Women's health care: why it matters in the health care reform debate.

• Author: Davis, Gregg

The Patient Protection and Affordable Care Act was signed into law by President Barack Obama on March 23, 2010. Different provisions of the lave will be phased in over the next decade. Still central to America's debate is whether the new lave will change status quo spending on health care from an unsustainable path to one that will "bend the cost curve." The factors underlying the present trajectory of health care spending are complex and intertwined, making any debate on health care reform challenging for the American public to comprehend. One way to bend the cost curve is to identify differential patterns of health care utilization and spending. Identifying where "excess rates of disease" occur, and addressing ways to reduce those diseases, is one direct way to bend the cost curve. For example, four diseases that are highly amenable to reduced prevalence rates through preventive measures alone are diabetes, hypertension, stroke, and renal disease. One study quantified the increased costs to the U.S. health care system at $337 billion for these four diseases over a 10-year period, nearly two and half times the projected savings in all the health care bills before Congress. So why focus on health care disparities?

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Disparities in health care reflect variations in access, utilization, and health status among certain demographic groups. One group that is large in number and a frequent user of health care is women. Compared to men, women are more likely to be raising children alone, have lower incomes and hence more likely to be on Medicaid, and have higher rates of chronic illnesses. Women are also more likely to use community health centers and other government programs that provide health services to low-income individuals. Women also serve as the primary decision-makers regarding health matters for family members, so they indirectly control health care spending for the entire family.

Improving the health of all population groups is vital if we are to succeed in changing the current unsustainable path of health care spending. Postponing health care due to cost or lack of insurance is expensive. In Montana, more than $54 million is spent each year on avoidable emergency room visits alone. Improved health increases productivity and reduces the strain on the health care system.

Women are more frequent users of health care than men. Women are almost one and a hall times more likely than men to have visited health care...