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MEMBER DIARY

Why are we even calling it “Health Insurance”?

From the diaries…

Insurance (n): financial protection against loss or harm: an arrangement by which a company gives customers financial protection against loss or harm such as theft or illness in return for payment premium.

So, the Obama administration has just announced that all employers will henceforth pay for birth control medications and abortifacients. Setting aside the (substantial) conscience issues that many religiously-motivated employers have with this government compulsion, how exactly is this even “insurance”?

Consider traditional forms of insurance, such as fire, flood, or life insurance. When someone buys these types of insurance, they are protecting themselves against catastrophic financial harm from an unanticipated, unambiguously disastrous event. Nobody would wish a fire or flood on themselves, and by pooling resources, millions of insurance policy holders spread the risk of such events so that everybody pays a little to ensure that nobody suffers the full impact when it happens to them.

In this light, what we are calling “health insurance” is not health insurance at all. It’s more of a purchasing pool which gives people the right to consume certain goods and services paid by a third party. I can’t think of any other product we buy this way. Imagine paying a flat fee to Safeway for the right to pick up our weekly grocery haul (perhaps with a small co-pay at the cash register) – and calling it “food insurance.” Even stranger – imagine having your employer pay that fee on your behalf as part of your compensation package. Double down on strangeness – imagine the government organizing purchasing pools for people who can’t afford “food insurance,” setting standards on what employers must pay for in their “food insurance” policies, etc.

When you buy groceries, you buy only what you need; you economize by comparing prices across brands and stores; you pay attention to the quality measures that matter to you, such as taste and freshness. Suppose, instead, you knew that you’d be paying $50 regardless of what was in your cart. You might load up on expensive meats and packaged foods, and blow past the plain-tasting generic aisle. (Even if you didn’t, you can bet your neighbor will. So you might as well, right?) To hold down costs, the grocery store might stop carrying premium brands; or it might impose controls, such as no more than two visits per month, and approval by a dietary specialist as a condition to enter the expensive deli section. What do you suppose would happen to the availability, quality, and cost (the real cost, not the out-of-pocket co-pay) of groceries if this was how they were paid for? (Hint: it’s exactly what has happened to health care.)

Getting back to the new Obamacare mandate: Obama’s HHS has decided that our so-called “health insurance” policies must cover the cost of birth control and abortifacients. I may have found the explanation. In March 2008, candidate Obama famously offered the following remark at a town hall meeting. Speaking about his daughters, he said: “If they make a mistake, I don’t want them punished with a baby.” (That phrase – “punished with a baby” – is very revealing.) Perhaps this new mandate finally provides a rationale for calling it insurance. It makes sense if you take the view that a pregnancy is nothing but a disaster against which one should take precautions, and a baby is merely a financial catastrophe against which one should be protected.

COMMENTS

  • Repair_Man_Jack

    Karl Denninger made a similar point of Market Ticker.

    http://market-ticker.org/akcs-www?post=201758

    If health insurance were really insurance, it would be interesting to see how the premiums would be set, and what impact such changes would have on the actual market pricing of health-related services.

    • acat

      The only point I don’t see addressed fully is that flood insurance is *only* available from FEMA. You may call your local agent and buy it, but it’s FEMA who will collect the money and pay the settlements, using our tax dollars to augment what they’ve collected.

      I mention this because, if we want to see where health care insurance is going under Obamacare, flood insurance is a good place to start looking.

      Mew

      • Repair_Man_Jack

        nt.

        • acat

          Mew

        • Flagstaff

          Two years ago there was a serious forest fire in a mountain valley there. I don’t believe there were any deaths at the time of the fire–more about that later.

          I have to point out here that Flagstaff sits at about 7,000 feet above sea level. Not exactly what you picture when you think of flood insurance. Because of bureaucratic bungling and EPA/Interior Department rules, mitigation of the after-effects of the fire damage to the forest has been excruciatingly slow to develop. As a result, there was a known flood hazard for the houses downhill from the fire area.

          Flood insurance was made available for those homes. Did you know that you can only buy flood insurance if the government decides your property is located in a flood zone? There was a kicker–a 30-day waiting period before the insurance could go into effect.

          As you can guess, heavy rainstorms within a couple of weeks brought flooding and destruction for some of those homes–covered, but uncovered. Last I heard, Congressman Gosar was tying to get an exemption through Congress to make the insurance cover the losses.

          You can argue points on both sides of this situation, but it’s not clear why only the government can handle flood insurance, nor why it can only be sold in a designated flood zone. Maybe only because it’s a government program.

          • bobvious

            …does not exist in that situation, at least at affordable rates. After a burn, natural cover is lost, cover which would otherwise slow down the rain hitting the earth, allowing the rain a chance to penetrate the soil. Without cover, erosion and flooding are much more likely. No insurer is likely to cover any homeowner in that situation, at reasonable rates. Any homeowner is welcome to find out the market rate. Should the Feds step up, and why?

        • cheetah2

          I wish people understood this. I think a huge cause of the mess our country is in is because so many are so ignorant.

      • bobvious

        You are right, no private insurer will cover flood insurance in high risk areas. So we are subsidizing those who live in flood-prone areas through FEMA. FEMA requires insurance for government mortgage-backed loans like FHA and VA. The true costs of housing should be borne by those that choose to live in risky area. End the FEMA flood insurance subsidy now!

      • clowngirl

        Health “insurance” increasingly means that what a person spends on healthcare will have little or not connection to their use of medical services.

        Aside from the financial disaster this causes, it also limits insurance companies from being able to provide incentives to pursue a healthy lifestyle (by raising a person’s rate in proportion to risk factors)

        Btw, what are “abortifacients”?

    • bobvious

      …is a fascinating read. It speaks of “outright fraud by both the Church and everyone else involved in it, both government and private sector.” And then there is the “”faux outrage” of the Catholic Bishops.”

      The link should be read by more people.

      You are right, health insurance premiums should reflect market pricing. For example, smokers should pay more. At least a higher co-pay.

    • kowalski

      I have a little blog entry over in the diaries as an adjuvant to this thread.

  • Flagstaff

    of telling companies they must provide “health insurance” to employees, what must be covered, and what the insurance company must give away even if it’s not paid for?

    • http://www.examiner.com/x-1597-Charlotte-Law--Politics-Examiner Mike gamecock DeVine

      commerce was supposed to mean breaking down state barriers that were akin to separate nations under the Articles of Confederation and to be an umpire to ensure against fraud, enforce contracts etc.

      But of course they advanced to essentially central planning ala ObamaCare on many other levels long ago. We see the dictatorship in the raw just now because we see such an eager smug elitist punk youngster weilding the power.

      • Flagstaff

        Obama’s reign is similar to the tyranny of Savonarola of Florence from about 1495 to 1498. Particularly in the way they both ignored the written law and got away with it because of incompetence among the opposition.

        Savonarola nearly destroyed the Florentine Republic in three short years through his own delusional beliefs and his inability to carry out anything big that was also good.

        I think I feel a diary coming on. I thought this one would do it, but it didn’t hit a couple of important aspects of the current flap, such as the one you just mentioned.

        • http://www.examiner.com/x-1597-Charlotte-Law--Politics-Examiner Mike gamecock DeVine

          emphasize the economic liberty aspect as well. I should be able to bargain with an insurance company directly for coverages and price and not have that company saddled with all sorts of mandates that raise the price.

        • jaykali

          I think this helps the supreme court case against the individual mandate. I think that will fall and also this rule. We can’t a) be forced to buy private insurance and b) force private institutions to buy gov’t sanctioned “private” insurance.

          This rule will eventually fail and what’s great ab this is that it completely re-animates (ala Han Solo) the raging Obamacare debate that had been laying dormant for a year or 2 just bc the level of intensity in opposition had tapered off, if only temporarily. But now we have I think a legitimate change to dismantle this thing as it is obvious that they are using insurance as a vehicle for a government plan. If liberals cant get govt run health insurance all they have to do is tell private insurers what they have to cover (just like a govt plan would) and tell citizens and companies they have to buy it.

          I suppose Obama will let the courts sort this out, but man he has put himself in an impossible position. I think he miscalculated blowback which again illustrates how he doesn’t understand opposition – he noted opposition was ‘cynical’ on friday. He always has to disparage opponents. Anywho if they had just had a religious exemption, publicly there would have been zero blowback but they are ARROGANT.

          • renl57

            Unlike the Right, the Left believes that their ideas are not only desirable but inevitable. To them, our civilization is moving inexorably toward Social Democracy, despite an occasional speed bump like the Reagan Administration.

            And so since this is our inevitable destiny, there can be no legitimate opposition to it.

    • Kyle-MI

      They don’t get to choose their own health insurance policy because they have abdicated it to their employer. Of course, this is because they think they are getting it for free. And the tax system doesn’t help by giving the advantage to the employer and no tax break to an individual doing exactly the same thing.

      Anyway with loss of choice, individuals think they can regain control through the government by passing laws forcing coverage on everything. The downside is that this just jacks up the price for the employer.

      But as long as most people think they are getting free healthcare insurance through their employer, there is no way to break the cycle. It is economic ignorance that keeps the government in healthcare.

  • Locked and Loaded

    But keep this under your hat. Health care is a RIGHT, and before you know it, food stamps; WIC; free breakfast lunch, and dinner; and the whole host of feeding programs will be deemed insufficient, and we’ll be on our way to FoodObama.

    • Common_Cents

      and free 250min a month phone plans.

  • 6eorge Jetson

    Next to be paid for by the gubernmint.

    Because we Americans can’t manage that on our own.

  • texasref

    Great article ;-)

  • johnt

    I thought an ounce of prevention is worth a pound of cure, there are ways of avoidng pregnancy, better than subsidizing death.

  • greyeagle

    They need the individual mandate to bring in the money to pay for this nightmare. States by rights manage insurance issues. If the individual mandate is thrown out by the Supreme Court, then it would be easy to repeal the rest. Simply that all rules, regulations and mandates connected to this bill are null and void.

    • demsaresatanic

      probably be happy to let the whole thing crash and burn without a mandate. It would crash and burn anyway, this just gives them an excuse for the failure and an excuse for complete socialized medicine, not the watered down version.

  • greyeagle

    You nailed it. It really is not Health Insurance. This ruling will also force religious hospitals to perform abortions. It is an attack on religion. Obamacare is a nightmare to be visited on the people in this country. Seniors, physically and mentally handicapped, people will birth defects, chronic illness, premature babies, are all individuals who will have no worth, and medical care will be rationed to these individuals. The bean counters that Obama hired to monitor the physicians and ensure that not too much care is given, will tell them what care they can give. People should be very scared.

  • renl57

    Whether it’s Blue Cross or an HMO or Medicare or ObamaCare, the term “insurance” is definitely a misnomer.

    Insurance gives you protection from rare catastrophe, but these health care plans go way behind that to include things like routine care and even preventive care.

    I’ve always said that what we call “health insurance” is really more like a service contract.

    When you purchase a service contract to maintain your car or the major appliances in your home, you pay a fixed fee up front. Then whatever maintenance needs to be done is covered in the future, everything from a minor adjustment to a major overhaul.

  • demsaresatanic

    is too absurd to waste time on; obviously the cost will come from premiums collected. Liberals lie, fools believe them.

    There is one fundamental thing to remember, liberals hate you and your country, they will kill both if you let them.

  • benko

    Liberalism is a philosophy of consolation for Western civilization as it commits
    suicide.

  • littlehouse18

    ..

  • Thad Hunter

    Your are correct. Today’s health insurance is not actuarial based underwriting like Blue Cross Blue Shield offered in the seventies and eighties. It is simply pre-payment for healthcare for one year with an option that your self-insured employer will likely pick up major medical events up to stop loss.

    “Insurers” today just manage the administrative claims process, provide some medical review and fraud detection.

    Basically, if you are under 30 you are not consuming a lot of healthcare unless you have a baby. So you are paying for three other people’s health expenses. Private insurers have essentially become a regional single payer funding model, which is the government’s goal all along. All the government needs to do is load the system down with more mandated and free benefits and it will implode within 10 years. Until the patient controls the money within a market/charity based model (like when I was young) nothing will improve.

  • bobvious

    There are costs due to condoms, IUDs, pills, and abortions.
    There are costs due to pre-natal checkups, delivery, and well-baby care.

    Insurance companies make a profit by taking more money than they pay for in services. Any insurance company will provide contraception and abortions because of the bottom line. What can we do about this in a free market?

  • clowngirl

    Aside from the moral issues, surely an abortion is – in most cases- an elective procedure? Not performed from any medical neccessity whatsoever.

  • snowshooze

    And if you need health care..
    go see you Doctor.

  • ragstoriches

    explains a lot, actually, about some people’s views on abortion.

    I mean, sure you made a bad choice, but there shouldn’t be consequences or anything and hey, you probably weren’t aware of those consequences when you decided to take the action that led to the pregnancy.

    Consequences are only valid for elections, apparently, and then only elections in which liberals win. For everyone else, we can just exploit the recall option.

  • persiflage

    This modern incarnation of “health insurance” is nothing of the sort.
    It is precisely pre-paid health care services, with the government ordering which services shall be included in the pre-paid plan, regardless of what services you would choose to buy were you free to do so.

    I remember going to the doctor (rarely), and paying immediately, in cash, for the services rendered. That system worked without the army of billing clerks evident in every modern medical office.
    For those who were truly needy, the doctor worked out special billing arangements, face-to-face with the patient or guardian.

  • jaykali

    I feel like we have a chance to throw this guy out of office. What’s unfortunate is that I don’t think a lot of things are going to make it into the decision-making process this election year that should. A perfect example was the oil spill. This was a disaster by the Obama team. Will there be any significant mention of this? Sure we have Obamacare, the stimulus, cap & trade (altho it never passed), Solyndra, etc but I feel like there are so many things that won’t even be touched bc the media certainly won’t cover it. Like the underwear bomber who was interrogated for 5 minutes. Or trying the 911 mastermind IN NYC! It’s like the 4th quarter of a big football game where the score is close enough that unfortunately it doesn’t really matter what happened in the 2nd quarter.

    What I’m getting at is that we have to rely on Obama making /fresh/ mistakes as he is apt to do and he is delivering. We might look back at this moment as the moment when he lost the election bc this is not going away. It’s probably been Obamacare all along, not surprisingly and that will probably sink him in the end and this is 1 facet of Obamacare. Not only do we have this we also have the supreme court ruling on this soon and I think they will strike down the individual mandate. So that will be big news. Anywho I think there is a VERY good chance that Obamacare becomes so radioactive AGAIN that it wont matter if the economy is slightly better by the time November rolls around. That is my theory and hope.

  • GregInFla

    Then they will cover the costs ON THEIR OWN. Why would government need to step in?

  • Uma Richie

    might also discover a relationship between the cost of contraception in an unmarried person and STD treatment. An insurance company may discover a relationship between the cost of abortion and the cost of acute psychological care. And in the long term, an insurance company might also discover a relationship between contraception for a 20 year old and infertility treatments when she is 35.

    Maybe, just maybe, in a free market, premiums would then go down for people who lead low risk lifestyles.

  • kowalski

    The only way to get the omnibus expanded definition care is to force everyone in the country to buy insurance coverage. Period.

  • kowalski

    Here’s a good part of the reason why this is happening now:

    It is because the people who are involved in healtcare provision know that in the very near future, it is going to be possible to estimate people’s vulnerability to different kinds of diseases according to genetic analysis. Increasingly, clinicians will be able to take a genetic analysis of a child and determine which diseases they will be most susceptible to in utero. If you allow those children to be born, you will *know* that they’re more vulnerable to joint problems, cardiovascular diseases, eye problems, tooth problems, etc., etc., all the way down the line.

    What they are doing with this legislation is: “We will treat the ‘sick’ and the ‘nonsick’ equally, even though we will *know* that certain people are going to be more susceptible to disease the day they are conceived.”

    It’s a very profound transformation. Medicine is going to become increasingly predictive of illness based on people’s genetic makeup. To get out ahead of the science by a generation or two, the people who want the mandate right now (“rich or poor, sick or not, you have to have insurance”) are laying the groundwork to continue to care for the people who have not-so-nice genetic dispositions to illness – along with those who make manifestly unhealthy lifestyle choices. As the sophistication with which predisposition to illness increases in the coming years, this “egalitarian” approach is what they deem necessary, because the data is going to be there.

    In the not too distant future, you are going to be able to have a genetic analysis done on your child and it will say: “This person is predisposed to have cataracts, be nearsighted, suffer from asthma, and be especially vulnerable to certain types of bacterial infection.” And your child’s pediatrician will know that at the time they are born.

  • kowalski

    And absent cures for those problems (they are exceedingly difficult to create and very difficult to effect in a living human being), the health care profession is recommending now that everyone, always purchase insurance. That is one of the reasons this is happening now, instead of 20 years from now.

  • kowalski

    It is my very firm belief that within 50 years, almost all of the common maladies that people suffer from that require expensive care will be predictable at birth to a high degree of confidence, based on genetic analysis – everything from susceptibility to Alzheimer’s to alcoholism and schizophrenia. The people who are looking hard at that avalanche of data are trying basically to say: “Just because your kid is going to have asthma doesn’t mean we won’t cover him.”

    This is a very deep question and believe me it’s bigger than the political talking points.

  • kowalski

    It’s profound because lumped in with those other things, it’s going to be increasingly possible to estimate how intelligent the child will be, what kind of reflexes they’re going to have, and possibly even whether or not they’ll be better suited to being an illustrator of graphic novels or an economist who runs the models on supercomputers. This century is going to be the century in which we really begin to understand the genetic basis of human differences right down to the alleles.

  • talgus

    since Medicare and certainly Medicaid. A perfect example of a Democrat’s policy/laws creating the reverse of what everyone thought was intended. (I, believe, it has always been their intent to destroy choice, except the choice to destroy new humans.)

    Excellent diary on oxymoron of “insurance”

  • http://www.nighttwister.com NightTwister

    -no-text-

  • kowalski

    Honestly I’ve never watched that show. I just know that it is going to be increasingly that way and a lot of very difficult decisions are going to have to be made. In the past we’ve done genetic screening to avoid really terrible birth outcomes like exposed brains, etc. The more we learn in this century about the genetic causes of diseases the more that data is going to determine how we create our offspring, and I use that word deliberately.

    In the past it was luck and love and rolling the dice, so to speak, and everyone just deals with the consequences. That is all going to go away.

  • http://www.nighttwister.com NightTwister

    It’s about two classes of people. Those genetically engineered, and those that are conceived by accident.

    I put in on par with Soylent Green & Logan’s Run.

  • kowalski

    And if people don’t think professors are just as keen to maximize the fitness of their children regardless of which party they belong to, they only have to travel to a university like Bard where they will find that the professors DO NOT have sex with the janitorial staff. Same thing at big schools in Chicago. So they know it’s in the genes and once the evidence is very clear cut, we’re going to have a lot of really interesting times.

  • kowalski

    But honestly what I do a lot of the time right now is to try and shield myself from ideas that other people came up with. I know I’m speaking in my own voice when I can’t find the antecedent to my thoughts in something I’ve watched on the tube.

    But I’m sure it’s a cool show.

  • kowalski

    I’m sure it’s a great show but I very rarely, if ever, watch television or cable, including cable news, including Fox. I turned off the television in my mind about 15 years ago and I’ve never really started watching it again. I’ll watch an episode or two of Mythbusters from time to time and during the holidays I might watch a program, and of course from time to time the televised debates, but that’s about all.

    I have the shows I want to watch on DVD and Netflix and almost everything I think about in terms of prepackaged televisual information comes to me via the Internet. I’m a big fan of old episodes of Frasier and Everybody Loves Raymond and some Seinfeld but basically after those shows, I think television became completely irrelevant to me, even for comedy. It’s all suffused with boilerplate political messages, as are movies. I never watch the Emmys or the Academy Awards, and I haven’t seen a movie in the theater since “No Country for Old Men” and that was only because of Tommy Lee Jones. I had to go.

    I listen to NPR for laughs and giggles and occasionally I watch skits from Saturday Night Live on Hulu. I think Stefon is one of the funniest characters ever done on SNL and he’s horrendously politically incorrect but Bill Hader is an exceptionally gifted comedian and he’s right on with that skit during Weekend Update. I love how he can’t stop laughing at himself during the skits, because I’m rolling on the floor myself.

    http://www.hulu.com/watch/144710/saturday-night-live-update-stefon

  • kowalski

    I plink around with the piano and I know it’s important to have influences but I cannot stand when the influence is the dominant element in the theme. I’ve listened to so much music (and I remember a lot of it so well) that it’s really hard to separate sometimes what is “me” and what I’ve heard before. Probably that’s how it’s supposed to be, though. :)

  • jaykali

    So let’s say the individual mandate is thrown out…we still have these other mandates – a combination of a company/insurer mandate to cover certain things, sometimes at no cost to the individual (ie contraception). Now this has been done at the state level for some time, but is there a precedent for this at the fed level? Is there any other private product that the federal government has this much control over? It seems to me that should this stand this so-called insurance can be used as a vehicle to provide anything loosely associated with ‘health care.’

    I am just curious if there is something exactly like this at the fed level that is comparable? Maybe there are dozens of examples I am just not aware of. Such as we had a law recently that essentially outlaws incandescent lights eventually right? Like what authority do they have to just ban incandescent lights? I fear that the government already has essentially power to do anything ‘in the public interest’.

  • mkozikowski

    Pregnancy and Child Birth are now classified by our President as a disease.

    Once we accept that, we MUST protect ourselves from it.