The Queering of Health Reform


The relative silence of a queer –
or even a gay – voice in the health care reform debate of the last six
months is confounding.  As someone who spent my 20’s and 30’s dealing
with close friends and colleagues dying of AIDS, who watched many
people become impoverished by their disease, and saw first hand how
pre-existing conditions clauses rendered health insurance coverage
useless when it precluded any coverage for HIV-related care, it strikes
me that the lgbt community knows as well as any other group of people
why these reforms – including a public option – are necessary.

But
the implications of health care reform for the lgbt community extend
well-beyond HIV – because the employer-sponsored health insurance
regime we live with is, essentially and unavoidably, hetero-patriarchal
– it assumes the nuclear family as the typical unit needing and
deserving insurance coverage.

nuclear_family

By insuring not only the employee but his
spouse and minor dependents as well, our employment-centered health
insurance paradigm imagines a male employee/head of household with a
wife (who is not employed and therefore does not have her own
insurance) and kids, all of whom were covered incident to the male
adult’s employment. The family wage brought with it family benefits.

Rendered invisible, or at best marginal, in these policy choices
around health insurance are those of us who cannot or will not get
health insurance on account of a relationship to a husband or father
who brings home both the bacon and a health insurance card.  But gaying
the story doesn’t quite fix the problem.  Marriage equality advocates’
demands that same-sex couples be allowed to marry so that we too can
get on the insurance policies of our well-employed partners somehow
fails to get at the underlying problem of what is at bottom a health
care delivery system that presupposes the nuclear family.

A queer approach to the issue would question the norm of a health
care delivery system that privileges those people who are willing
and/or able to organize their lives into a traditional household, with
a head who is working a good job that includes health care coverage for
all the rest in the family.  Just as it is wrong to make better health
care available only to those who can afford it, so too, the queer argument
goes, it is wrong to make health care coverage turn on one’s ability to
line up your life like the Brady Bunch.  Good health care should have
nothing to do with wealth or conformance with hetero-patriarchy.

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  • heather-corinna

    A queer approach to the issue would question the norm of a health
    care delivery system that privileges those people who are willing
    and/or able to organize their lives into a traditional household, with
    a head who is working a good job that includes health care coverage for
    all the rest in the family.

    Just as it is wrong to make better health
    care available only to those who can afford it, so too, the queer argument
    goes, it is wrong to make health care coverage turn on one’s ability to
    line up your life like the Brady Bunch.  Good health care should have
    nothing to do with wealth or conformance with hetero-patriarchy. 

     
    A-freaking-men. (As it were.)  Seriously, that just says it all so, so brilliantly.

  • tschleder

    What we don’t know will hurt us – in health reform and in life.
    Our broken system is built on discrimination and rationing of care by arbitrary social categories. That’s what brings home the bacon for Big Insurance/Big Medicine.

    Terry Schleder, MPH

    http://healthcarenownm.blogspot.com/

  • margaret-conway

       
    I think you get at part of the problem but not all of it.  It’s not that its based on a hetero model–we essentially have an employer-based,  health system, and that leaves too many people out.

       
    Gaying the story or Queering it–sorry, that feels like you are being intentionally divisive (or intentionally simplistic).  So now "Queer" equals someone who smartly analyzes hetero privilege and "gay" equals someone who wants to mimic the patriarchy? 

    Marriage equality advocates’
    demands that same-sex couples be allowed to marry so that we too can
    get on the insurance policies of our well-employed partners somehow
    fails to get at the underlying problem of what is at bottom a health
    care delivery system that presupposes the nuclear family. 

     

       
    I think we should give folks a little more credit than that.  Its possible to walk and chew gum at the same time–to advocate for marriage equality (yes, it might help low income people and immigrants too!) and recognize it is not the panacea for everyone or that ideally the government wouldn’t legislating relationships at all.

       
    There are a whole lotta folks besides us queers who are questioning the current health insurance norms — those that require employment at large(er) companies, and the correct immigration status, and/or some sort of relationship, and no health problems to qualify for coverage.  Perhaps it would be more helpful to to look at our commonalities instead of just pointing to supposed divisions.

  • mikeoliphant

    I am a health insurance agent in Utah and run two websites that sell insurance http://www.benefitsmanager.net and http://www.dentalinsuranceutah.com. I mention this because in Utah it would be great to have a guaranteed public option to put people that the private insurers will decline for health conditions. Plus the way Weiner discribes the public option, it will be priced competitively. So what this means in my industry (I’ve been at it 18 years) is that all my unhealthy clients that get charged more or declined can be put onto the public option now. All my healthy clients can stay on the private option. Hmmmmm follow me yet???? How long can the public option stay affordable?? Who is going to pay for the losses of a big sick pool of people….taxpayers?????