# The ethics of health insurance

**URL:** <https://boards.straightdope.com/t/the-ethics-of-health-insurance/1011177>\
**Category:** Miscellaneous and Personal Stuff I Must Share\
**Created:** [December 5, 2024, 3:45am UTC](https://boards.straightdope.com/t/the-ethics-of-health-insurance/1011177 "2024-12-05T03:45:03Z")\
**Posts on this page:** 1\
**Showing post:** 110

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**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\
**Post date:** [December 6, 2024, 11:00pm UTC](https://boards.straightdope.com/t/the-ethics-of-health-insurance/1011177/110 "2024-12-06T23:00:17Z")

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> [@bump](#):
>
> Historically, it _was_ insurance, in that most doctor visits, etc… were something you paid your doctor for, and insurance was something you would get for unforeseen issues, like being in an car accident or the like. Very much like auto insurance or homeowner’s insurance works for accidents and fires, in fact.
> 
> It wasn’t ever intended to be some sort of health care management scheme.
> 
> As medical care got more complex and more capable, it went from being literal insurance to something else, and that’s what got us in trouble.

That’s an interesting perspective on the matter, though I would stress that it’s definitely only **part** of the problem. Insurance only for catastrophic health issues still leaves at least three major problems unaddressed:

- Everyone needs ongoing health care and not everyone can afford it. As a basic principle recognized by all other advanced democracies, access to such care is a fundamental human right and for both ethical and practical reasons cannot be treated as a free-market commodity. Access to critical health care is simply not in the same category, ethically or practically or by any other measure, as a new TV or a new car. Furthermore, some of that ongoing care, such as surgery, can be ruinously expensive while not necessarily meeting the criteria for being “catastrophic”.

- Health care is essential and so doesn’t conform to normal economic rules of elastic demand. So the costs tend to spiral out of control without regulated controls. Such controls are intrinsic in publicly managed universal health care, especially single-payer, and almost impossible to implement otherwise, as we see in the US.

- Another perfect illustration of how free-market principles do not and can not ever apply to health care is in **[a post I made over here](https://boards.straightdope.com/t/united-healthcare-ceo-assassinated-the-p-e-edition/1011195/120)**. It unfortunately furthered a hijack in that particular thread, but I think it’s very relevant here and well worth a read. To put this point very briefly, those who’ve never known anything other than the private insurance system (and by “system” I mean the whole economic landscape of American medical care) take it for granted that for every medical expense, you literally put in an insurance claim, sometimes requiring “pre-approval”, and that the claim may be denied or the treatment option may be downgraded to save costs. This kind of clinical meddling is inherent in the insurance system, but simply does not exist in single-payer, for the reasons I discussed in that post.

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