Wednesday, November 12, 2008

not covered

I never got around to blogging about this back at the time, but when I was first hired for my new job, I had to fill out a whole bunch of forms for HR, some of which pertained to the health care plan that I would be covered by. There were two options, a PPO and an HMO, with thick booklets explaining the difference between the two.

I didn't know much about the difference between the two, save that I've only ever heard HMOs referred to with scorn, and I remember one Dykes to Watch Out For comic featured a character wearing a tshirt that read HMOphobic. It turns out that it basically has to do with how much freedom you want to be able to choose your own doctors and specialists vs relying solely on the people that are chosen for you. The HMO is also the cheaper option, in terms of monthly deductions from one's paycheck.

What struck me the most, as I settled down to compare the two and make my choice, was how similar (and surprising) they both were on the topic of transsexuals. Both booklets contained an extensive (though not exhaustive, as they took pains to disclaim!) list of items not covered by the plan, ranging from refractive eye surgery to infertility treatment to foot orthotics. But waaay at the top of this list (both lists!), clocking in at number three, the third most important thing that these insurance companies want to make clear they will not pay for was, and I quote, "Transsexual surgery, including related drugs or procedures." (One said transsexual, the other "gender reassignment")

Wow. Really? Number three? I wasn't surprised to find that my specific health care needs wouldn't be covered, but I was rather surprised to see it so explicitly stated, and so early in the list. I was rather under the (apparently misguided or outdated) impression that trans health issues were, while not being supported by the health insurance companies or even most medical practitioners, mostly flying under the radar. When I had to fight my Union to grant me short-term disability leave after my chest surgery, they tried to deny it because it "wasn't medically necessary" and was "cosmetic" but they didn't have any explicit No Transsexuals rule. It was more de facto discrimination than blatant.

It was surprising to see my health care needs so clearly invalidated like that. I wonder when that line was added to the list, and what the reasoning was to make it the third item. Is it because trans surgeries are so expensive? (though I dare speculate that part of the reason they're so expensive is that so few surgeons perform them, in part because of a lack of support/funding from the medical establishment, from research of new techniques to insurance payments.) Is it because trans health care makes up a large percentage of insurance claims? (unlikely, it seems, given how few of us there are.)

There is so much to be said about trans heath care and how and why we don't get insurance coverage and how and why we ought to. I hope to have more of an opportunity to organize around this issue in the future- it's more important to me than, say, same-sex marriage. Not that I don't think everyone should be able to get married because, hey, I do! It's just when I read about the huge protests thare going on now against Prop 8 that just passed in California, I can't help but be astonished that this is such a big deal. Seriously, can we get some of that energy directed towards the myriad other issues in this country?


kkryno said...

I agree: same sex marriage is a no-brainer! It's nobody's buisiness whom one chooses to marry! If I wanted to marry my 100 year old gym teacher; would anyone really give a rat's butt?! There are other issues that might be more pertinent: like global warming, national employment, medical coverage for all, education, food and housing for the poor, and education. If a person is paying for their own medical coverage; they should be able to choose their coverage, with no interference from any corporation who changes the boat in the middle of the stream. I'm just sayin'!

kkryno said...

Oops! I said education twice in my comment. I do feel it is important; so maybe it's okay that I mentioned it twice!

Sarah said...

This doesn't surprise me at all, actually. There are a lot of services that are uncovered by many insurance companies that shock me a lot more and affect a much large segment of the population, eg, childbirth or birth control pills (I guess you could say that they also discriminate against sexually active women, as well as transgendered people,) but I think they're just a mostly unethical business trying to make money rather than evil discriminators.