Guest Post by Eric Peters
People think it’s crazy to go without health insurance – not that it’s any of their business. But they think it is their business – and so we have Obamacare and almost Trump Care, which at least would have resurrected some connection between the cost of premiums and the insured person’s risk profile, including such variables as their age and pre-existing conditions.
If you are older or have an established chronic illness, you’d have paid more for coverage under TrumpCare.
Egads!
This is considered by some to be morally outrageous.
These same people don’t, however, complain about the iniquity of car insurance costing convicted drunk drivers or teenagers or the glaucomic elderly more.
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But if my health and track record of physical problems should have no bearing on what I pay for insurance (less or more) why should my DMV record, age or any other such factor affect what I pay for car insurance?
Isn’t the principle the same? Or am I uncouth for mentioning it?
I don’t have diabetes, high blood pressure or any chronic health problems at all. I’ve incurred (cue Dean Wormer from Animal House) zero point zero in medical costs to the cartel. I am still relatively young and very healthy. I don’t smoke, I hardly drink and I exercise often. No allergies. No medications. My BMI is “fit” and I am the same waist size today that I was in high school. I run 3-5 miles every other day.
My health insurance premiums do not reflect any of this. Which is very odd.
Very unfair.
It doesn’t matter, Obamacare-wise, that I am a low-risk candidate. The premiums quoted for an individual policy are in the $500-plus a month range and based not on my health but on the not-so-great health of others, whose care my and other healthy people’s premiums subsidize. This includes such things as maternity care, which I as a single male am not likely to need – and pediatric care, which I as a single male without children also am not likely to need. But which I and other single men without kids are made to subsidize.
Which makes our premiums – which ought to be be very low – extremely high. It’s exactly like having to pay $2,000 annually for a car policy because my neighbor is a habitual drunk driver and keeps mashing up his car.
Well, I’d like to have the same principle applied to car insurance – for the sake of equality and fairness.
If it doesn’t matter – and it doesn’t, under Obamacare – whether I am an obese chain smoker who lives on fast food and Hoovermouths a medicine cabinet full of expensive prescription drugs every morning and night – then why should it matter, car insurance-wise, whether I have a couple of speeding tickets under my belt? Or whether, for that matter, I am a habitual drunk driver?
It is outrageous that some people pay higher car insurance premiums based on such “pre-existing conditions” . . . is it not?
Some will tell me that it is a choice – deliberate bad behavior – to break traffic laws or drive drunk and that by doing so, you are demonstrably (statistically, at least) a person who is more likely to have an accident and therefore it is reasonable to charge you more, especially since you could choose to not speed and could drive more cautiously.
Well, sure – certainly.
But why, pray, does the same principle not apply to health insurance? People do not become morbidly obese because an evil genie waved a wand and – presto! – their formerly lean and lithe selves were transmogrified into People of Wal Mart. No one is forced to visit McDonald’s daily, as many people do – or drink several sodas a day. Or forbidden to go to the gym or even for a walk. These are all choices as much as the choice to exceed the speed limit and arguably, less morally defensible because there is no doubt at all that being morbidly obese and eating shit food will result in health repercussions while driving faster than the speed limit will probably result in no repercussions at all.
Why is it considered mean-spirited to expect the Tubby and the Lazy or even the elderly, for that matter, to pay out more for the cost of their actually higher and more frequently necessary medical care – as opposed to the cost of insurance for the young and not-tubby and not-lazy, who generally need less and often no medical care?
Of course insurance ought to be based on risk – else it’s not insurance and absurd to call it that. And yet – uniquely, bizarrely – the element of risk is entirely excluded from this one kind of insurance. Which explains why it’s bankrupting everyone, including most of all those who don’t even use it.
Like myself, for example.
For the 15 years I was married, I was “covered” under my wife’s policy, which she got through her work. But – other than an occasional physical (done at her prompting) I never darkened the doctor’s door. I am blessed with good health but also take very good care of myself.
At some point, eventually, I recognize that I will probably need a doctor’s services. But for now, not. So, after my divorce, I checked out what it would cost me as a self-employed individual, to buy a basic plan – which, per Obamacare, isn’t available. I must buy coverage for things I do not need, such as maternity and pediatric care. And of course, the cost of my premiums reflects the costs of other people’s health problems which – selfishly, I suppose – I am not particularly interested in paying for.
Because I can’t afford to do so. My resources are limited; other people’s problems are unlimited.
I would pay for a policy that took into account my lack of physical problems, past or present – and the probably much lower-than-average risk of my having them in the foreseeable future, based on my health and conditions and habits. I’d go in for a thorough physical to establish such things as my blood pressure and resting heart rate (62 beats per minute, if you’re interested) and which took into account that I exercise a lot and am not likely to become pregnant and don’t have children, pre-existing or otherwise.
I’d pay for it, because (ta da!) it wouldn’t cost $500 per month – based on the fact that I would likely not use it much.
If I did, then it could go up – fine, that’s fair.
But I’m not paying $500-something per month – which is the lowest quote I could find – for nothing . . . to cover other people’s problems, which is what Obamacare amounts to. Which takes no cognizance of my risk profile and which charges me for other people’s risk profiles and for things I absolutely do not need (such as maternity care/pediatric care).
I did the math – and find that pocketing the $500 per month instead leaves me with $6,000 more in my pocket at the end of each year and that covers a lot physicals and even a few stitches, if I happen to have a mishap with the chainsaw again.
Over the next five years, say, that $6k per annum comes to $30,000 in my pocket. Over ten years and it’s $60,000. That would pretty much cover anything less-than-catastrophic that might occur – and leave me change, too. And if nothing catastrophic did occur, I’ve got $60,000 I would otherwise have spent on . . . nothing.
Well, nothing for me – selfish prick that I am.
It’s true I might have a heart attack or get cancer. Something catastrophic might happen.
But probably won’t.
For which insurance would be great.
A high deductible/low-premium policy based on the remote risk of a payout, that would cover me if such an unlikely thing were to happen. Kind of like the way my car insurance premium assumes I won’t cause a major accident, based on my track record of not having them – and charges me accordingly.
But Obamacare isn’t insurance – and neither was/would-have-been TrumpCare. They are not even pre=paid medical care plans. They are wealth transfer plans from the young and healthy and responsible to the old and sick and irresponsible.
No one wants to talk about this, which is why the problem is going to get worse (cost everyone more) and make no one happy.
The People of Wal Mart will continue to abound; there will be less and less incentive to not join their ranks, too.
Why not? Working out is . . . work. Hey, I like fast food, too. And if I’m going to be charged as if I were a Super Sizer, why not at least enjoy the lifestyle of a Super Sizer?
Until I no longer get dunned for “speeding” and other such “pre-existing conditions” when it comes to my car insurance, I don’t see why I ought to be made to pay for non-existing conditions when it comes to (cough) health insurance.
Maybe someone will explain it to me.
Oh but we do pay for the drunk driver next door with our auto rates Eric. Those continuous blood sucking lawyer ads on the tv for bodily injury cases cost EVERYBODY.
You also pay higher rates on your homeowners insurance when there have been major losses due to storm damage etc. no matter if you yourself had no damage.
The problem with healthcare premiums is the fact that costs are are just waaaay too high and the medical cartels need to be busted…..that’s it in a nutshell.
Healthcare insurance is sort of like a guaranteed annual income for the healthcare industry.
And like a guaranteed annual income, those who don’t use it are the ones expected to pay for those that do.
One of those “from each according to his ability, to each according to his needs” sort of things.
Oh, but when the day comes,(may it never), & you get cancer or some other serious problem, do youwant the whole bill ($100,000 on up) on you? I, too, paid for years when I had no problems. Now I’m 69 yrs. old & have a couple of issues. Over the years,I feel I have more than paid my healthcare forward. You just want to consider today, & don’t want to pay until you need to. That is the problem. You have done well exposing your greed & selfishness. KMA!
You made your choice, he made his.
The point is you both have the opportunity to make your own choice according to your personal desires, and willingness to face the consequences, in a free country.
Do you lament that freedom?
Many people to day are on your side if you do, and are working to remove it.
Obamacare being a prime example.
The bill is fake, doofus. You could have banked 1/4 mil + investment earnings or more over your working life (remember to count what your employer “paid”), paid cash for your healthcare and had the remainder to pass on to your heirs. Instead, it’s gone to stock options and bonuses to United Health Care management who enjoy their second homes in Sonoma and on Marco Island.
“This includes such things as maternity care, which I as a single male am not likely to need – and pediatric care, which I as a single male without children also am not likely to need.”
I don’t like Obamacare, however this is a specious argument. Currently everyone in the US is taken care of, if they need medical care – be it insurance, medicare, medicaid, welfare. It doesn’t matter how you ‘cut it’ – it’s the same amount of money – that we collectively have to pay.
Everyone can pay less in health insurance – but then taxes will go up for medicaid / welfare. It’s a zero sum game.
All the BS about pre-existing conditions – hell anyone over 50 has a pre-existing condition. It’s not about having a policy that covers only certain things – if you have such a policy – and you get sick with a condition that’s not covered – we (taxes) will pay for it anyway.
But maybe it shouldn’t cost $100,000+ to treat cancer?
This article misses a big point (aside from the fraud that Denninger talks of) – that insurance isn’t supposed to cover foreseeable expenses. Health insurance paying for blood pressure meds is like auto insurance paying for oil changes. It’s a truism that insurance raises the aggregate cost. If regular body maintenance costs were apportioned fairly (and included as part of so-called insurance) more people would rightly conclude that insurance isn’t worth it, especially since, under EMTALA, if they get in a car crash they have a “right” to treatment and a lot of people have no assets to protect anyway. Therefore, in order to gin up demand for insurance, the medical industry has colluded to issue fake, vastly inflated, scary invoices to patients.
HSA’s coupled with catastrophic policies would address that issue.
Nothing else I’ve seen proposed does.
HSA’S + catastrophic is good, but the phony bills have to be ended first.
I wonder if HSA’s with people paying the majority of their routine medical bills out of their own cash would deal with that by making consumers demand both competition and price accountability?
The catastrophic parts might be different, but I’m wondering about all the self paid routine care that constitute the majority of the medical spending for most of us.
I know I’m a whole lot more of a tightwad with my own money than someone else’s and definitely shop for the best prices when I’m spending my own.
Yes, for those of us willing to have free-choice, and live responsibly, an HSA with a catastrophic policy is perfect.
The nanny state cannot permit people to make choices that reflect their needs according to their lifestyles and desires. Thus the insurance policy holder pays for ( as an example only ) diabetic care for obese people who never exercise and never eat properly. And likely smoke too.
Or you can opt out of Healthcare Insurance completely, like some creative people have managed to do, myself included.
I turn 65 on August 1, after five years of absolutely no insurance. I took the risk and saved tens of thousands of dollars. And I lived responsibly and bought my BP meds from India and my warfarin also. Thus I am still alive.
( Life cannot be made risk-free, I’m afraid )
SnowieGeorgie
Where in India do you get your BP stuff and how do you go about it?
I’m thinking about going that route but don’t know how.
Here’s what I did and how I did it :
(1) I found the best CANADA pharmacy ! Years ago that meant Chinese drugs a lot of the time.
(2) I ordered Warfarin 5Mg tabs from the pharmacy. My dose is 3Mg, but 5-s cut in half were the best price.
(3) The meds came from India in about three weeks. Longer than I would have liked, but there you have it. You can get a discount with a following order.
(4) I tested the Warfarin before using it in this seemingly dangerous way : I took a high dose for over 2 weeks. I have Kidney damage from a prior medical event, and when my Warfarin dose has gone too high, my urine turns pink. As soon as my urine turned pink, I guzzled about a gallon of water in 8 hours to flush the excess Warfarin from my system. Which worked.
In retrospect, it would have been faster, safer, and smarter to get some Vitamin K to reverse the effects of the Warfarin overdose. Vitamin K works fast and is safe at the correct dose. But you cannot get Vitamin-K in Massachusetts without a prescription — a controlled substance which lots of people abuse ( LOL )
I did take some generic Vitamins which have Vitamin K in them to help fight the Warfarin overdose — while I was drinking the gallon of water.
I also bought Lisinopril and Metoprolol and tested those BP meds by increasing the dose to see if my BP reacted — which it did — as hoped for. I do not trust India, but I need the meds, and was able to demonstrate efficacy, and also to get the meds sans prescription, for a reasonable price.
If you have more questions ask away, the getting prescription drugs w/o a prescription was a life-saver for me. I am glad to help.
SnowieGeorgie
Sadly, your BP meds and that rat poison warfarin are likely to kill your ass.
My doctors at Brigham and Womens prescribed Warfarin, Lisinopril and Metoprolol as my lifetime maintenance regimen, after life-saving heart surgery.
They saved my life with complex surgery ( they had to chill my brain while they had my lower body on bypass ) and I survived a medical emergency that most people do not survive, John Ritter being one example.
So they saved my life with a hundred’s of thousands of dollars emergency surgery ( I was fully insured at the time ) and gave me a regimen of three drugs, plus an aspirin — all of which they said would keep me alive.
Now, a decade later, the last five years with zero health insurance, I am healthy and very much alive, although I do get a bit out of breath when I encounter hills on my daily walk.
All things considered, an excellent result.
Thank you for caring enough to offer helpful advice !
SnowieGeorgie
While in general I agree, but you put it all in black and white.
On Obesity:
1. I’ve known two women, thin as a rail, but happened upon a medical condition where the treatment involves ingesting a specific medication. In both instances, the women ballooned to non-appealing states.
2. I have an older brother (currently 77) that was Always heavy. For 20 of the last 23 years, he went to the gym and worked on the exercise equipment, especially the Ellipticals; he was dedicated and most youngsters could not compete with him.
Generally speaking, he never lost weight. He is overweight today.
its simple- weight is fundamentally controlled by calories in vs calories burned. in your two examples of excess weight involving medication and exercising, they still had too may calories coming in, they ate too much.
1. So after 45 years she suddenly changed her lifestyle after taking the medication and started gulping calories.
That is bullshit.
2. Hard to respond to your lack of knowledge. That brother was heavy when he played in Little League. We were VERY poor and didn’t have snacks or plentiful food.
My point is you are ignoring that people can be born with certain traits beyond their control.
Maybe you also have a reading comprehension problem – at the start of my original comment I stated that the article was putting everything in ‘black and white’ – but humans are not created in one mold or one set of DNA.
AND – no fast food outlets back then!!!
Two words my friend – Insulin resistance. It is that simple. When you see someone overweight, it is their cells telling them to STOP eating the damn carbs. Whether it was the medication – which she should have just passed on anyway, considering most pharma products are just high grade poison, and are not even designed to FIX the problem, only for dependence – or simply deciding that a plate of pasta and “healthy” breads was what they should be eating makes no difference.
Tell both of them to start doing intermittent fasting, and not eating high metabolic carbs and I would bet anything that they would see pounds fall off. Add in exercise, and wow, it could be a miracle.
But that takes something that is seems only 1 ‘murican in 200 has, and that is called discipline and focus. Very rare commodity these days, and getting rarer by the minute.
Anon….brother has been off carbs for 20 years; no bread, no pasta; only fish, chicken, steak, veggies. I couldn’t eat like that.
then your brother is eating too much fish, chicken, steak and veggies
As we grow older, certain drugs not withstanding, we need fewer calories even with the same basic lifestyle.
A lot of overweight in older people comes from being behind the curve in how fast we cut our calories compared to how fast our metabolisms need for them decreases. It sort of sneaks up on most people.
And the slowing metabolism of aging makes it even more difficult to get rid of the weight gain it caused once it has already happened.
Anon…getting older; completely agree, as it hit me like a ton of bricks in the last 6 months. My appetite is reduced and I am generally not hungry. I now eat very simply and not much and I still can’t lose weight (I’d like to lose 5 pounds).
Calories in/calories out is flawed as a model, and far too simplistic. The reason is that the two are *not* independent variables. This has been known for decades. Fat mass is regulated by hormones, which in turn are dependent on what you eat, your existing level of bodyfat, activity levels and so on.
2,500 kcal/day of cake and soda will not produce the same results as 2,500 kcal/day of meats and vegetables, despite the caloric content being equal.
A great book that explains the biochemistry of obesity in detail: “The Obesity Code” by Dr. Jason Fung.
That’s only true because differing types of food have different effects on metabolism (calories out) and on hunger (affecting calories consumed). “Crashing” after eating carbs can slow your metabolism (more than the carb spike had previously increased it) and avoiding carbs can ward off hunger so that you consumer fewer calories. Calories in/out is still what matters to maintaining weight. “whatever” above is correct. There’s one thing you have to eat in order to lose weight: less.
I am glad that your brother is 77 and healthy but that isn’t an argument. There are always exceptions. I know a guy, still going, who smoked two packs a day and drank like a fish for nearly 60 years. A while back he quit cold turkey. These days at 82, he is still cutting and splitting his own firewood. It is just a fact that being overweight puts a person at much higher rate of chronic illness. Truth hurts but if the risk pool for insurance being written is full of fatties then payouts are more likely for a whole host of things. So it is black and white if you are an Actuary. That is the whole point Eric was trying to get across. The Fatties can’t afford their health care unless they get young healthy people to pay for it. But when it comes to health people take personal offense to life choices they make.
It is not a Vega they bought and rusting in a field being made fun of..
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it’s mobility scooters pimping their rides in the snack food aisle.
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Sure genetics matters a little but by and large people are fat because they eat too much.
Women have babies when they should sitting on their ass.
People get cancer because they smoke.
Ruin their livers because they drink.
Have heart attacks from voting Democrat.
Prices would come down if people paid for their own shit and prices hospitals charge were posted.
In what other industry does one buy product while having no idea how much it is going to cost. No sane person would drop pet off at vet and not ask about price. Why should it be any different for health care for people.
Just the other week at Monday night curling discussion turned to government and budgets. A Doctor sitting at table chimed in by saying that many government departments need streamlining. Less money. Tough medicine for me to swallow when health care budgets in Nova Scotia are expanding at a rate far above the rate of growth or inflation. I couldn’t help myself so I asked him to his face.
Why don’t we cut the health care budget?
He looked at me and never even bothered to answer question. He then moved on to other things so I asked him again. Crickets! In his world more money is not enough. Nope for him everyone needs to give till it hurts or Granny gets pushed off the cliff.
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That ain’t health care. It is a protection Racket. And it should be illegal.
That comment (mine) wasn’t an argument; it was an exception to an argument.
Same as the Education racket.
Your exception is invalid when it comes to arguing about black and white. I really don’t see the point you are trying to make. Is it that because some people get a shitty deal with genetics that others should pay more.
The reason to allow pre-existing conditions is that while some are CURED, the insurance industry uses the idea “pre-existing conditions” to charge anyone who was ever ill of anything more, and charge them through the roof.
My wife had cancer; eight years past surgery, chemo and radiation, her maintenance regime has ensured she will not get (that) cancer again. However, because she had cancer before, they will charge her an arm and a leg NOW and FOREVER for insurance coverage.
We were without any health insurance for a while, but it did not really matter; the occasional cold and flu we paid for ourselves. But now, the government FORCES us to have health insurance, at the point of the IRS penalties: we have no choice, and we pay over $600 a month (over $850 if you include our collegian child as well) for insurance, more than our mortgage payment.
This will implode, and not far from now; either the laws and charges change, or a majority of Americans will go bankrupt or break the laws. Wonder which will happen first?
Eric should stick to cars, something he writes very well about. Why should anyone give a shit about his fitness, heart rate or over all health? Or his pissing and moaning about insurance rates.
The author sounds like a young to early middle aged person.
Sadly, barring accident, disease or overdose, every young person becomes late middle aged/old.
Medical care at that point becomes necessary.
The problem in the US isn’t insurance – the problem is costs are out of control. Costs being out of control are entirely due to the lack of a national health care system.
I call bullshit. Costs are out of control in Canada as well.