Friday, January 06, 2012

Popping out of the foxhole

I didn't realize just how long it has been since my last post until just now.  Wow.  I miss writing here; I am constantly thinking of things I'd like to talk about but never force myself to do it.  I hope you all had a happy holiday season and are enjoying the new year.

Tonight on Facebook I saw a link to a story and video clip of US presidential candidate and former senator Rick Santorum, talking about how people should be charged more for health care coverage if they have pre-existing conditions.  The link is here.

Blaming people for their health issues is ludicrous - there is often no way to know why they have the issue they have.   I'm not even speaking for myself here... it's entirely possible that I have kidney cancer because I am fat - therefore it is my "fault", since obesity is widely considered a risk factor for many cancers.  But while I would be charged more for insurance - or even be denied coverage - what about another cancer patient, who has always maintained a normal weight, has always eaten a healthy diet, has exercised regularly, never smoked, and did all the other "right" things?  Would they get to pay less than I would, even though we would both be costing the insurance company the same large amount for our treatments?  

Let's say the answer is no, they would also pay an increased premium.  OK, well then, what bad choices did they make that justifies a higher premium?  Nobody can point to anything, so the good-choice cancer patient is going to complain, and rightfully so, that they are being penalized for something that they didn't cause.

Now think about the other answer... if the good-choice cancer patient doesn't have to pay a higher premium, how is this saving the insurer any money?  It isn't.  Sen. Santorum says it's all about charging more to those who cost the system more.  But by adding the whole notion of assuming that high cost medical issues are in large part a result of poor personal choices, what he seems to really be saying is that we should penalize people who do "bad" things to their bodies. Now it's no longer about having those who receive more benefit pay a larger share, but about punishing people.  And punishing them for issues that can't be easily proven to be directly caused by their actions and choices.

After I read the story above, I read another article where in explaining why it would be okay people with pre-existing medical conditions to be denied coverage, he compared health insurance to car insurance.  He states that it's not fair for people to only buy coverage if they are sick and know they are going to use it.  He also thinks that maybe insurance should only cover large-ticket care and we should all pay for our own "maintenance" costs.  OK, this would make insurance cheaper.  But would it save money in the long run?  I don't believe so.  If people don't have coverage for well visits, prescription drugs, immunizations, etc. then many of them are not going to pay out of pocket for those things.  Then what happens?  If they get REALLY sick, they incur huge health costs.  We see this daily in the overuse of emergency room care in the US.  Maintenance care can catch things early and keep complications from happening.  Ask any dentist about this - if you go for your exams and cleanings regularly, problems can be caught early so that you might not need really expensive work later.  

Sen. Santorum also stated that 

"insurance rates shouldn’t pay for your general maintenance any more than they should pay for the general maintenance of your car. [...] Should they pay for the operation, well just as much as they should pay for the car accident."  
Wait a minute... a car accident is something that happens unexpectedly.  Do most accidents occur because drivers didn't get regular oil changes, fluid checks, and other maintenance?  Of course not. But accidents aren't the only high costs that can be incurred by car owners.  Engines and transmissions break, brakes fail, lots of other things happen, none of which car insurance will pay for.  So the argument doesn't really hold up to me.

In another video clip, Sen. Santorum makes fun of the idea that everyone should be able to be covered by the same high level of health insurance.  Meanwhile on his own web site, he says "Every American should have access to high-quality, affordable health care".  I guess it's okay to have access to it, even if I can't afford to actually purchase it, in his world.

I work for an employer who offers excellent health care coverage at a very reasonable premium.  I feel extremely fortunate to have this coverage.  My insurance plan has spent an enormous amount of money on me over the last almost seven years.  However, during that time, I've been able to maintain full time employment, pay my taxes, and generally live my life.  The idea of having lesser, or no coverage, scares the bejeezus out of me. 

I totally agree with everyone on both sides of the political spectrum that we have an enormous health care problem in the United States.  I just don't think that Sen. Santorum's ideas are going to solve anything.