Saturday 17 November, 2018

'Don't punish the pregnant': Insurers urged to rethink upfront payment

Insurers have been asked to rethink their policy of having expectant mothers upfront their healthcare costs and claim refunds later, on grounds that it jeopardises the women’s right to the highest attainable standard of health and risks less than favourable pregnancy outcomes.

“This should be examined by all parties, including the government, employers and insurers, as ensuring that mothers and their children have access to quality healthcare is critical to the health of the nation,” said Professor Wendel Abel, lead investigator for the European Union (EU)-funded ‘Partnership for the Promotion of Patients’ Rights in Maternal, Neonatal and Infant Health in Jamaica’ project.

The project aims to strengthen human rights in patients’ care and improve the role and effectiveness of civil society in advocacy for maternal and child health.

“Maternal health is important and every attempt must be made to ensure that pregnant women get timely access to the healthcare they need. While the decision taken by the insurance companies may be well founded from their perspective, it certainly discriminates against women who are pregnant,” added Abel, who also heads the University of the West Indies Department of Community Health and Psychiatry (UWI DCHP).

“When you deny women access because of these barriers, it is yet another hurdle to healthcare for pregnant women and can impact negatively on the health of the mother and baby with potentially disastrous outcomes, especially when emergencies occur,” Abel said further.

His comments come in the wake of a local newspaper report publicising the complaints of pregnant women who have had to pay out of pocket for their care, despite having insurance coverage.

Linnette Vassell, advocacy specialist at the Women’s Resource and Outreach Centre, which is co-implementing the EU-funded project with the UWI DCHP, said there is need for a national conversation on the issue. 

“People have reservations about dealing with so called market forces in the private sector domain when it comes to basic rights, but in this case, it is perfectly justifiable for the government and civil society to engage in a conversation with the private sector to enhance the health and well-being of citizens, and in light of our maternal mortality objective,” she noted.

As at 2015, Jamaica’s maternal mortality ratio was 89 per 100,000 live births, reflecting an increase from 1990 when it was 79 per 100,000 live births. The neonatal mortality ratio, meanwhile, was 11.6 per 1,000 live births in 2015 compared to 17 per 1,000 in 2000.

Given these statistics, Affette McCaw-Binns, Professor of Reproductive Health and Epidemiology at the UWI, and resource person for the EU project, suggested that the government and employers throw their weight behind a rethink of how health insurance providers treat with expectant mothers.

“Young women 20-40 years and their partners are generally healthy.  Their main health concerns revolve around their reproductive health needs, such as for family planning resources, and efficient access to antenatal care when pregnancy occurs.  Some may also need specialised care for an ill newborn hospitalised after birth,” she said.

“Their positive health status means they are the mainstay of the health insurance system where they invest consistently more than they withdraw, except during pregnancy and childbirth.  Then, as the article in the Sunday Gleaner of March 18, 2018 suggests, they are punished for consistent payments by having to pay up front for care. The government and employers need to stand up for their employees. For young people just starting a family, a pregnancy shouldn’t break the bank,” Professor McCaw-Binns added.

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