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Culhane: Fighting the wrong health insurance battle

September 2nd, 2011 Leave a comment Go to comments

Sometimes I feel like we’re fighting the wrong battle – even when it’s a battle I myself have fought.

The issue of employer-provided health insurance for our partners was recently addressed in a story appearing in the University of Virginia’s newspaper, the Cavalier Daily (and that was linked to this site). The University doesn’t provide health benefits to the same-sex partners of its employees, although it does make them available to the spouses of married couples.

A spokesperson for the University said that state law prohibits the school, which is state-funded, from granting such benefits. (Virginia, as you might remember from my first column on this site, isn’t exactly a friendly place when it comes to LGBT rights.) This statement probably isn’t accurate; state schools have a great deal of autonomy, and the school might well be able to grant the benefits absent a specific law that would prevent them from doing so.

Even if the school wanted to avoid incurring the wrath of the state’s right-wing governor (whose propensity for outrageous assaults on GLBT rights is exceeded only by his willingness to back down when the political costs are too high) and legislature, it could easily sidestep the problem. Here’s how the University of Michigan did so:  it simply created a new category of benefit-eligible employees (“otherwise qualified”). If anything, the task was harder in Michigan because of a state supreme court ruling that read the state’s marriage anti-equality amendment to prohibit any government entity from recognizing the status of domestic partnership.

In short, the University of Virginia could allow the benefits, if the will to do so were there.

And the current policy has a cost of its own. First, partnered LGBT employees feel they’re being treated unfairly. The Cavalier article quotes a professor Ellen Bass, who has concluded that it’s cost her “thousands of dollars to be a gay person” at the University – in part because neither her son nor her partner are covered by her health insurance.

Second, for every person like Bass, there are doubtless many others who might pass over the University, which is an otherwise prestigious and desirable employer, in favor of other schools with more enlightened policies. Those who have such choices are likely the most qualified of the applicant pool.

This issue should be easy.

Health benefits are a valuable and, for many, vital part of compensation. Eight years ago, I went to my law school’s dean to make this case. Within a year-and-a-half (light speed by university standards), it was done. The university had no answer to the dean’s argument that, by providing benefits to straight couples but not gay ones, they were fostering an unfair wage disparity.

But is it really that simple? Not if we start from a different place: Why do employers offer (much less pay for) health insurance in the first place? It wasn’t always thus; during World War II, employers came up with the idea as a way to get around the wage freeze that was then in place. And then the practice just…stuck. To make the pot even sweeter, many employers now offer benefits to the families and spouses of their employees, too. But this only creates a wage disparity between employees. The single worker realizes less of a benefit than the one with a family.

Granting benefits to same-sex partners doesn’t solve this problem; it only addresses one small part of it. Someone needs to come up with a better idea; like, oh, I don’t know…single-payer, universal health coverage?

That’s not going to happen any time soon. So we continue to skirmish over the extent of coverage in an accidental system. We have only this hand to play, but should remember that the goal is to get as many people covered as possible – no matter what kind of relationships they’re in.

John Culhane is a Professor of Law, a contributing writer for Slate Magazine, and a blogger. He is the editor of “Reconsidering Law and Policy Debates,” and contributed the chapter on marriage equality.

  1. hot501s
    September 2nd, 2011 at 10:05 | #1

    > Someone needs to come up with a better
    > idea; like, oh, I don’t know…single-
    > payer, universal health coverage?

    Exactly. Keep fighting the good fight, John.

  2. lukebrux
    September 3rd, 2011 at 10:59 | #2

    I still think as european that it’s a shame that a country like US doesn’t have a universal medical coverage where everybody pax taxes to build a system for everybody. I still ask to myself how this easy, fair and right system it’s not applicated in US. Why giving to private insurance something vital like the public health?
    Even in developing countries they understood that.

  3. Kari
    September 3rd, 2011 at 20:11 | #3

    In general, the more people in a risk pool, the lower the cost of insurance is per insured. This consequence of the Law of Large Numbers is one of the reasons medical insurance (and increasingly, other forms of insurance) are offered as employee benefits.

    Of course, the largest possible group would be the size of the population (a single-payer system), but I wouldn’t expect that to come about given the politics of it. (And, notably, the fact that the health insurance companies line the pockets of many legislators.)

  4. DaveW
    September 12th, 2011 at 14:57 | #4

    I recieve the gold standard employee sponsored health care and have had my (now) husband on the policy for many, many years.

    I had an aortic aneurism (still can’t spell it) that was very close to killing me diagnosed two years ago and 400k of the companies money later, I’m in good health (we are self insured, using an insurance company simply to adminster, so this was truly out of my company’s pocket).

    Even I now support single payer. Not because I think the care would be better, but because of the many indegent people I saw in my ward who I know were causing the bill to my company to go up. These people deserve this care, but should my company pay for it?

    What about all the people who use the emergency room as they have no other option? (sure, education could help them avoid this costly choice too…)

    It is a matter of fairness, but for me, single payer is actually a CONSERVATIVE issue because it would save money by spreading the risk and causing all to pay something into the system.

    Now, I have a friend in the Netherlands whose best friend just left the country to give birth in Hungary, beacause of better health care. (can you believe it?)….so we keep hearing how good the Netherlands does it. I’ve been to Hungary, and I’m not sure why she went that route, but my point is we need to do it better than the Dutch, but we need to do it.

    Won’t happen with our disfunctional government that can’t even set a balanced budget. We have much bigger issues it seems, not the least of which trying to get a candidate for president that doesn’t put their cult beliefs ahead of science.

    We have a very long way to go.

  5. Jessica K
    September 13th, 2011 at 15:19 | #5

    The Republicans don’t want the single payer system because that would cause their Ins. Co. friends from making the huge profit they currently enjoy.

    @DaveW, I agree, this health care law will make the deadbeats pay at least something rather than the current nothing they pay.

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