Originally appeared on DSA’s Democratic Left blog.
March 8 is International Women’s Day – celebrating the struggles and achievements of women around the world. While IWD was initiated by the Socialist Party in the United States, for decades it was ignored in the U.S. until the second wave of the women’s movement revived it in the 1970s.
Yet its revival isn’t reflected in the actions of Congress. For example, on January 28, Republican leaders in the Senate scheduled a vote on the “Pain-Capable Unborn Child Protection Act,” a bill that would ban abortion after 20 weeks. The procedural vote set by Majority Leader Mitch McConnell failed as expected, but the attempt to further restrict reproductive rights came just a week after the Trump Administration introduced new rules granting health care workers the license to discriminate against women seeking an abortion. These two measures expose both the Trump administration and GOP perspectives on women and health care and are in stark contrast to the Medicare for All bill introduced by Bernie Sanders last September.
The Sanders bill, S 1804, protects women’s reproductive rights and takes a crucial step in the fight for reproductive justice. The bill would repeal the Hyde Amendment, which for decades has restricted access to abortion. Pro-choice groups such as NARAL have endorsed the bill; their president, Ilyse Hogue, called it “a groundbreaking advancement for a simple truth: we will never solve our healthcare crisis until women have full access to reproductive services.” The bill goes farther than that – it would provide women across the country comprehensive care covering breast and cervical cancer screenings, contraception, domestic and interpersonal violence counseling and various sexually-transmitted disease and health screenings.
Yet reproductive justice and women’s health are but two positives for women in a universal health care program:
- Women currently interact with the health care system more frequently than men and thus pay more than men for health care;
- Women are also more likely to be the parent who deals with children’s health care needs;
- Women are more likely to be the caregivers for aging parents and spouses;
- Women are among the most important workers in the health care system and among the poorest paid.
A recent study in the Journal of Family Practice showed that “[w]omen have higher medical care service utilization and higher associated charges than men.” Insurers use this as an excuse to charge women more. Women pay more than men for comparable coverage. In some cases, a woman who doesn’t smoke pays more than a man who does for the same coverage. Women tend to live longer than men, and thus older women represent seven in 10 of all Medicare beneficiaries living in nursing homes, assisted living facilities, and other long-term care facilities. Yet Medicare only offers time-limited coverage for long-term care services provided in facilities or in the community. This coverage limitation exposes many women to high out-of-pocket spending when they can no longer live independently and need care for extended periods of time.
Women are also typically responsible for their children’s health care – when Sam gets the flu, his mother Helen must stay home to care for him and thus loses the wages she gets from her nursing job. Family and medical leave in conjunction with universal health care would provide some additional protection for her as she takes care of her family. Medicare for All would also provide better coverage than the cheap plan she currently has access to – one with few protections for chronic illness for her children.
So women encounter the health care system not only for themselves but also for those they care for – and that’s not only their young children. Take Betsy – her adult daughter, Alice, can’t work and so Betsy and Alice rely on Medicaid to get Alice the help she needs with her mental health issues. And Amy’s husband has senile dementia – she’s trying to get Medicaid so that she can get help with his care, but in many states access to Medicaid requires the recipient to work, something Amy’s husband just can’t do. Women are much more likely than men to become caregivers for adult children who can’t find jobs and thus don’t have insurance, for aging parents who can’t afford quality nursing home care, or for spouses like Amy’s husband Bill who can no longer take care of themselves. Two-thirds of these unpaid health workers are women.
While women represent the unpaid labor that supports our costly but inadequate health care system, women also make up the vast majority of paid health care workers. Three-fourths of hospital employees and those working in doctor’s offices are women. Almost 90% of home health workers – visiting nurses, physical therapists and other health aides – are women. They are often among the most underpaid. One-quarter of home health workers live below the poverty line. A recent Washington Post article described the plight of a school nurse who must work two jobs just to stay above water.
As we fight for universal and comprehensive health care we must recognize that this is a women’s issue. From reproductive health to children’s health, from maternity care to aging, from insurance to health care work, women are the ones suffering in our current system.
Our fight for health care has to ensure that women are a focus of our efforts. By working on family leave and Medicare for All, the Austin DSA local shows how care-giving and health care are linked. Pairing work on Medicaid with universal health care gives an opportunity to fight back against the cuts of the right while showing the importance of universal health care. Linking labor solidarity with health care shows fighting for women workers results in better health for all of us.
The fight for Medicare for All is the first step in ensuring universal and comprehensive health care and the first step in our campaign for democratic socialism.
Christine Riddiough is a member of the DSA NPC, the DSA Medicare for All Steering Committee, and a long-time feminist activist.