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Title VII of the 1964 Civil Rights Act outlaws discrimination against any person on the basis of sex. Title VII makes it illegal to refuse medical care services, which the law views as a “public accommodation,” to anyone because of their sex.
But bigotry and ingenuity are frequent bedfellows. Here’s how the NCQA discriminates against men’s health:
The Washington, D.C.-based NCQA (National Committee for Quality Assurance) is the outfit that accredits health maintenance organizations (HMOs) and managed care organizations (MCOs). Lose your accreditation and you’re toast—employers yank your contract and the feds turn off the money.
In 1990, men died seven years sooner than women. Compared to the fairer sex, men are twice as likely to die of heart disease and injuries. And men are at four times greater risk to die of AIDS, suicide, or homicide. Part of the reason for this inequity is that men are less likely to seek medical care. In1995, men made an average of 4.9 physician visits per year, while women had 6.5 contacts.
The NCQA has a peculiar definition of equality, because a couple years ago they established a Women’s Health Measurement Advisory Committee, but no committee for men. The Committee started coming up with criteria to gauge HMOs performance in providing gender-specific services. Effective January 1, 2000, HMOs and health plans will be expected to comply with these standards in order to receive accreditation:
Women’s Health:
- Breast cancer screening
- Cervical cancer screening
- Chlamydia screening in women
- Prenatal care in the first trimester
- Check-ups after delivery
- Initiation of prenatal care
- Frequency of ongoing prenatal care
- Discharge and average length of stay - maternity care
- Cesarean section
- Vaginal birth after delivery
- Management of menopause
- Weeks of pregnancy at time of enrollment
Men’s Health:
.
.
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No, that’s not a typographic error. There are 12 standards for women’s health, and none for men’s health. Check it out for yourself at their HEDIS 2000 (Health Plan Employer Data and Information Set) page.
Isn’t NCQA clever? They are not actually turning away men who present in need of medical services—that would be obvious bias.
So they are resorting to a subtle form of discrimination. They are requiring HMOs to shunt more resoures to women’s health. This will assure women receive more medical services, which will further worsen the disparity in medical care between men and women.
Shouldn’t men be outraged by this maneuver? Shouldn’t men, and the women who love them, be complaining in no uncertain terms to their HMO, their local human rights commission, to the state attorney general?
National efforts are underway to force HMOs to delay implementation of these standards until similar standards for men are put into place. But strong grass-roots support is needed. Click here to download a sample complaint letter.
Yes, we will prevail this time around.
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