Women’s out-of-pocket healthcare costs are higher than for men
Out-of-pocket healthcare costs are $15 billion higher for US women than men, qz.com, Clarisa Diaz
Healthcare financial burden on women persists outside of maternity related care. That is the crux of the issue. Women pay more for healthcare.
Consulting firm Deloitte:
The analysis of the resulting costs after the current benefit coverage is applied, indicates a women’s out-of-pocket medical costs are significantly higher than men’s for every age grouping from 19 to 64. The results exclude pregnancy-related services. On average and under single coverage, female employees have approximately $266 more out-of-pocket spending per year than male employees or over 18% more than men’s out-of-pocket costs. This again excludes pregnancy-related services and pharmaceuticals.
Generally, men are more than twice as likely as women to wait two years or more between visits to see a doctor. When they do seek care, they also use fewer services across the board. Forty-six percent of men in the study had less than $1,000 in claims annually compared to 35% for women. Women generally encounter medical services surpassing the typical deductible leading to higher out-of-pocket payments. The higher payments suggest women could be seeking more services from primary care doctors or specialists more frequently than men.
Key categories women spend on besides maternity care, include services in radiology, laboratory, mental health, emergency room, office visits, chiropractic, and physical and occupational therapy. The Deloitte report suggests insurers and employers should closely analyze members and benefits to better understand coverage needs based on demographics and health status. This could be due to their seeking more services from primary care doctors or specialist, more frequently than men.
It is true that exceeding your deductible leads to more out of pocket, but for most policies it also drives significantly higher covered service. On an 80/20 plan you spend $20 and get $100 of service, for which the claimant still under their deductible pays $100. The nature of insurance is that those with low needs subsidize those with higher needs. I think classical insurance products are poor fits for funding healthcare, but from an insurance viewpoint it is just as easy to argue from this data that women as class have a better deal as their total outlays (premiums plus out of pocket) buy proportionally more service than men get.
Mammograms, pap smears, birth control, hormone therapy for menopause are all things that affect women almost exclusively. Were they excluded as well? If they were not excluded, then the extra costs for women seems reasonable, with most of the additional cost meeting the deductible limits, at least based on costs I have seen.