A recent report from Deloitte has brought to light a concerning issue in the world of healthcare – women spend a whopping 20% more on out-of-pocket medical expenses than men. In concrete numbers, that translates to a staggering $15.4 billion annually. The findings of this report have raised eyebrows and sparked discussions about the existing gender disparity in healthcare costs.
Beyond the expected expenses related to maternity care, women are bearing the brunt of these additional costs, a revelation that has surprised many. This article delves into the reasons behind this gender-based discrepancy and explores potential solutions, all while keeping the conversation informative and engaging.
The "Pink Tax" in Healthcare
The "pink tax" concept is not new to many of us – it refers to the phenomenon where products marketed to women are priced higher than similar products marketed to men. However, this typically pertains to items like pink razors or floral soaps. What's alarming is that this gender pricing bias has extended its reach to annual check-ups and cancer screenings.
Although the Affordable Care Act mandates equal premium costs for both genders, the Deloitte report reveals that women receive lower actuarial values despite seeking more healthcare treatments. This means that insurance covers a smaller portion of their health claims than men.
Analyzing the Discrepancy
To arrive at these findings, Deloitte researchers conducted an in-depth analysis involving over 16 million individuals aged 19 to 64, all with employer-sponsored health insurance.
They scrutinized these individuals' total medical service costs from 2017 to 2022, assuming each person received the average single-person medical benefit design. The study had limitations as it relied on binary gender data, not encompassing gender-diverse individuals. Nevertheless, the results were striking.
Where Women Bear the Brunt
The report uncovered that women's higher healthcare spending goes well beyond maternity and childbirth care. Categories such as radiology, laboratory tests, mental health, emergency care, office visits, and physical or occupational therapy emerged as key areas where women incur higher costs than men.
Although pharmacy costs were excluded from the analysis, these identified categories encompass a broad spectrum of healthcare services.
Understanding Healthcare Utilization
One contributing factor to this gender discrepancy is healthcare utilization. Men are twice as likely as women to wait more than two years between visits to a healthcare professional. Yet, when they do seek medical attention, they require fewer services.
Women's higher utilization of healthcare services can be attributed to earlier recommendations for annual check-ups, regular gynecological exams, the effects of menopausal transitions, and more. However, the massive gap in actuarial values remains unexplained.
Potential Explanations
There are several plausible explanations for this gap. One possibility is that while insurers cover basic preventive care, they might not cover the more expensive follow-up services. For instance, if a woman undergoes a standard mammogram, insurance covers it, but if she requires additional imaging due to an abnormal result, copay charges start to accumulate.
Another theory is that women might have worse insurance plans with higher deductibles or copays, possibly due to gender disparities in their chosen industries or a higher likelihood of part-time employment.
The Call for Change
The report puts forward a compelling case for change. It suggests that insurers and employers should conduct similar analyses on their members or employees to assess whether essential services are being equitably covered. Deloitte's analysts estimate that adjusting benefit designs to change cost-sharing for specific services would cost employers less than $12 per year per employee.
The incentive for insurers to make these changes depends on their perspective. If higher out-of-pocket costs deter people from seeking necessary care, it can lead to worsening health conditions and, ultimately, more expensive healthcare needs down the line.