As a physician, I am often consulted by my friends about their medical ailments. I have never minded these discussions, even when the details were not always the best dinner-table topics for those unaccustomed to hearing about discharges and dysentery.

Occasionally, though, my friends' concerns have been serious. And when I have been worried, I have advised them to seek official medical care.

In some cases, however, that hasn't been possible, since too many of them remain uninsured — even a few with life partners who are gainfully employed and have health benefits.

When applying for jobs, most people assume that a spouse can be covered under their health care benefits. This assumption, however, does not extend to those in same-sex domestic relationships.

Coverage for domestic partners is available to employees of the majority of Fortune 500 companies, but it has only sporadically been extended to workers of companies with 50 employees or fewer.

From a health-care standpoint, expanding these benefits makes sense. We should be seeking opportunities to reduce the rolls of the uninsured and to reduce the burden of publicly funded health-care programs. Changes in health care policies that extend current benefits, such as covering domestic partners, have the potential for creating healthier communities.

Despite fears, extending these benefits is in no way a budget-breaker. The Williams Institute in 2006 estimated that only 0.1 to 0.3 percent of employees would want to sign a domestic partner up for benefits. In fact, when the University of Colorado extended these benefits to their 25,000 employees, only 60 enrolled.

Though the numbers are small, to those enrolled this coverage can mean the difference between illness and health.

Recognizing this, Anthem Blue Cross Blue Shield of Colorado stepped forward last July to become the first large insurance company in Colorado to routinely offer benefits to domestic partners of eligible employees of small businesses. Just this year, United Healthcare joined them in doing so.

Other insurers have occasionally extended domestic partner benefits to employees of small organizations receiving funding that require them to provide these benefits.

Opponents of same-sex domestic partnerships or civil unions have frequently argued that legal recognition of these relationships is not necessary as all the rights contained within them are available already. Though Anthem and United deserve to be commended, most insurers do not offer such coverage.

Colorado does not require that insurance plans provide benefits for same-sex domestic partners, and many plans continue to deny employees in domestic partnerships benefits equivalent to those afforded their married colleagues.

My friends have filled out the forms, found the notaries, and paid the legal fees, but still occasionally come up short in the growing struggle for equal access to health care benefits. These are benefits that so many other committed couples take for granted.

Though I will always be happy to hear the gruesome details of my friends' health concerns over dinner, I look forward to the day when they consult me simply as a second opinion — not out of necessity.