# Making Private Health Insurance Illegal **URL:** \ **Category:** Great Debates\ **Created:** [July 16, 2009, 10:54am UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207 "2009-07-16T10:54:07Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 17, 2009, 7:29pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/41 "2009-07-17T19:29:54Z")
> [@Grumman](#): > > If each customer is charged according to their risk, any member may come out in front, and any member may come out behind. You’re missing the part about the risks of needing major medical care, in both magnitude and frequency, being mostly _out of the customers’ control._ It’s a lottery. We compound it with another lottery about the availability of insurance coverage. Some people lose both lotteries. Is that consistent with a just society to you? > [@](#): > > Since everyone has an equally good chance of coming out ahead, there isn’t a disincentive to participate. With a public option and a guaranteed coverage system, that becomes the case. We don’t have that now. > [@](#): > > Your proposal is to skew this, so that some customers come out ahead more frequently, while others come out ahead less frequently. No, it isn’t. My “proposal” is to extend coverage to \*all \*who are at risk, as in everyone, not just those who hit either the health lottery or the employment lottery. It’s based on doing a public good, not the cupidity of the HMO executives. > [@](#): > > But if you do this, the people who now have a worse chance of coming out ahead have no reason to stick around. Makes the baby Ayn cry, doesn’t it? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 17, 2009, 7:36pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/42 "2009-07-17T19:36:31Z")
> [@Grumman](#): > > “Competitiveness of its price” is the only reason why insurance has any value. Universal health care is worse than useless unless your health care is offered at a price that doesn’t make people worse off for joining. Come on now. How can having insurance be worse than not having it? For another thing, please consider that people without coverage get treatment anyway, at emergency rooms, when their conditions are typically advanced and much more expensive to treat, and that such treatment _is paid for by the insured_. Did you know that? Extending coverage so that fewer people get advanced problems will reduce the total cost to the system. > [@](#): > > But yes, my position is that the need to ensure that the entire system doesn’t go bankrupt is paramount, because a bankrupt company can’t pay insurance claims. There are other ways to run a health care coverage system that don’t involve companies at all, you know. Quite a few members of this board live in places like that. You need to broaden your view of the range of possibilities. > [@](#): > > The “service” is the conversion of random expenses of random severity into a predictable constant. The cost of providing that service, and the benefit received by the customer of that service, is dependant on their level of risk. The total cost of that service is dependent upon the total of the costs of treating those in the system. That total is not very random at all. And it is what is shown in the company’s bottom line, which is bluntly the only line that really matters to them. > [@](#): > > You appear to be operating under the assumption that the downsides of both options are equally bad. But one merely can’t cater to everyone, while the other _can not function_. Somehow it manages to function in quite a few other places. You sound like the economist in the joke who says “That’s all very well in the real world, but it will never work in theory”. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 17, 2009, 7:38pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/43 "2009-07-17T19:38:31Z")
> [@ElvisL1ves](#): > > Come on now. How can having insurance be worse than not having it? IOW you don’t need a parachute until you need a parachute. 😃 ---
**Author:** ![Richard\_Parker](https://avatars.discourse-cdn.com/v4/letter/r/35a633/32.png) [@Richard\_Parker](https://boards.straightdope.com/u/Richard_Parker)\ **Post date:** [July 17, 2009, 7:38pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/44 "2009-07-17T19:38:31Z")
> [@SenorBeef](#): > > And if I may paraphrase the current interpretation of Acticle 1, Section 8, Clause 3: > > “Article 1, section 8 is meaningless. Please ignore it and do whatever you want.” It is not meaningless. The court has several times in recent history struck down legislation as going beyond Congress’ power to regulate interstate commerce. Nor is it obvious that a more restrictive interpretation should exclude the regulation of health care. Maybe it should, maybe it shouldn’t. Simply saying that health care regulation should is obviously unconstitutional is far too shallow an argument, I think. How would you define Congress’ power under the commerce clause? ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 17, 2009, 9:10pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/45 "2009-07-17T21:10:54Z")
> [@Grumman](#): > > “Competitiveness of its price” is the only reason why insurance has any value. Universal health care is worse than useless unless your health care is offered at a price that doesn’t make people worse off for joining. Any for profit insurance plan by definition makes people worse off for joining, because in the aggregate they pay in more than they get out. The benefit to the customers is the reduction of uncertainty. The reason why customer with pre-existing conditions is not going to bankrupt the system is that all insurance companies will be forced to take them, and thus there is no reason why one will get more than the others. Without a law, there is clearly no reason any insurance company will take them (it would hurt competitiveness.) So, unless you want the government to pay without having the offset of lower risk customers, or you want these people to not have insurance at all, you have to force the insurance companies to write for them. Your issue with people dropping out of the system as the cost goes up from covering these people is valid, which is exactly why low risk people either have to buy coverage or pay a tax into the system. This keeps them from gaming it, since they will eventually and inevitably get old and enter the high risk pool. I don’t know if there is a flat fee or not. I’d think a gently rising cost with age would make sense. It sounds like you wish to charge based on a client’s health or risk. But this isn’t a constant. I could be a low risk customer today and turn into an expensive one tomorrow. Similarly, I can turn from a high risk one to a low risk one very quickly, when my issue gets under control. Things like smoking can be self-reported. But do you want to pay for checkups that high risk patients will request to show they are low risk? Do you want insurance companies to force customers to get regular checkups for risk assessment? You’ve got three choices. You can coerce the insurance companies to take risky patients on an equal footing, offset by forcing low risk people to enter the pool, you can have high risk patients covered by a separate government program (which is going to be expensive) or you can let these people go without healthcare or get healthcare they can’t afford (which gets subsidized by everyone else.) Which do you prefer? ---
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [July 18, 2009, 6:15am UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/46 "2009-07-18T06:15:02Z")
> [@ElvisL1ves](#): > > Come on now. How can having insurance be worse than not having it? Because insurance only makes you better off if your new situation (x dollars per month for coverage) is less bad than your old situation (y(t) dollars per month, plus the negative value of these costs being variable). No matter how highly you value the predictability that insurance provides, you’re eventually going to find a price of coverage where it’s simply not worth it. Let’s just say you only use an average of $500 of health services per year. How much are you willing to pay for insurance to cover those services? $600 per year? $1,000? $10,000? > [@Voyager](#): > > Any for profit insurance plan by definition makes people worse off for joining, because in the aggregate they pay in more than they get out. > > The benefit to the customers is the reduction of uncertainty. Here’s a hint: if you’re going to claim I am incorrect, don’t contradict yourself in the next sentence. Because uncertainty has negative value, the removal of uncertainty has positive value, which may outweigh the negative value of the higher average cost per month. Therefore it is possible for both the insurer and the customer to come out ahead as a result of their agreement - the insurer gets more money, and the customer gets more reliability. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [July 18, 2009, 10:52am UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/47 "2009-07-18T10:52:13Z")
> [@Frylock](#): > > (Does the law even say that people with pre-existing conditions have to be covered at the same rate as people without? I knew it said they have to be covered, but I assumed the coverage would be more expensive.) My experience with insurance and pre-existing conditions is that people with pre-existing conditions ARE charged more - sometimes to the point where the premiums exceed their monthly income, essentially making insurance unobtainable even if technically it is offered to them. ---
**Author:** ![tumbleddown](https://avatars.discourse-cdn.com/v4/letter/t/e9bcb4/32.png) [@tumbleddown](https://boards.straightdope.com/u/tumbleddown)\ **Post date:** [July 18, 2009, 1:53pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/48 "2009-07-18T13:53:46Z")
> [@straggler](#): > > Why can’t it be run just like most other developed country in the western world? Two health care systems - one public, one private? Because that would be socialism and government run healthcare and that would be bad and wrong and dangerous and antithetical to America, rah rah rah, love it or leave it. Haven’t you read _any_ of the debate on healthcare before? > [@jtgain](#): > > I don’t think that my doctor is crying because of his lost revenue 😉 But I do notice how I argue over things. When I had the “pay everything” insurance, I didn’t care about tests, tests, more tests, follow up visits, etc. Now that I pay for each visit, he had better be able to tell me why it is necessary. It’s a good thing and it keeps costs down. But that shouldn’t have anything to do with what insurance you have. Everyone should be asking these questions. It’s called being an informed and proactive consumer and taking control of your own health. Too many people just go along with what a doctor says because s/he’s a doctor and “knows more” but it’s a wrongheaded approach to the situation. > [@](#): > > They might as well kill these companies. There is no way that insurance can survive on this model. It would be like telling State Farm that you must sell an auto insurance policy to a guy with 3 DUIs who is drinking a beer in the insurance office right now at the same price that you sell it to Churchy McGoodDriver. It’ll be more like telling State Farm that they must sell auto insurance to Churchy McGoodDriver _and_ Bob Whose Car Got Vandalized in His Own Workplace Parking Lot (probably by the miscreant kid of the woman he had to fire two weeks ago) _and_ Sally With Bad Credit Because of her Divorce _and_ Ray Who Had An Accident When Got Stung By a Hornet _and_ Terri Who Speeds More Than She Should But Never Had an Accident _and_ Family With Quadruplets Who Just Turned 17 and Got Licenses _and_ Sam Who Has Had Problems with “Reverse” In the Past _and_ Marilyn Who Is Getting Up There In Years and Whose Eyesight Isn’t As Good As It Once Was _and_ Aaron Who Lives In a “Bad” Zip Code And Doesn’t Have a Garage _and_ Leslie Who Had That One DUI Ten Years Ago But Doesn’t Actually Have an Alcohol Problem (Just Had a Boozy Night) _and_ the guy with 3 DUIs. In other words, there are a lot of things that count as a “pre-existing condition” many of which won’t substantially change the actual risk of insuring that person over the span of the coverage. Having had cancer as a child with no recurrence for more than 20 years can count as a pre-existing condition. Having mild or medicinally controlled high blood pressure can count. Being obese but with absolutely normal range metrics (blood pressure, blood sugar, cholesterol, even a strong heart health profile) can count. Having _had a cesearean section_ is now a pre-existing condition – healthy young women are losing their coverage and finding that they can’t get other coverage unless they agree to be **sterilized** or use long-term birth control, because insurers don’t want to pay for additional sections. (We’ll ignore that many sections _happen_ because of pressure and/or regulations imposed by insurers - in the malpractice field, not health insurance.) The insurance companies like to play equivalence games, and say that all people with pre-existing conditions are the same, that we’re all too risky and costly to cover, and frankly that’s a lot of crap. And of course, let’s not forget that while Bob with 150/100 blood pressure _without_ his meds (normal with his meds) can’t get insured today, Frank whose blood pressure is borderline high can get insured, and three months from now, when his blood pressure is definitely an issue, the insurer will be on the hook… to pay for the same meds for Frank that Bob has been using. > [@](#): > > And ohbytheway, the government will now be competiting with State Farm and selling auto insurance at a huge loss. Who will Churchy go with? Will he pay out the ass with State Farm or go with the government plan? There’s a difference between “not to turn a profit” and “at a loss” and I think we don’t know enough yet to know if the government plan will be run at a loss. I’d prefer a government plan that’s just breaking even every year than, say, Aetna, which is making enough [to give its CEO $38 million in total compensation in the last year](http://www.askdeb.com/careers/ceo/), $24 million of which was straight salary. If people want to pay the larger premiums to private insurers and subsidize outrageous fortunes for individuals, so be it. If not, and if there’s a mass exodus to the government plan and we end up moving toward a single payer plan due to attrition from companies that make their profits by denying coverage even to duly paying members of their plans, what exactly is the downside to that? > [@](#): > > That’s why I think that Obama is being disingenous here. Sure you can choose your own plan. It’s just that your own plan will be 5 times more expensive because of the policies that he created. Again, that remains to be seen. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [July 18, 2009, 5:08pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/49 "2009-07-18T17:08:35Z")
> [@Lobohan](#): > > I did a search for both Health Savings Account and HSA and turned up no hits in the bill. I imagine if this were to come to pass you could keep your HSA and your High Deductible Health Plan. I certainly haven’t seen anything to the contrary. > > There is an option to opt out, you can keep the health care plan you currently have. > > No it isn’t. Yes it is. This is no-fault insurance which will raise premiums. Keeping your current health plan is just a grandfather clause and excludes new people from making sound financial decisions. So basically, the kids who will paying for today’s spend fest-will not have the health care options that we have now. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [July 18, 2009, 5:16pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/50 "2009-07-18T17:16:00Z")
> [@Magiver](#): > > Yes it is. This is no-fault insurance which will raise premiums. Keeping your current health plan is just a grandfather clause and excludes new people from making sound financial decisions. > > So basically, the kids who will paying for today’s spend fest-will not have the health care options that we have now. That’s the point silly. You think the system is good the way it is? You think it makes sense that someone who is sick and loses their job can’t get insurance? You think it makes sense that someone self-employed should spend half their income on insurance if they have asthma? You think the current system, growing faster than inflation is something that our kids will want? That’s moronic. It’s arguing that the children of today are worse off because they can only have paper routes, instead of the full range of sweatshop labor they had access to in the 19th century. :rolleyes: ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [July 18, 2009, 5:28pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/51 "2009-07-18T17:28:47Z")
> [@Lobohan](#): > > That’s the point silly. You think the system is good the way it is? You think it makes sense that someone who is sick and loses their job can’t get insurance? You think it makes sense that someone self-employed should spend half their income on insurance if they have asthma? You think the current system, growing faster than inflation is something that our kids will want? > > That’s moronic. It’s arguing that the children of today are worse off because they can only have paper routes, instead of the full range of sweatshop labor they had access to in the 19th century. :rolleyes: You can currently buy health insurance that is dramatically cheaper than an HMO. The rising costs are do to the complete lack of individual involvement in the process. This will raise the cost of living not lower it. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [July 18, 2009, 5:55pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/52 "2009-07-18T17:55:02Z")
> [@Magiver](#): > > You can currently buy health insurance that is dramatically cheaper than an HMO. The rising costs are do to the complete lack of individual involvement in the process. Not true in the least. People with pre-existing conditions can either be turned down directly, or simply priced out of accessibility. Rising costs are happening for a lot of reasons, but to say that individual involvement would cure it is asinine. > [@](#): > > This will raise the cost of living not lower it. There is no reason for that to be true. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [July 18, 2009, 6:29pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/53 "2009-07-18T18:29:25Z")
> [@Lobohan](#): > > Not true in the least. People with pre-existing conditions can either be turned down directly, or simply priced out of accessibility. Rising costs are happening for a lot of reasons, but to say that individual involvement would cure it is asinine. I just bought insurance with pre-existing conditions as did a friend of mine. We paid premiums based on our status and it was considerably cheaper (by multiple factors) than an HMO. I get directly involved with medical decisions with my Doctor. I just changed one of my medicines from something that was $65 to something that was $4. To say that individual involvement would lower costs is just common sense. > [@Lobohan](#): > > There is no reason for that to be true. There is every reason to know it’s true. Social Security and Medicare will continue to require additional sources of revenue (higher taxes) We are paying people to represent us and so far I’m seeing a stimulus package that doesn’t work that was rushed through before anyone could reasonbly review it. Now the same process is being applied to health care. The reason it’s being rushed through is because it won’t stand the test of public review. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [July 18, 2009, 8:36pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/54 "2009-07-18T20:36:58Z")
I see. So the people advocating this don’t have any faith in it, they are simply hoping to fool the public long enough to bring their plot to fruition? Its a conspiracy, then? ---
**Author:** ![Aji\_de\_Gallina](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aji_de_gallina/32/260_2.png) [@Aji\_de\_Gallina](https://boards.straightdope.com/u/Aji_de_Gallina)\ **Post date:** [July 18, 2009, 8:39pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/55 "2009-07-18T20:39:52Z")
> [@Frylock](#): > > (Does the law even say that people with pre-existing conditions have to be covered at the same rate as people without? I knew it said they have to be covered, but I assumed the coverage would be more expensive.) THat’d be a big loophole. “Sure Mr. Diabetes and Mrs. MS, you can get insurance here fro 2.3 trillion dollars. Just sign here, here, and initial here.” ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [July 18, 2009, 9:33pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/56 "2009-07-18T21:33:51Z")
> [@elucidator](#): > > I see. So the people advocating this don’t have any faith in it. I think they have perfect faith in it. ---
**Author:** ![athelas](https://avatars.discourse-cdn.com/v4/letter/a/5e9695/32.png) [@athelas](https://boards.straightdope.com/u/athelas)\ **Post date:** [July 18, 2009, 11:19pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/57 "2009-07-18T23:19:41Z")
> [@elucidator](#): > > I see. So the people advocating this don’t have any faith in it, they are simply hoping to fool the public long enough to bring their plot to fruition? Its a conspiracy, then? Politicians of both parties do it all the time (earmarks, amendments, riders), and the only reason for you to use the word “conspiracy” here is to poison the well. ---
**Author:** ![NinetyWt](https://avatars.discourse-cdn.com/v4/letter/n/cc9497/32.png) [@NinetyWt](https://boards.straightdope.com/u/NinetyWt)\ **Post date:** [July 18, 2009, 11:32pm UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/58 "2009-07-18T23:32:16Z")
> [@Magiver](#): > > I just bought insurance with pre-existing conditions as did a friend of mine. Well, I have been unable to get health insurance for one of my kids because of a mis-diagnosis. This is for a healthy 20-something kid. Anecdote != data. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [July 19, 2009, 12:05am UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/59 "2009-07-19T00:05:52Z")
> [@NinetyWt](#): > > Well, I have been unable to get health insurance for one of my kids because of a mis-diagnosis. This is for a healthy 20-something kid. Anecdote != data. While that is a problem that can be addressed your son does not represent the majority of people and is not a reason to spend trillions of dollars. At most it’s a tax deduction for higher premiums and a program that promotes greater cross-coverage between insurance companies (something regulated better than the AIG situation). ---
**Author:** ![Mighty\_Mouse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mighty_mouse/32/7776_2.png) [@Mighty\_Mouse](https://boards.straightdope.com/u/Mighty_Mouse)\ **Post date:** [July 19, 2009, 12:11am UTC](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207/60 "2009-07-19T00:11:10Z")
> [@NinetyWt](#): > > Well, I have been unable to get health insurance for one of my kids because of a mis-diagnosis. This is for a healthy 20-something kid. Anecdote != data. But the people in favor of nationalized health insurance are the ones trotting out the horrible examples as justification for a trillion dollar expense. [Previous page](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207.md?page=2) [Next page](https://boards.straightdope.com/t/making-private-health-insurance-illegal/503207.md?page=4)