In an unexpected turn in the health care debate, Michelle Obama recently drew attention to the fact that in four states, it is still legal to deny a woman health insurance coverage because she's been a victim of domestic violence. "This current situation is unacceptable," Obama said about the gender disparities in the system, "no one in this country should be treated that way. It's not fair. It's not right."
The theory behind denying coverage to victims of domestic violence is that if you're abused once, chances are you'll be abused again and insurance companies shouldn't have to assume that risk. Although there has been a crack down on the insurance industry practice of discriminating against people with pre-existing health conditions, private companies are still allowing ridiculously broad interpretations of policy to deny people insurance if they have a history of abuse.
An even more insidious problem lies just beneath this surface. People who are abusive towards others ("abusers") are terrified of seeking help. In some states, people who admit their abuse can be reported to the police. In all states in the nation, someone convicted of a domestic violence crime must pay for his or her own treatment. While this may seem to make sense - why shouldn't they "pay" for their crimes? - many people convicted of domestic violence crimes can't afford treatment and therefore drop out, or even serve jail time rather than get the treatment they need. It's important to realize that those who don't complete treatment have a much higher likelihood of repeating their violent crimes. This means an increase in the amount of violence in the long term, costing both insurers and taxpayers significantly more.
If we are really serious about addressing domestic violence in this country, we should undo barriers for both victims and abusers who seek help. This should include insurance coverage for all those who can't afford to pay for treatment.
In addition, and perhaps most importantly, options for treatment should be wide-ranging. Beyond group batterer programs (the standard approach to treatment for abusers) or one-on-one counseling for victims, insurance companies should also fund innovative programs designed to reduce domestic violence. Two such programs are Peacemaking Circles and Violence Anonymous.
Peacemaking Circles, a new program in Arizona, brings partners who have been abusive together with willing family members, support persons, a trained professional facilitator, and community volunteers. The goal is to encourage dialogue about the violence in this family, explore gender dynamics, and to create meaningful change to which each participant in the circle can contribute. In 2008, this program was selected as one of the Harvard Kennedy School Ash Institute's "Top 50 Innovations in American Government."
Violence Anonymous is a twelve step telephone fellowship program for women and men, victims and abusers, who through shared experience, strength, hope and honesty are recovering from violent behavior.
Hopefully, programs like these will create a new attitude towards the treatment of intimate partner violence in our society and end the discrimination experienced by those who choose to seek help. If the cycle of interpersonal violence is interrupted by treatment, it is possible to dramatically reduce intimate violence in our lifetime.
---------------------------------------
Peacemaking Circles and Violence Anonymous are two examples of the many new barrier-breaking programs across the country approaching the prevention of domestic violence from a holistic perspective. These programs will be featured at the upcoming conference at New York University: "Intimate Partner Violence in 2009: The Next Wave of Solutions from Today's Top Innovators" (www.nyu.edu/cvr/conference) on November 12th-13th. Register now to secure your spot!