Devil’s Advocate
On the subject of smoking and related insurance costs, HB comments:
This matter of insurance is a big one, though. Insurance costs get passed along to the public at large, whether directly, in the case of subsidized health care (low-income, seniors, veterans, etc.) or indirectly, through premiums that I suspect don’t vary nearly enough based on personal behavior and history. And of course, whether a person brought a condition on themselves or not, they have to be treated. Therein lies the quandary, for me at least.
This is an argument used often by the anti-smoking crowd (not to suggest that HB is a member) and is somewhat of a Pandora’s Box. First of all, there is evidence to suggest that, through taxes and premiums, smokers already pay for themselves, health care-wise. They also tend to live shorter lives, thus putting less burden on Social Security and private pensions. It’s not impossible that when all is said and done, rather than non-smokers subsidizing smokers, the opposite is true.
Theoretically, if that were the case, should “health nuts” be taxed and charged for health care at a higher rate because they live longer, creating a better chance for higher health care costs and a greater burden on social safety nets?
Secondly, how far do we want to go with this risk model for health care costs? Should young applicants be genetically studied for inherent risks of heart disease, cancer, diabetes, etc? Since she is likely to cost the system much more later in life, should a young woman at risk for breast cancer be charged more for health care?
Ironically, using this model would create the lowest costs for someone who with a zero risk factor. The greatest reward would go to the person who sits on his couch all day, in a padded environment, wearing his patented “life helmet.” This, of course, would create a society of obese couch potatoes afraid to do anything like ride a bike, climb a mountain, play hockey, or generally do anything that would put their bargain basement health premium at risk.
It seems that the idea of risk-based health premiums is fine in theory, put in practical application is all but impossible to factor. It would also create an invasion of privacy so great as to place any employee of the ACLU at immediate risk for a heart attack, thus raising its insurance premiums.