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jaunthieI've mostly stayed out of discussing health care reform on this blog, largely because a) the fact that anyone questions whether our heath care system needs serious reform raises my blood pressure, b) it's a really complex problem that people keep trying to shoehorn into little soundbites (or shouts) rather than hold reasonable discussions around and c) I've been very busy. However, for any readers out there who might still question whether there is a need for overhauling the health care system, consider the following fact.
If you live in one of the following states or districts:
being a victim of domestic violence is defined as a "pre-existing condition" that allows insurance companies to deny you coverage.
Now, from a for-profit insurance company's point of view, the reasoning behind this is simple. Domestic violence is one of the most powerful predictors of increased health care utilization. In other words, if you've been hit once, you're statistically extremely likely to be hit again, whether you are a child being beaten by a parent, a woman who was raped by her boyfriend, or a man who was clocked over the head by his spouse. And that means you're likely to be an expensive person to cover, so they deny you coverage.
However, from a human decency point of view, and also from a public-policy-for-the-common-good point of view, this is absolutely the WRONG idea. Discouraging a mother from reporting that her husband is beating the crap out of their five-year-old child because she's afraid she'll lose her health insurance not only helps perpetuate the cycle of violence, it increases the overall cost to society in the long run. Domestic violence leads to a variety of social ills (increased likelihood of criminal behavior, underperformance in career/life/work, depression, and of course the massively increased likelihood that the abusee will become an abuser somewhere down the line, among many other things), all of which cost the rest of us real consequences, not only in terms of money (loss of revenue, increased taxes to pay for more jails, etcetera) but also in terms of the overall health of our society. It incurs real risk to us, the general population.
The insurance companies don't care about that. It doesn't impact their bottom line, which is, after all, what they are in business to care about. They have to justify their costs and profits to their shareholders, and their shareholders aren't paying them to take the long view, or to care about anything but making money.
But we, as a society, have a vested interest in stopping domestic violence, in halting and reducing the number of people affected by it. Our interests and the insurance companies' interests do not align. The same can be said about many other issues, from regular preventative care to duration of hospital stays to efficiencies in paperwork.
In short, public health policy should not be dictated by the cost/benefit analysis of for-profit, private health insurance companies. A healthy population (and a sane health care system) benefits us all. We need to rationalize our system so that the public need, the public good, is the driving force behind our health care system, and not the private profit of the health care industry.
If you live in one of the following states or districts:
- Arkansas
- Idaho
- Mississippi
- North Carolina
- North Dakota
- Oklahoma
- South Carolina
- South Dakota
- Washington DC
- Wyoming
being a victim of domestic violence is defined as a "pre-existing condition" that allows insurance companies to deny you coverage.
Now, from a for-profit insurance company's point of view, the reasoning behind this is simple. Domestic violence is one of the most powerful predictors of increased health care utilization. In other words, if you've been hit once, you're statistically extremely likely to be hit again, whether you are a child being beaten by a parent, a woman who was raped by her boyfriend, or a man who was clocked over the head by his spouse. And that means you're likely to be an expensive person to cover, so they deny you coverage.
However, from a human decency point of view, and also from a public-policy-for-the-common-good point of view, this is absolutely the WRONG idea. Discouraging a mother from reporting that her husband is beating the crap out of their five-year-old child because she's afraid she'll lose her health insurance not only helps perpetuate the cycle of violence, it increases the overall cost to society in the long run. Domestic violence leads to a variety of social ills (increased likelihood of criminal behavior, underperformance in career/life/work, depression, and of course the massively increased likelihood that the abusee will become an abuser somewhere down the line, among many other things), all of which cost the rest of us real consequences, not only in terms of money (loss of revenue, increased taxes to pay for more jails, etcetera) but also in terms of the overall health of our society. It incurs real risk to us, the general population.
The insurance companies don't care about that. It doesn't impact their bottom line, which is, after all, what they are in business to care about. They have to justify their costs and profits to their shareholders, and their shareholders aren't paying them to take the long view, or to care about anything but making money.
But we, as a society, have a vested interest in stopping domestic violence, in halting and reducing the number of people affected by it. Our interests and the insurance companies' interests do not align. The same can be said about many other issues, from regular preventative care to duration of hospital stays to efficiencies in paperwork.
In short, public health policy should not be dictated by the cost/benefit analysis of for-profit, private health insurance companies. A healthy population (and a sane health care system) benefits us all. We need to rationalize our system so that the public need, the public good, is the driving force behind our health care system, and not the private profit of the health care industry.
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Date: 2009-09-13 09:09 pm (UTC)Another charming (if less obscene) example: exercise is good for long term health, but people who ride bicycles / play sports / etc are at a higher risk of treatment for injury. Overall the reduced costs from diabetes and heart disease probably make athletes less expensive to insure than couch potatoes, but the fact that you will be cheap to treat at 80 doesn't mean much to the company insuring you at 40. So - sports-related treatments often count as pre-existing conditions, too.