupak to introduce a ban on the coverage of abortion in health insurance pools and other government plans even if paid for by private or individual monies. Despite the defeat of this initiative, restrictions on abortion still may enter the operations of preexisting health care insurance plans through administrative rules that were proposed but not finalized as of this writing.¹

How will women benefit from the reform? Like other Americans women no longer can be denied or dropped from insurance because of preexisting conditions or have lifetime limits to benefits imposed upon them. The government will offer preexisting insurance coverage plans to eligible people. Their children must right away gain insurance even if they have a preexisting condition and can stay on a parent's plan until age twenty-six. Cost sharing, or copayments, will end for preventive care measures, like breast cancer screening, bone density tests for women sixty-five and older, mammograms, PAP smears, and prenatal care. Particularly important for women is the right to choose one's ob-gyn without a prior referral from a general practitioner. The qualifying income for Medicaid when the act is fully implemented in 2014 will extend to those 133 percent above the poverty line. Finally, the act expands Community Health Care Centers that cater to low-income people.²

For this "Feminist Currents" I hoped that readers would share their health care experiences. Perhaps the topic is too personal, though the women's health movement of the 1970s taught us that our care is political in ways that the ongoing debate in Congress merely reinforces. If Republican opponents gain control before full implementation, this health care reform, despite its limitations, could be repealed. It certainly would be starved through refusal to appropriate funds. That Obama's reform is more insurance reform than universal health care speaks to the political reality rather than our needs.

Respondent Rebecca Plant, who holds an MPH, reminds us that women's health is more than reproductive health:

Perhaps I am biased because I have studied public health, but I believe that the physical and emotional health of our nation as a whole is more important than almost anything else. Without health, we cannot accomplish much. And, as many of us who were lucky enough to have caring and attentive mothers know, women are primarily responsible for everyone else's health. Women, even those who work full time outside of the home, still tend to be the primary caretakers of children, and often make most health-related decisions for their families. Women tend to be "early adopters" taking the newest health information and putting it into practice before their male counterparts do. Additionally, their spouses and children depend heavily on them for caretaking and emotional support. Therefore, any health...