I was inspired by Akwhit's recent article to do finally put down some of my own research on the matter.
For the past two years I have studied in New Zealand, I am still amazed by the questions I didn't ask or did not know to ask. I assumed my adjustment to life here would be smoother because NZ is all and all a safe, prosperous country where English was the official language and I am very lucky that things have gone as well as they have. I will admit that I am 20 pounds heavier and 100 times happier (NZ doesn't seem to believe in diet food but their immigration medical exam is not size-friendly either...), but I will also admit that I will be relieved when my Masters' degree is over because I will finally be free of my terrible, mandatory medical insurance.
If wishes were fishes I wished I harangued my scholarship officer, my supervisor, and the International Student Support about which of the very-women-unfriendly medical policies would bring on the least financial pain.
Now, straight up, I am originally from Canada and lived much of my life with my parents' supplementary insurance which kept my birth control, pap smears, blood tests, prescriptions, and Doctor's appointments under 10$ at any time and a national/provincial health care system that keeps me from paying out of pocket (but comes with a very different kind of cost). Thus, as a citizen, I have come to expect a certain level of health care but, at least at the two institutions I attended, International students either received coverage equal to other Canadian citizens or a right to access other supplementary insurance to balance the suckage of the foreign student policy.
Most Universities provide International students with a range of providers to choose from, be it 2 or 5, but usually they promote one as their main provider. After all the paperwork that goes into getting into the country and enrolling as an IS (international student) in the first place, I can vouch that you are not all keen to complete any additional paperwork that is not related to your graduation. With insurance deemed mandatory for enrollment at any NZ University, most ISs are in an unenviable position of paying for less than beneficial policies.
In examining the policy wording of at least 5 providers of medical insurance to ISs and ignoring what loopholes can be offered by the general exclusion of pre-existing conditions, treatments, and medications as outlined by numerous programs, medical insurance in New Zealand is incredibly unfriendly to female international students. The particular focus on anything sex-related is troubling as pregnant women are treated as poorly as women who are unable to get pregnant, do not want to be pregnant, or are simply trying to stay physically healthy.
For the sake of brevity, I have selected and paraphrased sections of the policy wording that I felt relevant. However, links are provided to the original policies for those interested.
InterGlobal Student Care
Will Cover:
-Unlimited Drs fees and public/private hospital fees.
-Emergency maternity: complications to pregnancy childbirth following injury or illness where a medical practitioner considers it to be an emergency at a rate of 100$ of the cost up to a maximum in any 12 month period.
Will Not Cover:
-Any claim for emergency maternity unless a doctor has certified the facilities are not adequate and a surgical procedure is required to safeguard the lives of mother and child.
-Pregnancy, childbirth, infertility, abortion or birth control (except where covered under the emergency maternity section).
-All services or treatments associated with an assisted reproduction program.
-AIDS or AIDS-related sexually transmitted diseases
UniCare
Will Not Cover:
-Pregnancy, childbirth, infertility, abortion or birth control if the pregnancy existed at the time the policy was issued
-All the events/services above is the pregnancy commenced after the policy was issued except where such costs are incurred because of unexpected medical complications or emergencies that occur up to and including the 28th week of pregnancy.
-Infertility and childbirth.
-In respect to a child born during the period of insurance, we will not pay for post natal care or for any amount in excess of $100,000 for the treatment of condition(s) existing prior to or at birth.
-Sexually transmitted disease or AIDS or HIV infection.
Southern Cross
Will Not Cover:
-AIDS, HIV, or sexually transmitted diseases
-Pregnancy or childbirth except for illness or emergency medical treatment up to and including the 28th week of pregnancy and only for unexpected medical complications
-Intentional self-inflicted illness or injury, suicide or attempted suicide, voluntary abortion, influence of alcohol or any drug (other than a drug administed or prescribed by a legally qualified medical practitioner), chronic alcoholism, person(s) invited to Your accommodation, participating in any prostitution, hitchhiking or Your criminal activities.
-Continued treatment or continued medication during Your period of insurance for any condition which existed or occurred prior to Your start date.
Orbit
Will Not Cover:
-Expenses of childbirth or pregnancy unless they arise from complications that occur before the end of the 24th week of your pregnancy.
-Sexually transmitted diseases.
-HIV, AIDS or mutant derivative or variations of HIV.
StudentSafe
Will Cover:
-25$ for one consultation during your study course per year with a registered medical practitioner or registered nurse in New Zealand for advice on Sexual Health.
-Up to 100$ for one test per year at a campus medical facility for any sexually transmitted diseases.
-Any child born during the period of insurance in New Zealand with medical conditions that necessitate medical treatment at time of birth to pay for reasonable cost of medical and surgical treatment up to 100,000$.
Will Not Cover:
-Contraception of any type.
-If the event is the diagnosis, management, and treatment of infertility.
-Sterilisation
-Routine screening (Mammograms, Pap Smears etc.)
It is also worth mentioning that when specialists fees are covered, otherwise called well-being specialists, indicated are the services of dieticians, chiropractors, and podiatrists.
To put some of this in perspective, my insurance is StudentSafe. An average visit will cost me 25-30$, 15$ if I see a nurse. I will have to pay out of pocket for most but at least one sexual health visit will be covered. Since my birth control is distributed in packs of six, I have to make at least 2 visits over the year. Due to the brand of birth control, I pay more than someone on Ortho Tri-Cyclen and as an International student, I pay twice as much. How do I know? For at least a year, I was mislabeled as a Domestic student and became utterly in love with paying 30$ for a six-pack. Now that the glitch is corrected, I pay 62$ and I believe that is after the student discount.
Thus, by December 2008, for two visits to get birth control, I will have paid 154$ for uninsured services.
However, I have also had to pay ~ 230$ for uninsured routine screening fees this year as well as 15$ for a nurses visit in which I was told that by the time a diaphragm is inserted, the moment will have passed. I never thought I would have heard anything that would beat last year's advice ' If you are in a monogamous relationship for more than six months, you can stop using condoms'.
I am cognizant that by dint of being an international student, I have agreed to this situation the minute I applied for my Visa and in the end, since I do not bring in any additional health costs, I am pretty damn lucky that despite my work restrictions, my medical fees will only take a small portion of my funding and I will still be able to pay rent and work on my thesis. However, that balance is pretty tenuous and, well, shit happens.
The situation for female citizens of New Zealand, on the other hand, has become less and less favourable:
Woman dies after Medics miss Cancer
Judge questions legality of abortions
Woman had abortion after misdiagnosis
Clark condemns hospital policy after newborn dies
Coast mums forced to travel
In the end, it is old news. For all the hollering by Pro-lifers, only some babies are valued and only some couplings are approved. However, very little is done to encourage women's health in general.
I also find it troubling that with the recent AIDS awareness/information campaign that is happening in NZ at the moment, spreading the message that people with AIDS are not who you would expect, student insurance policies still directly link AIDS solely with sexually transmitted diseases.
So, I would like to hear how members of the feministing community see this situation played out on their own campuses or in their own lives? I know there are some readers from New Zealand and I'm interested in how they perceive the situation from their end.
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As a domestic student, I was totally in love with my Student Health Centre - they set their appointment fee at the reimbursement rate for the Community Services Card, which most students have due to earning basically nothing, so visits (for me) were free. Birth control cost me $3/6months, since I can only take the mini-Pill, and that's subsidised by Pharmac.
Now I've graduated, and paying $50 for each doctor's visit (that's with the CSC reimbursement) stings a bit. Prescriptions are still the same - $3 a time for 6 months pills, or the paracetemol and ibuprofen I stock up on. I recently aged out of my parents health insurance, and due to the family history of arthritis and blood disorders, I've decided to go with the same company and pay for insurance, although my current, very basic plan doesn't cover routine GP visits, any OBGYN procedures (actually, I think it covers PAP smears) and I probably won't need it for another 20 years. If I don't get covered now, there'll be all sorts of issues trying to get cover then. And now that I'm covered, I can extend the coverage when I can afford it.
I have to admit, I never really thought through the situation for IS's. In the back of my mind, I knew that they had to have insurance, but I didn't think very hard about what that meant. Kiwis tend to think we're pretty good in terms of health care provision - with ACC, public hospitals, Pharmac subsidies, sickness benefits. We're not perfect though, as your example articles show. There's also the Herceptin debate (Pharmac is only covering a short-course treatment of the cancer drug, instead of the one year treatment course recommended by the manufacturer, and several studies. They're basing this decision on one study, and the fact that 8 weeks of the drug costs less than 12 months, and say that more women can be helped if the costs per person are lower), historical PAP smear problems (incorrectly read, not read at all).
When it comes to abortion, I've always told myself that it's OK that abortion is technically illegal (it's covered under the Crimes Act, not any medical legislation), because school sex ed is pretty good, most GP's know how to get around the law (about 95% of abortions are performed for the benefit of the mental health of the mother), and there's plenty of help for those who do have babies (Plunket, the Domestic Purposes Benefit, free healthcare for under 6's, now 20 hrs free early childhood education for 3-4 year olds). However, I now know more about the situation, and the court ruling earlier this year really started me worrying. My experience of school sex ed was only any good because of my state, single sex school being so aware that they needed to equip us girls with these facts, because nobody else would. Now I know how greatly sex ed varies from school to school, I'm trying to find a way to bring up the discussion with my Girl Guides, so that they get some straight facts, and know that there's someone they can come to with questions. I just found out that one of the girls is moving to a right-wing state-integrated Christian school, which has a dubious history when it comes to providing life skills.
BTW, I went to Canterbury. What university are you at?
I am a Canty student as well. Interesting how drastic the changes in charges are. I am not eligible for a Community Services Card because I am on a permit to study in NZ. I have, however, benefit from the services of ACC but it was not cheap.
One thing that has frustrated me about the SHC is that they always, always forget that I am an International student and on StudentSafe. More than once I received an email telling me my account is in the red when after the appointment they told me it was being billed directly to my insurance company.
-HIV, AIDS or mutant derivative or variations of HIV.
Geeze, as if getting SuperAIDS wouldn't be bad enough, this insurer specifically exempted it from coverage in advance!