Experts like to talk about cost-benefit analyses. Badly needed reforms to inefficient systems may cost money, but often the benefits from that change far outweigh the costs.

What gets overlooked is the cost of NOT implementing reforms.

Take the Affordable Health Care Act, which is celebrating its second anniversary. Offsetting the costs to reform our health insurance system are a multitude of benefits.

Children with pre-existing conditions are no longer frozen out of insurance plans. Families trying to cope with the pain of a dreaded illness for a child or spouse no longer have to face bankruptcy or lose a home because of running into lifetime limits on cost reimbursements. Young adults can stay insured long enough to finish college and launch a career. People all across the country will now have access to preventive care services, including life-saving mammograms and colonoscopies, without being charged a deductible or co-pay.

Women in particular benefit from the new law, including support for nursing mothers, maternity coverage, and an end to the outrageous practice of allowing insurers to consider C-sections and domestic violence “pre-existing conditions” that can be excluded from coverage.

And starting soon, women won’t be forced to pay outrageously higher amounts for health insurance just because of their gender. A new report by the National Women’s Law Center (NWLC) documents the gross disparities. In states that haven’t banned the “gender rating,” women were charged more in 92 percent of the best-selling health plans.

Experts can quantify the actual costs when these reforms are not in place – costs in health outcomes, in family economics and for the economy overall when people have less disposable income. For example, the price tag for the differential in how women and men are charged? A billion dollars.

It’s harder to put a price on the stress and heartbreak that accompany the lack of basic fairness.

What’s also harder to quantify is the degree of blatant sexism behind these practices.

Take the issue of charging women higher rates. Insurers actually have a justification for this. Claims show that women ages 19 to 55 tend to use more health care services, they argue. That means women are more likely to go to the doctor, get regular checkups and take the medicine they’re prescribed.

The NWLC report challenges the insurers’ rationale because of the range of disparities among insurers. In Arkansas, for example, NWLC co-president Marcia Greenberger pointed out that one health plan charges 25-year-old women 81 percent more than men, while another plan in the same state charges only 10 percent more.

But even if we take the insurers at their word, isn’t this behavior what we want everyone to practice?

You don’t have to be an expert to know that getting regular check-ups and following through on what the doctor prescribes helps keep you healthy or recover more quickly. Aside from helping people feel better, these are the practices that cut down on health care costs! Stopping high cholesterol, for instance, is much less expensive than hospitalization, surgery and follow-up care for someone who has a heart attack.

In just the same way, allowing workers to earn paid sick days will help people get well faster, prevent more serious illness, and detect problems earlier – steps that will help cut down on the insupportably high cost of health care in our country.  These cost savings, estimated by the Institute for Women’s Policy Research, amount to upwards of $1 billion a year in healthcare costs, including more than $500 million in tax-dollars!

We should care about costs. But let’s make sure the definition includes the high cost to families, the economy and our nation of failure to bring the workplace into the twenty-first century.

Name a country where large numbers of women legally earn less than minimum wage and have to drag themselves to work sick or risk losing their job.

To all the places that come to mind, add the United States of America.

The workers in question are employed in one of the largest and fastest growing sectors in our economy: the restaurant industry.  And while revenues have been increasing even during the economic downturn, now amounting to $635 billion a year, the federal minimum wage for servers is $2.13 an hour and 90 percent of employees have no paid sick time.  More than 7 in 10 of the workers affected are female.

The problems for women in these jobs are being highlighted in a report released today, 2/13 – a date that matches the industry’s artificially low minimum wage. “Tipped Over the Edge” was prepared by Restaurant Opportunities Center (ROC) United, a smart and strategic group started ten years ago among Windows on the World employees who were not working when the World Trade Centers collapsed to improve the rights and livelihoods of restaurant workers in New York and across the country. ROC partnered on the release with a dozen groups, including Family Values @ Work.

Many people think of tipped workers walking out the door each night with pockets filled with cash. In reality, servers — the largest group among all tipped workers — experience almost three times the poverty rate of the workforce as a whole, according to the ROC report. Like child care workers who can’t afford child care and health care workers who are uninsured, our nation has large numbers of servers who have trouble putting food on the table – nearly twice as many rely on food stamps as the rate of the general population.

As the report points out, the restaurant industry is one of the only sectors in which predominately male positions have a different minimum wage than predominately female position: “In many sectors, lower wages for women are often a product of discriminatory employer practices but in the restaurant industry, lower wages for women are also set by law.”  The law in question is the tipped minimum wage.

National Restaurant Association Takes Credit for Inequality

How did this happen? Lobbyists for the National Restaurant Association – the same folks who are pouring money into attempts to defeat paid sick days initiatives – worked behind the scenes to convince the House Committee on Education and Workforce to exclude tipped workers from the bill increasing the minimum wage. We know this because the NRA bragged about it in their trade publication, which reported that “at the behest of the NRA,” the committee gave “industry trade groups much of what they wanted.” Read the rest of this entry →