Health insurance is not like fire insurance. Not having fire insurance can lead to loss of property. Not having health coverage can lead to disability or death. Fire insurance is a choice. Health insurance, in a moral world, is not.
I guess what you are suggesting is that people with preexisting conditions should just go away & die. Just kick the sick to the curb & forget about them, let them go bankrupt or die so insurance companies can make money. Is this ethical or moral? Just let people die.
Universal health insurance is the only sensible solution. It works well in Canada & is actually cheaper than the US system. True, it's not perfect but it provides the most health care to the most people, unlike the US system which covers only some people.. Health care which is mostly provided by the private sector, by the way.
Few people seem to understand what insurance is & how it works, so I'll provide a potted version. Essentially, insurance is a bet you make with a group of people but hope to lose.
Americans, in love with the idea of competition, think that if they just provide competition all will be well, but insurance is not like other businesses. It requires the other side of the Capitalist coin: cooperation. It's also just as vital to capitalism as competition (but that's another story.)
For insurance to work in a competitive environment it is crucial for those companies to be able to accurately predict the future. This is done using science, math, & pooling of large numbers of people.
I' ll provide a little history. In the beginning of the modern era, in 16th century Holland, merchants realized that at least one of their ships would not return every year. They decided to get together & make a small payment which would go to the merchant(s) that lost ships. By cooperating, each merchant lost a small amount of money in order for the ones who lost a ship could gain something if disaster struck rather than be wiped out.
By the 18th century, in Scotland it was realized that we could accurately predict death rates & life insurance as we know it was created. Death, fire, auto, theft, & some other things can be quite accurately predicted & therefore make for a profitable business. If you can accurately predict how much money you need to pool & how much you will have to pay out, you can make money.
However, you have a problem when prediction is impossible. Take floods, for example, at the current time they are impossible to predict accurately and that is why no for profit insurance companies will provide it. And what is strange to me, is that the US government does provide it for a small premium. You have socialized flood insurance that even the Republicans approve of. Perhaps, due to the fact that rich people benefit inordinately from it. They can build beach front mansions with little fear of loss. This, of course, is one of the moral hazards of insurance (But since it involves rich people's property it must be OK, unlike those pesky sick poor people who want health care.)
Back to health insurance. Health care needs, like floods, are impossible to predict under the current state of knowledge. Due to the continued improvements created by science & technology, health care is always changing. This means that it is impossible to make money providing it.
So why are health insurance companies in the US so profitable given this reality? Because they don't have to cover everyone. First, the sickest, riskiest persons are removed by Medicare, Medicaid, & the VA. Second, they can reject anyone they think might have a health problem. Third, if someone gets sick they can often get rid of them by sighting preexisting conditions or they agree to cover you but you may still have to make copayments.
This makes for a very profitable but ultimately dishonest business. Essentially it's a scam. Their business model is flawed & I predict without reform it is ultimately doomed to fail. Why? Because healthy people will continue to drop out if they perceive (rightly) that it provides no benefits to them. This is happening already.
Even with reform the business is already doomed due to the above mentioned unpredictability of costs.
When it comes to life, health, freedom from pain, humans have an insatiable demand for it. They will always demand more & more. We could spend every penny we make to save our lives. This is obvious even now, when so many people are going bankrupt in the US in order to pay for health care. Due to this insatiable demand the whole economy could end up being devoted to it, to the exclusion of everything else. This is not sustainable.
The only sensible solution, in my opinion, is universal health insurance paid for by taxes. Since everyone is covered it provides the largest possible risk pool. It is cheaper than the current system due to less administration & no need for profit. I know that Americans believe governments can't do anything but this is a myth. Governments can & do provide cheaper, fairer health care in the rest of the first world.
Of course, they do have to ration it, but this is inevitable. There just is not enough money to provide all the health care people demand. In the US, rationing is already being done: some people are not provided with health care. That works but is it ethical or moral?
by
susanfrom on
11/04/2009 05:30:36 PM EST
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