Thursday, September 10, 2009

Fairness and Pre-Existing Conditions

Under Obamacare, insurance companies would be barred from denying coverage based on pre-existing conditions. Most people think this is basic fairness, since they assume pre-existing conditions result from bad luck.

In some cases, this view is correct. People born with genetic diseases like Huntington's corrhea or hemophilia did nothing to cause their conditions.

Yet many pre-existing conditions result from decions made by those affected. High blood pressure and high cholesterol are often due to bad diet and lack of exercise. Most lung cancer is caused by smoking. Cirrhosis of the liver reflects excessive drinking.

So it is far from obvious that fairness means people who have insurance should pay higher premiums to fund health insurance for those without. Instead, fairness would seem to dictate that those who contributed to their own health problems should bear the consequences of their decisions.

14 comments:

Nayer said...

"Yet, many pre-existing conditions result from decisions made by those affected. High blood pressure and high cholesterol are often due to bad diet and lack of exercise. Most lung cancer is caused by smoking. Chrrhosis of the liver reflects excessive drinking."

The view from outside of the ivory tower is a bit different.

My brother, based on what you say you've never been poor nor broke. Most poor/broke folks I know don't buy into the "given it's o.k. to rape , pillage and steal" philosophy. They'd rather smoke a joint, zero deaths, than a cigarette but the later is legal, hemp is not.

Pre-existing conditions can also come from environmental concerns, like Harlem being surrounded by 5 open sewers, living next to nuclear power plants, toxic foods, or under the flight paths close to airports.

Is it wise to go jogging in an area with a high rate of gunshot deaths like in Chicago?

Diet choices are based on budget. The corner store does not offer the same cuisine as it does to folks with money. Redlining has been proven.

Culture is a matter of programming and when pork and beef are considered comfort foods, they become abused for comfort. I write this as a vegetarian for almost 3 years.

Single payer health care financed by a hemp tax is the smart way to go. Germs do not respect government law, mutating at will. Your book DRUG WAR CRIMES explains in detail how to use savings and income/savings from stopping the drug war, is a clear solution to our problems.

Just a different perspective. I love you madly and am a confirmed fan of yours. Your book Drug War Crimes should be required reading in every school.

Kevin Adolph said...

Insurance companies should charge premiums that reflect the risk of their customers. Healthy people, who are less likely to make claims (thus making them less risky), should pay lower premiums than unhealthy people. If insurance companies can no longer make distinctions between the healthy and unhealthy, then healthy people will be charged more in premiums than their risk profile would really justify.

Everyone paying the same price for health insurance might be equal, but its not fair.

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