As the nation recovers from the carnage of September 11, we might do well to refocus on the many Americans, including innocent women, who are daily falling sick and dying, not from terrorism, but from lack of health care. Lack of Health Insurance:

An August 2001 report from the mainstream Commonwealth Fund shows that American women are losing health coverage at an alarming rate. Some major findings:

Insurance rates of women are falling below that of men:

• The numbers of uninsured women has grown 3 times faster than the number of men over the past 5 years. Nationally, the numbers of uninsured women is growing fast and could surpass numbers of men by 2005.
  
• Low-income mothers represent 3 out of 5 low-income uninsured parents and one-quarter of uninsured women.

• Women 55-65 are more than 20% more likely to be uninsured than men.

Lack of Access to Health Care Services

The Commonwealth Fund also reports that women have more trouble accessing care than men:

• Uninsured women are nearly 20% more likely to have difficulty obtaining health care services than uninsured men.

• Women 50-64 are nearly twice as likely as men to have trouble accessing care.

Immigrant women:

Immigrant women are less likely to have insurance than other women. In 1996, Congress greatly restricted eligibility of non-citizens to Medicaid (the public health program for low-income women, children, elderly and disabled). People who receive “green cards” (permanent residency) after August 22, 1996, are no longer eligible for Medicaid. Few immigrants, except for refugees and asylees, are eligible for Medicaid.

In real terms, many residents who work here and pay taxes are not eligible for Medicaid or other safety net programs; older immigrants, often brought here by their children, are usually not eligible for Medicare or Medicaid.

Immigrants are less likely to have employer-sponsored health insurance than citizens, for several reasons. Many work for small employers or work several part-time jobs. And, many employers take advantage of immigrants.

Women’s Health in Columbus

Insurance rates in Ohio – 11-12% - are better than the national average – 16%. Yet, many women suffer from lack of insurance and access to care. Women comprise a high percentage of Columbus’ over 130,000 uninsured people.

Columbus has a well-documented lack of primary and specialty care services for people with limited ability to pay. The problem is worsening: Many uninsured people use emergency rooms for primary care. But, in June 2001, we lost Columbus Community Hospital, which saw close to 20,000 people in their emergency room per year, many of whom were uninsured. So far, the city has done nothing to fill the gaps. Doctors North Hospital, which saw 20,000 people per year, is closing in 2002.

So the women who can’t pay for care pay with their health and their lives, especially African-American and minority women.

• Infant mortality in some African-American neighborhoods soars above 20:1,000 live births (compared to the state average of 8:1,000 live births).

• Diabetes is the 4th leading cause of death for Black women in Columbus; for white women, it is the 6th leading cause of death. Diabetes responds well to early diagnosis and treatment.

• Among African-Americans 20 years or older, about 12 percent of women have diabetes. For those 50 and older, the numbers climb to 28 % for women (and 19% of men).

Immigrant Women in Columbus

Columbus’ immigrant population has soared in the last ten years. Although many Somali and Russian refugee families with dependent children are eligible for Medicaid, most immigrants are not, and many work in low-paying jobs that do not provide health insurance.

Immigrant women, especially those who are Limited English Proficiency (LEP), have more difficulties accessing health care than U.S.-born women. In the past two years, most Columbus hospitals have increased their capacity to provide interpreter services to LEP patients. However, major problems remain.

Examples:

• In 2000, UHCAN Ohio’s Language Task Force telephoned 7 out of 10 Columbus hospitals, in languages commonly spoken by people using those hospitals. Out of nearly 15 phone calls made, only one hospital successfully connected the caller, through a telephone language line, with someone who could speak her language.

• Recently, a Spanish-speaking woman suffered a serious foot injury. The first hospital provided her an interpreter immediately, but transferred her to another hospital for specialty care. At the second hospital, she was admitted, received surgery and was discharged, all without receiving medical interpretation. Upon discharge, she called around, looking for someone to translate her discharge instructions and find out if her injuries were permanent.

How to Improve Access to Care

The Commonwealth Fund, in its August 2001 report, mirrored recommendations from many experts:

Expand Medicaid coverage to working parents. In June 2000, Ohio expanded Medicaid to parents with incomes to 100% federal poverty ($17,650 for a family of 4). Enrollment has been triple state estimates. Yet, parents above 100% fpl have nothing. And Ohio has refused to increase eligibility, despite an opportunity to use unspent SCHIP funds. Ohio would only have to pay 29 cents on the dollar to cover more parents.

Give women direct premium assistance (through Medicaid or other funds) to purchase employer-based insurance.

Give tax incentives to employers to provide health coverage – especially in small firms or to part-time employees.

The Commonwealth Fund rejects tax deductions –the chief Bush strategy for expanding private insurance.

While Congress writes a blank check for defense and war, let’s not forget the millions of Americans dying prematurely for lack of health care.

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Cathy Levine is the Policy Director of the Universal Health Care Action Network (UHCAN) which promotes health care justice including universal access, quality and public accountability. They are located at 1015 E. Main St., Room 302, Columbus, Ohio 43205, 253-4340. UHCAN is also a member of Greater Columbus Community Shares. Look for UHCAN in your workplace fund-raising campaign this fall.