But the most staggering takeaway from the Parsley survey was that 80 percent of women were simply delaying medical care. “The reasons were time poverty; feeling like they were going to go to the doctor and basically just be dismissed, handed a pill, and shuffled out the door not getting what they need; and the third was cost,” says Berzin. A recent Deloitte consumer survey supported those findings with one in five women saying they decided not to see a doctor when they were sick because of cost, and one in seven delaying follow-up care because of cost. And their fall research report (aptly titled Hiding in plain sight: The health care gender toll) delved further into gender-based pricing discrepancies and found that women are paying significantly more in out-of-pocket healthcare costs: $15.4 billion more a year, a disparity that persists even when you take out all the charges related to pregnancy.
“The value that we get for a dollar is less than the value that men get,” says Kulleni Gubreyes, MD, Deloitte’s US Consulting Health Care Sector Leader and US Chief Health Equity Officer, who started out her career in public health and as an ER doctor. “We’re paying more for the services that we get because we use healthcare differently.” Women often don’t reach their out-of-pocket mark and the services they need require more co-pays, so they end up paying the same amount for premiums as men, but getting less value. Even though they use certain health care services, like radiology, physical and occupational therapy, emergency room visits, and mental health services, more than men.
One common gap in spending is around breast cancer screenings. Your initial preventive screening is covered but, says Gubreyes, for many women medical needs dictate that they will require additional tests. “Research shows that one in 10 women will have an abnormal initial diagnostic mammogram,” says Gubreyes. “The way that cost-sharing is designed, once you’re that one out of 10 women your costs skyrocket, because then you need an ultrasound or a biopsy or an MRI, and all of these are additional copays.” What if insurance costs were designed, not as one-size-fits-all, but with women’s biological and physiological needs in mind, Gubreyes posits. “For example an insurance company could create an episode of care that once you have an abnormal test your co-pays are a single amount as opposed to being a la carte where you’re paying for every single thing until you get to the final answer,” she adds.
To begin to close some of these gaps Deloitte in their report suggested employers look at how they design their benefits and what the value is of the care women are getting, and lower the cost-sharing of services that women use with more frequency. Meanwhile Parsley Health is increasing the number of major employers they’re working with so they can make their holistic care model more accessible. “In both the medical world and our culture at large, we’ve all been trained to not go to the doctor until you’re really sick,” says Berzin. “It should be in the healthcare system’s interest to be more proactive about health.”
In the meantime though, it’s on women to be proactive about both seeking out care when they need it and also evaluating how that care is covered. Now, about that tax on women’s time…
