photo by EfrankE

Monday, April 19, 2010

The First Step is ...

... admitting you have a problem.

New York has had mandatory pre-existing condition coverage in its health care insurance system for over 15 years. Here's a report from the New York Times which, perplexingly, is not a subject of national coverage.

New York ... became one of the few states that require insurers within each region of the state to charge the same rates for the same benefits, regardless of whether people are old or young, male or female, smokers or nonsmokers, high risk or low risk.

Healthy people, in effect, began to subsidize people who needed more health care. The healthier customers soon discovered that the high premiums were not worth it and dropped out of the plans. The pool of insured people shrank to the point where many of them had high health care needs. Without healthier people to spread the risk, [odd choice of terms to me - ed.] their premiums skyrocketed, a phenomenon known in the trade as the "adverse selection death spiral."
In other words, healthy people who don't need insurance must buy insurance at significant cost to help pay for the treatment of people who live in poor health.

Wouldn't true health care involve not settling for "spreading the risk" but, rather more beneficially, lowering the risk?

For a long time now, the government has created special income tax breaks for whatever, ostensibly, it deems important behavior ( e.g., buy an infant car seat, install a solar hot water system, give to charities, subsidize farmers, fishermen or multi-national corporations, et al.). Yet, contrarily, the health care bill ignores responsible behavior and treats everyone the same - an active twenty-year old of normal weight will incur the same premium costs as a four hundred pound 55 year old couch potato.

If congress applied the same taxation logic to health care as various existing special interests, there should be significant tax breaks for people of normal, age-appropriate weight, blood pressure and fitness. So, I ask you, why is this not the case?

Without a productive change in behavior, the health of a high-risk individual cannot improve. Some people would rather continue in self-destructive eating behavior. I say that is their right. But, the rest of us should not be taxed to subsidize their laziness and foolishness. Risky behavior, in any form, should not presume public subsidy.

Some people don't care about their health anyway, until it becomes a matter of life and death.


  1. It seems that logic and government in the same sentence will never happen....

  2. Yeah, I hear that a lot. No argument there. If there's one self-damaging, unhealthy entity we should be concerned about we might start with our political leadership and the economic collision course they've charted for the nation's future.

    Thanks for visiting, Miss Vee.