May 2, 2017

About "those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy..."

That's a phrase bestowed on our political discourse by this Alabama Congressman, Mo Brooks, who's looking to "allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives, they’re healthy, they’ve done the things to keep their bodies healthy."

That hits the news the same day as Jimmy Kimmel's story of the emergency heart surgery needed by his newborn son, a story that segued into a plea to preserve the existing protections for those with pre-existing conditions.

I suppose Brooks thought the un-good people he was talking about were smokers, drug and alcohol users, the obese, and people who engage in the wrong sports (or sports the wrong way), but what's our motivation to give this guy a sympathetic reading? Not all pre-existing conditions are the consequence of something bad a person has done. For example, Brooks may be laboring under the disability of a low-powered brain. And yet he's to blame for running for office, taking a seat that could be occupied by somebody better able to carry out its responsibilities.

There's also the notion that Mo Brooks is beset by the worse-than-medieval belief that a sick person really is someone who hasn't led a good life — that the illness is divine punishment that is deserved. That's the kind of ugly comfort that I could understand people cooking up in places where there is no medical care, but it's not an idea that could improve my opinion of Mo Brooks.

112 comments:

Yancey Ward said...

Brooks has a point though- you get no premium break for taking care of your body and your health. It is all based on age now, nothing else. As a 50 year old who takes care of himself with no unhealthy vices, I will pay the same premium as another 50 year old who is 400 pounds and smokes 3 packs a day. Does that describe fairness? It would be same as charging a 50 year old driver who has never been involved in an accident or gotten a single traffic infraction the same premium you charge the guy who has caused 10 accidents and been arrested for DUI four times.

If you want to cover people with pre-existing conditions, it needs to be completely financed by taxes, and/or by insurance policies that pay out for changes in health status. Not through the insurance policies that pay for goods and services.

readering said...

People almost always have a point.

Sean Gleeson said...

I can't comment on Mo Brooks's words, except to say they strike me as infelicitous. But if he was trying to say that insurance premiums should be based on the probability of an event times the cost of that event, then he is inarguably correct. That's how insurance premiums have to be calculated.

Inga said...

Oh ye unhealthy sinners! Repent! Your disease is a judgment from the Almighty!

Seriously folks, this isn't surprising. And don't forget women can't get pregnant from rape either.

Yancey Ward said...

The major flaw in Obamacare is the attempt to finance the structure largely through the premium system, and it only works if you stick it to those who consume very little in the way of medical resources. This works as long as most people are willing to pay real money for literally nothing in return but psychic comfort. However, real people aren't quite that stupid.

Finance it all with taxes, or don't do it at all.

tcrosse said...

Using the term 'good lives' adds a moral dimension which is out of place. But a lot of moralizing has moved from sex practices to diet.
BTW, why do we have to see Inga's Diaphragm ?

Nonapod said...

If you're looking at it from a simple cost/benefit perspective, people who engage in unhealthy lifestyles are far more likely to die early, and dying decreases future medical costs to zero. So in the long run, all these healthy who are living longer are probably costing us all more, the jerks.

exiledonmainstreet said...

BTW, why do we have to see Inga's Diaphragm ?

5/2/17, 2:56 PM

Actually, I think it's an upside down chamber pot.

Inga said...
This comment has been removed by the author.
Yancey Ward said...

Actually, I think it's an upside down chamber pot.

In other words, her hat.

Mark said...

And these are the guys who are going to fix our health care system

Earnest Prole said...

A grown man named Mo?

Ann Althouse said...

"Brooks has a point though- you get no premium break for taking care of your body and your health. It is all based on age now, nothing else. As a 50 year old who takes care of himself with no unhealthy vices, I will pay the same premium as another 50 year old who is 400 pounds and smokes 3 packs a day. Does that describe fairness?"

How are you going to pry into everyone's life enough to create all these layers and layers of distinctions and not have lying and cheating? The cure is worse than the disease.

Dust Bunny Queen said...

The issue is that a person with a PRE existing condition....already sick....should not get the same lower premium on insurance as a person who is not sick.

You pay for the risk that the insurance company is going to assume. The higher the risk that the company will have to pay for your "event" the higher your premium. That is the essence of insurance.

If you have a car in a high crime area where more cars are being stolen or more traffic causes more wrecks.....like East LA...then you will pay more for car insurance than someone in a less risky area. If your house is surrounded by a forest that routinely has wildfires and you are far from a hydrant or fire station you WILL pay more than someone in a less risky area. That's what insurance is. Don't like it...>MOVE.

It doesn't matter what the reason for your poor health pre existing condition is. Little innocent baby, or big fat slob addicted to Ho Ho's and diabetic. Risk is risk.

Why should the rest of us who are not at risk have to pay more for yours?

Kevin said...

There's also the notion that Mo Brooks is beset by the worse-than-medieval belief that a sick person really is someone who hasn't led a good life — that the illness is divine punishment that is deserved.

Ask any cancer patient, the first thing people want to know is what you did to create your cancer. Smoked a cigarette 30 years ago or eat red meat? That's probably, in their mind, why you got it.

Since they don't do whatever it is they surmise you did, they can return to their world where it's not going to happen to them and it's not a tragedy it happened to you.

There. All better.

Ann Althouse said...

Yeah, where's Larry and Curly? Curly made an appearance in the first post today.

Dust Bunny Queen said...

As a 50 year old who takes care of himself with no unhealthy vices, I will pay the same premium as another 50 year old who is 400 pounds and smokes 3 packs a day. Does that describe fairness?"

Insurance isn't fair. It is a business.

You want fairness.....establish a charity.

Inga said...

😾 Hey! That's my pussy hat, it goes on my head. I no longer have the need for a diaphragm, I'm a grandmother. My fertile days are behind me now, more time to attend protests.

Ann Althouse said...

"Ask any cancer patient, the first thing people want to know is what you did to create your cancer. Smoked a cigarette 30 years ago or eat red meat? That's probably, in their mind, why you got it. Since they don't do whatever it is they surmise you did, they can return to their world where it's not going to happen to them and it's not a tragedy it happened to you."

Yes, people like to think things happen for a reason. They also like to think they are the good people. And if they get sick, they cry "Why me?"

Kevin said...

How are you going to pry into everyone's life enough to create all these layers and layers of distinctions and not have lying and cheating?

There are only two measures of "fairness" today. The first is that rich people pay for being rich. We have the IRS for that. The second is that bad people pay for being bad. The foundation for that Federal Agency To Be Named Later is already being laid in the name of stopping terrorism.

MikeR said...

I am happy that Donald Trump has bestowed on our political discourse, that people can say various dumb things and the world doesn't come to an end. I think that's a lot healthier than the idiotic notion that successful politicians are the ones who have never said anything since the Internet or tape recorders came into being.

Greg said...

Here is the rest of his comment for context which NY MAg being a fake new site left out

"Now, in fairness, a lot of these people with pre-existing conditions, they have those conditions through no fault of their own. And I think our society under those circumstances needs to help. The challenge, though, is that it’s a tough balancing act, between the higher cost of these mandates — which denies people coverage because they can’t afford the health insurance policies anymore on the one hand — and having enough coverage to help those people who are truly in need. And it’s a very complicated question, and I’m sure over the years, there’ll be different permutations of it, both in the past and as we go forward.

Ron Winkleheimer said...

How are you going to pry into everyone's life enough to create all these layers and layers of distinctions and not have lying and cheating? The cure is worse than the disease.

When my wife and I went to purchase long-term care insurance the insurance company required us to provide copies of our medical records. When we got life insurance the insurance company required us to under go a basic medical exam. I can can get a discount on my medical insurance if I do a health care assessment and agree to participate in programs meant to better my health. Some companies are now requiring testing to insure that people aren't smoking. Pretty soon people will be required to undergo DNA testing to see what diseases they are predisposed to.

That ship has sailed.

exiledonmainstreet said...

Blogger Yancey Ward
Actually, I think it's an upside down chamber pot.

In other words, her hat.

5/2/17, 2:59 PM

Good one! With the additional virtue of being accurate.

Inga said...

The "good" people eat a week's worth of fat and sugar at one night at the church banquet. They'll be needing afforadable health insurance.

JohnAnnArbor said...

"Yes, people like to think things happen for a reason."

It keeps trial lawyers who sue obstetricians in business, like how John Edwards made his money.

Fernandinande said...

Variance in life-span is about 25% genetic, but variance in the personality characteristics associated with unhealthy habits is around 50-60%.

Trying to make life fair creates new unfairness.

Sean E said...

I am completely onboard with the notion that babies born with heart defects should have access to high quality care, no questions asked. But that has nothing to do with insurance.

Ron Winkleheimer said...

Oh, and in all of those cases my wife and I were asked about our families medical history. We could have lied about that, but with DNA testing for less than $99 that can be accomplished with nothing more than a little spit, that won't be possible any longer.

Nonapod said...

Getting to choose who lives and who dies, who receives coverage for being good by keeping their body pure or is denied it for living a sinful, indulgent life is the ultimate statist's wet dream. Sometimes I think the medieval Catholic church has nothing on the modern progressive.

Ann Althouse said...

"Insurance isn't fair. It is a business."

It's a business that has the government fining people for not buying the product. That's not normal. The normality was removed. There's also the thing that happened long ago, when the American people decided that hospitals could not turn people away but had to treat them, even if those bills would never get paid. The insurance companies were charging all their customers more to account for those unpaid bills because the hospitals added the cost to the charges for the people who do pay, so these costs weren't really being fenced out.

That is, you are speaking as if insurance was done in a completely free market, but that isn't the situation, and there's no proposal to get back to that situation. Americans are not going to let Americans die in the street/

Fernandinande said...

exiledonmainstreet said...
"BTW, why do we have to see Inga's Diaphragm ?"
Actually, I think it's an upside down chamber pot.


Penile cornu cutaneum was my guess.

Bad Lieutenant said...


Inga said...
The "good" people eat a week's worth of fat and sugar at one night at the church banquet. They'll be needing afforadable health insurance.
5/2/17, 3:09 PM

How would you know? What's the last time the floor of a church groaned beneath your weight?

exiledonmainstreet said...

"My fertile days are behind me now, more time to attend protests."

Scott Walker and President Trump thank you for your part in turning Wisconsin red. I'm sure you probably convinced at least 25 people to vote R in November.

AJ Lynch said...

In many states, they can't charge you more for your high risk behaviors. That goes back, I think, to the AIDS epidemic where pols were trying to protect gay men who were more susceptible to the disease.

Sean Gleeson said...

"How are you going to pry into everyone's life enough to create all these layers and layers of distinctions and not have lying and cheating? The cure is worse than the disease."

The cure is freedom. Let every insurer charge whatever they want, using any calculation they want to use. The competition among insurers for customers would result in everyone getting the best possible rate.

If any of the "layers and layers of distinctions" turn out to be irrelevant to the actual risks (like, e.g., charging a higher premium for blondes, or something) then whatever insurer makes them would be punished by the market, as the customers they were trying to overcharge went elsewhere.

I would expect that the "prying" would consist of a physical examination, or a medical record, which insurance companies already pry into. But if any (hypothetical) insurer said "We can offer a better deal if you let us pry more," then customers could freely choose to go that route.

Inga said...

Blogger Nonapod said...
"Getting to choose who lives and who dies, who receives coverage for being good by keeping their body pure or is denied it for living a sinful, indulgent life is the ultimate statist's wet dream. Sometimes I think the medieval Catholic church has nothing on the modern progressive."

Mo Brooks is a conservative/Republican. I didn't know he was a statist and a progressive.

Ron Winkleheimer said...

That is, you are speaking as if insurance was done in a completely free market, but that isn't the situation, and there's no proposal to get back to that situation. Americans are not going to let Americans die in the street/

Correct, they are going to let them die in the hospital or at home because the resources are finite.

Medical care is going to be rationed one way or another. There is only so much of it and there will always be only so much of it, but the demand for it is infinite.

Martin said...

This is what happens when someone who is not nearly as smart as he thinks he is hears a partisan or advocacy sound-bite thinks it is actually true, and spouts off.

Like Romney's "47%" gaffe back in 2012, but examples are legion.

My wife, who has had CRPS for 30 years, and I, would beg to differ with the benighted Congress-critter.

Now, how we go about covering pre-existing conditions, and how it is paid for, are subjects for debate. But leave the moralistic preening out of it.

Dust Bunny Queen said...

That is, you are speaking as if insurance was done in a completely free market, but that isn't the situation, and there's no proposal to get back to that situations.

This is true, especially about the medical insurance industry which has been crushed, broken and hideously distorted by government (State and Federal) interference.

There should be two separate, or possibly more than two, systems. One a free market, across state lines, medical insurance industry where people can purchase what level of coverage they want, from whomever they want and pay the premiums that are appropriate for the risk that they are posing to the insurance company.

The other should be somehow funded or supplemented for those high risk or even un-insurable people. High risk pools. We don't want people dying in the streets, however, to put the burden on everyone or make insurance UN-affordable for everyone is not a solution. That is the broken system that the government has inflicted upon us now. How that high risk pool is to be funded is problematic. Taxes? Charitable organizations and foundations?

The real problem is that we have economic ignoramuses and bleeding hearts of all kinds trying to make these decisions. Every time they put their fingers on it, the problem just gets worse and worse.

Nonapod said...

Mo Brooks is a conservative/Republican

I don't care if he's an anarcho-syndicalist communist. I was merely commenting on the slippery slope of paying for even a little healthcare with other peoples money. Suddenly you start thinking in certain terms and judging how others choose to live their lives.

n.n said...

It's a reference to elective procedures and behaviors, which does not cover preexisting conditions caused by congenital defects and post-conception choices.

Greg said...

I'm pretty sure that UK's NHS puts you at the end of the queue for healthcare in their single payer system if you are a smoker, drinker etc. Same in Canada where I live for certain treatments. All are rationed here, so smokers and drinkers go to the end of the line.

Bay Area Guy said...

9 out of 10 cancers caused by "lifestyle."

Thorley Winston said...

Thank you Greg, for posting the rest of Brooks’ comments.

Rabel said...

Althouse:
"Not all pre-existing conditions are the consequence of something bad a person has done."

Brooks:
"Now, in fairness, a lot of these people with pre-existing conditions, they have those conditions through no fault of their own."

The usually preternaturally astute Althouse gets sucked into the vortex of New York Mag's spin.

n.n said...

Medical reform begins with disrupting the anti-capitalist monopolies and practices enabled through government intervention. Health reform begins with education reform including opening the abortion chambers at Planned Parenthood and similar facilities, and forcing a separation of Pro-Choice and State in other areas law and culture.

Ron Winkleheimer said...

I really love how the leftist commenting here are aghast at the congress critters statement of the obvious. Back when Obamacare was still just a gleam in Obama's eye it was a given, on the left, that the government would need to intervene in people's life's to encourage them to be healthier so as to bend the curve of medical costs.


From the Executive Order, defining the duties of the Council:
Sec. 3. Purposes and Duties. The Council shall:
(a) provide coordination and leadership at the Federal level, and among all executive departments and agencies, with respect to prevention, wellness, and health promotion practices, the public health system, and integrative health care in the United States;
(b) develop, after obtaining input from relevant stakeholders, a national prevention, health promotion, public health, and integrative health-care strategy that incorporates the most effective and achievable means of improving the health status of Americans and reducing the incidence of preventable illness and disability in the United States, as further described in section 5 of this order;
(c) provide recommendations to the President and the Congress concerning the most pressing health issues confronting the United States and changes in Federal policy to achieve national wellness, health promotion, and public health goals, including the reduction of tobacco use, sedentary behavior, and poor nutrition;
(d) consider and propose evidence-based models, policies, and innovative approaches for the promotion of transformative models of prevention, integrative health, and public health on individual and community levels across the United States;
(e) establish processes for continual public input, including input from State, regional, and local leadership communities and other relevant stakeholders, including Indian tribes and tribal organizations;
(f) submit the reports required by section 6 of this order; and

(g) carry out such other activities as are determined appropriate by the President.

3rdGradePB_GoodPerson said...

"Americans are not going to let Americans die in the street."

Yup.

And, all sorts of medical treatments can cost tens and hundreds of thousands of dollars.

What other circumstance is there where normal folks have a quarter of a million dollars to blow on just getting them or their kid out of bed for another day?

That's real baller dough spending, and ya don't even get a Ferrari in the garage.

But, that's what normal people have access to, so they can live.

Obviously, that money gots to come from somewhere, cause Americans are not going to let Americans die in the street. And, they shouldn't.

CWJ said...

Sean Gleason wrote -

"I can't comment on Mo Brooks's words, except to say they strike me as infelicitous. But if he was trying to say that insurance premiums should be based on the probability of an event times the cost of that event, then he is inarguably correct. That's how insurance premiums have to be calculated."

But health insurance is no longer insurance. Obamacare made underwriting and actuarial calculation essentially illegal in anything other than the most rudimentary forms. Brooks is pointing out a hard truth which because it is a hard truth makes it difficult to say in a politically acceptable way, and conversely easy to mock.

exiledonmainstreet said...

Greg said of Canada: All are rationed here, so smokers and drinkers go to the end of the line.

5/2/17, 3:25 PM

It must have been heartless Republicans who decided that, right? No?

I wonder if Inga has heard of the Liverpool Care Pathway, which was discontinued by the NHS in 2014 because of complaints like this:

"The controversy centres around the conflict between the recognition of the LCP as a model of good practice, (NICE 2003, 2006) and the findings of the Review that in reality incidents of poor treatment – “uncaring, rushed, ignorant – abound” (Neuberger 2013, 3). The title of the Review, “More Care, Less Pathway” neatly sums up its flavor. It concludes that patients were often treated with less respect than they deserved, with the use of the LCP being reduced to a “tick box exercise” and that communication with the families was inadequate or entirely absent (Neuberger 2013, 3-4)."


Ron Winkleheimer said...

So basically the congress critter stated that some people are engaging in unhealthy habits and are therefore receiving a disproportionate amount of health care, which is a problem because other people are being forced to pay for it. However, some people have preexisting conditions through no fault of their own, and we should be willing to help those people out.

I can see why everyone is outraged.

Especially since that was one of the marketing points for Obamacare.

Michelle Dulak Thomson said...

Re: "these layers and layers of distinctions": They are not complicated. We already tax smokers at a higher rate, and have for ages. Obesity you can generally notice visually, but there also exist such things as scales. Diabetes is readily diagnosed. Alcohol and drug use is harder to measure, except for MJ (THC sticks around in your system for up to six weeks, I'm told).

In short: Easy-peasy.

Which reminds me: In all this talk about pre-existing conditions, have we just forgotten EMTALA? The pre-existing condition provision in the PPACA is about signing up for insurance when you haven't had any. Anyone continuously insured is fine, and has been for a couple of decades.

Big Mike said...

Jimmy Kimmel uses Obamacare? Now I've seen everything!

CWJ said...

"Jimmy Kimmel's story of the emergency heart surgery needed by his newborn son, a story that segued into a plea to preserve the existing protections for those with pre-existing conditions."

Say what? How on earth does "newborn" segue into "pre-existing conditions?"

Ron Winkleheimer said...

Obviously, that money gots to come from somewhere, cause Americans are not going to let Americans die in the street. And, they shouldn't.

Correct, that would look bad, so they let them die in hospitals or at home.

Ever hear of the VA?

Kevin said...

9 out of 10 cancers caused by "lifestyle."

And that's the perfect result, as it puts 90% of cancer patients in the "bad" category while leaving 10% for those who know they are good but fell victim to random acts of God.

7 or 8 out of 10 would have left too much random illness for the "good people don't get cancer" crowd. It would effectively destroy the meme.

In other news, 9 out of 10 rape victims asked for it.

Rabel said...

Where do these heartless Republicans get the idea that insurance companies can charge people more for unhealthy lifestyle choices?

Fernandinande said...

Sean Gleeson said...
I can't comment on Mo Brooks's words, except to say they strike me as infelicitous.


I think he was trying to say "people with unhealthy habits should pay more for insurance". Sounds reasonable, tho we might end up with more habit-nazis.

Glancing thru his Wiki page, I'd vote for 'im.

Balfegor said...

Jimmy Kimmel apparently has a net worth of $35 million. His newborn son does not need insurance, whether or not his pre-existing conditions lead to sky-high rates. If anything, the insurance pool as a whole will all benefit if his rich, rich father pays a lot more in.

Ron Winkleheimer said...

by the way the first definition of good (adjective) is:

to be desired or approved of

morality isn't mentioned until the 3rd definition.

And as a noun the 2nd definition is

benefit or advantage to someone or something

I know when I say its good that I walk 2 -3 miles a day I'm not making reference to morality.

Fernandinande said...

Dust Bunny Queen said...
big fat slob addicted to Ho Ho's


I think they're providing medical care in the 1st panel.

exiledonmainstreet said...

Ron Winkleheimer said...
So basically the congress critter stated that some people are engaging in unhealthy habits and are therefore receiving a disproportionate amount of health care, which is a problem because other people are being forced to pay for it. However, some people have preexisting conditions through no fault of their own, and we should be willing to help those people out.

I can see why everyone is outraged.

Especially since that was one of the marketing points for Obamacare.

5/2/17, 3:38 PM

"But it's OK when we do it!"

Peter said...

If you're looking at it from a simple cost/benefit perspective, people who engage in unhealthy lifestyles are far more likely to die early, and dying decreases future medical costs to zero."

Either that, OR, you'll develop a costly chronic illness.

As with most things, good health is a combination of inputs (lifestyle choices and genetics) plus luck. Neither genetics nor good luck are under one's control, yet both surely have much to do with one's health.

Nonetheless, allowing people to go uninsured by choice and then demanding those who did so be able to buy insurance at the same price everyone else pays if/when they develop a costly medical condition seems unfair and unreasonable.

How was a homeowner supposed to know that an electrical fault might burn the place down, or lightening might strike? Yet if you try to insure the ashes of what used to be your home you'll be laughed out of the insurance agency. And reasonably so, for why would anyone buy house insurance if one knew one could always buy insurance after disaster struck?

Perhaps separate funding might be provided for those who presently have pre-existing conditions, even while making it clear that in the future that coverage may be denied those who could have bought coverage yet chose not to do so and are now not insurable? Or at least preserve a mechanism to charge those who try to buy insurance on an as-needed basis a hefty surcharge?

It's not as if there's no precedent here; for example, if you are eligible for Medicare Part B and D and do not have equivalent insurance yet choose to decline this coverage, you will be charged extra- for the rest of your life!- if/when you later decide you wish to be covered.


Jack Tors said...

Jonathan Chait and NY Rag-I mean Mag-left out the following when quoting Brooks:

"In fairness, a lot of these people with pre-existing conditions, they have those conditions through no fault of their own," he said. "And I think our society, under those circumstances, needs to help. The challenge though is that it's a tough balancing act between the higher cost of these mandates which denies people coverage because they can't afford their health insurance policies...and having enough coverage to help those people truly in need."

Over the years, I've found Brooks to be one of the more thoughtful, most economics-literate members of Congress (he graduated Duke in three years with honors in economics) and not the neo-Randian portrayed by Chait.

jimbino said...

The most serious and common pre-existing condition is poverty, but we still allow people to stay mired in it. Trouble is, if we send them some dough, they'll buy booze or drugs with it, or even worse, breed. In fact, if they spent it on booze or drugs instead of breeding, the planet would suffer much less.

Martha said...

If Jimmy Kimmel had Obamacare insurance I doubt his son would have been born at Cedars Sinai Hospital. An LA native I know lost all his doctors and access to Cedars Sinai when he was forced to switch to Obamacare.

Bay Area Guy said...

Cigarette smoking, alcoholism and obesity cause a lotta disease. That's not being "mean," just simple, basic observations.

Yes, everyone on the planet is sympathetic towards people who are born with genetic diseases or get hit by a truck or have excruciating back pain from just getting old. Duh.

Freeman Hunt said...

The best (best as in kindest, fairest, healthiest, etc.) person I knew died from melanoma at 59.

Health isn't fair. It's largely a crap-shoot. You can nudge the odds a tiny bit better in your favor, but there are no guarantees.

Freeman Hunt said...

There are obese people with low blood glucose levels, excellent lipid profiles, and normal blood pressure. Are you still going to penalize them for being obese?

Do you penalize based on lab results?

What about the svelte people who do everything they can to take great care of themselves and still have Type 2 diabetes, poor lipid profiles, and high blood pressure? Are you going to penalize them even though they are doing everything they can?

To actually be fair, and it's not clear that it's really possible to be that, companies would have to be outrageously intrusive. Who would accept it?

Freeman Hunt said...

"Cigarette smoking, alcoholism and obesity cause a lotta disease."

But do people who smoke, drink heavily, or get fat actually cost more in healthcare over their lifetimes? Everyone dies. Those people, as a population, die sooner. The especially healthy need many more years of healthcare. Expensive!

n.n said...

Obamacare penalizes a pre-existing condition: birth, by levying a progressive tax on every unPlanned American through their death.

Freeman Hunt said...

Aha, the Dutch!

Fernandinande said...

Jack Tors said...
Jonathan Chait and NY Rag-I mean Mag-left out the following when quoting Brooks:


I googled and was surprised to see that Slate included it, and not surprised to see that they claimed he was back-pedaling so as to not appear insensitive.

Bay Area Guy said...
Cigarette smoking, alcoholism and obesity cause a lotta disease.


"Smokers actually save society about $.32 per pack smoked." By dying earlier.

HoodlumDoodlum said...

If people are "the backbone of society" then we should care about the costs we impose upon them and/or the costs they have to bear.
If people are not "the backbone of society" then there's no reason to give a damn about what costs they bear.
The Professor has been very clear on this.
Sympathetic sick people are part of "the backbone of society."
Case closed.

Fernandinande said...

Freeman Hunt said...
Aha, the Dutch!


They don't feel pain like we do.

Link -> "In a paper published online Monday in the Public Library of Science Medicine journal, Dutch researchers found that the health costs of thin and healthy people in adulthood are more expensive than those of either fat people or smokers."

Is this scientific socialism?

Mark said...

I would assume special needs kids would mean a vastly higher insurance bill.

Gee, I wonder what the abortion rate of special needs kids will be like once that happens. I assume Mo will feEl he had nothing to do with that increase.

Bay Area Guy said...

@Fernandinande,

Bay Area Guy said...
Cigarette smoking, alcoholism and obesity cause a lotta disease.


"Smokers actually save society about $.32 per pack smoked." By dying earlier.

Good point. It looks like they are factoring in the savings from pensions and non-medical related costs. But, still a good point.


n.n said...

The point is that the prerequisite for liberty, and in order to mitigate anthopogenic progressive corruption, the responsibility for life choices begins with individuals, and then is supplemented with either charitable donations or community investments (e.g. taxation). It begins with recognizing intrinsic value (e.g. rejecting the viability quasi-religious standard), but it does not end with respecting individual dignity.

The first step in medical reform is breaking the anti-capitalist, centrally managed monopolies and practices; then religious/moral reform (e.g. separation of Pro-Choice and State); then education reform (e.g. opening the abortion chambers at Planned Parenthood and similar facilities); and emigration reform (e.g. mitigating the first-order forcings of global CAIR).

mockturtle said...

It's a slippery slope that could lead to one's ancestry being used as actuarial risk data. I know plenty of fit, healthy-living folks who got cancer and plenty of the opposite who didn't. My mother smoked until she was 70 and is still living at 92.

Darcy said...

It is distressing to me how far down the road we have to believing that health insurance coverage costs should be "fair", a "right", should be "affordable" for all, etc.

That is not how insurance works, though the health insurance model is now completely broken, so I guess that is how it works now.

We, and not just the "healthy" we, were far better off in my opinion when health insurance was much more market determined, as I believe the market is always fairer than what the huddled, illogical masses decide is fair.

This really stinks because apparently there is no turning back.

Darcy said...

we have *gone...

mockturtle said...

The first step in medical reform is breaking the anti-capitalist, centrally managed monopolies and practices;

Amen to that! Why they are not subject to antitrust laws is beyond me!

heyboom said...

Blogger Martin said...

This is what happens when someone who is not nearly as smart as he thinks he is hears a partisan or advocacy sound-bite thinks it is actually true, and spouts off.


Pot meet kettle. You just did exactly what you castigated Congressman Brooks for presumably doing. I would suggest you read Greg's post at 3:07 or Rabel at 3:29 to get the rest of the quote.

cubanbob said...

Ann Althouse said...
"Brooks has a point though- you get no premium break for taking care of your body and your health. It is all based on age now, nothing else. As a 50 year old who takes care of himself with no unhealthy vices, I will pay the same premium as another 50 year old who is 400 pounds and smokes 3 packs a day. Does that describe fairness?"

How are you going to pry into everyone's life enough to create all these layers and layers of distinctions and not have lying and cheating? The cure is worse than the disease."

Life insurance companies require a physical before underwriting a larger policy along with your medical records. So it can be done.

The real issue is we don't have health insurance, what we have is prepayed medical care where some consume a disproportionate share of the care. And many of those who consume the disproportionate share don't pay anything close to their share. How that is to be solved is something else.

Murph said...

A frank discussion of the alternatives regarding pre-existing conditions, and the ultimate question.

https://economics21.org/html/who-should-pay-cover-pre-existing-conditions-2327.html

MaxedOutMama said...

Most pre-existing conditions have a pretty big genetic component - even addictions.

As for the idea that we should price people who have conditions like cystic fibrosis, lipid problems, clotting problems, genetic sugar problems, most cancers, etc out of the insurance market - that comes directly from insurers. Only an insurance executive could think that this a good idea.

The reason we hate Republicans is that they are often so disgusting.

This proposal combines short-sightedness, scientific illiteracy, and an utter lack of pragmatism with self-righteousness. The guy deserves some sort of an award for this, like being dropped off a hundred miles out in the middle of desert with two liters of water. If he has lived a good life, well, we'll see him again.

Char Char Binks said...

Did Mo necessarily mean some people live "good lives" in the moral sense, or just that they do the right things for their health? Many of the health problems people have now are due to affluenza, yes, even among the so-called poor. Unlike in the past when health problems were mostly due to scarsity and hardship, now they're more often caused by gluttony, luxury, and sloth, things the less-enlightened ancients once thought of as sins.

Mark said...

Mandated coverage for those with pre-existing coverage -- that is, treating it as an entitlement to be able to pay in only a small amount, knowing and intending that you will get a financial payout that is exponentially larger -- is not insurance. It's welfare.

Now, it might be the nice thing to do for someone, but like hell they are entitled to it and should be able to demand and expect it.

sinz52 said...

What we are now learning is that a lot of those illnesses that used to be considered "of unknown cause" have a major genetic component.

None of us are responsible for our genes or our children's genes. The act of procreation is a throw of the genetic dice. You have no idea what kind of child will result.

That represents a market failure, since it strikes a lot of folks (like me) as terribly unfair that someone should be penalized for the genes he or she was born with.

Mark said...

Now, exactly why should someone making $35,000 a year and renting a small apartment with few assets in the bank have to pay higher premiums to cover the added cost of insuring a guy with pre-existing conditions who makes $200,000 a year and has a summer home and additional assets of two or three million?

Mark said...

Why should the low to middle income guy have to go hungry or worry about paying rent or being homeless -- thereby making his health worse -- just so the one-percenter won't have to spend his own riches on his own health and can continue his wealthy lifestyle?

Jack Wayne said...

Althouse gets his comments completely wrong. Fake news ensues.

Sebastian said...

This wouldn't be Mo, the male escort referred to in an earlier thread, would it?

Anyway, the notion that insurance should be priced according to predictable risk is an obvious scandal in these US of A, so crucify the guy.

Mark said...

How do special needs kids factor into this? We know that they often need vastly more medical care than the average.

Do we as a society care, or are special needs kids now only something folks with high incomes can afford to insure?

Downs kids are born to all sorts of people, should they be financially hosed because of such a chance?

When I listen to the pro-life people, I hear they should have a chance at life .. yet some of these same people argue that their parents should have their insurance skyrocket.

What would Jesus do, anyway? I hope this guy's priest takes him to task.

Gahrie said...

The most serious and common pre-existing condition is poverty, but we still allow people to stay mired in it

You can't eliminate poverty. Literally, you can't. Every year as the standard of living of the poor improves, the U.S. government redefines poverty upwards. Compare the standard of living of the "poor" in the U.S. today to the standard of living of the upper middle class in 1964 when LBJ began the war on poverty.

If Trump gave everyone in the U.S. a million dollars cash the new definition of poverty would be "only has a million dollars".

If all wealth and material possessions vanished tomorrow, and we were back to sticks and rocks...someone would have more and/or better sticks and rocks than someone else. So poor people would still exist.

Poor people in the U.S. have a higher standard of living than 99% of all of the humans who have ever lived. The mere fact that we are debating the issue of whether there is a right to healthcare is my first proof.

mockturtle said...
This comment has been removed by the author.
mockturtle said...

What?? Johnson's War on Poverty didn't eliminate it?

As I posted the other day, a family in King County, WA, [Seattle] making $72K/year is officially considered 'low income'. It's all relative, I guess.

Or, as Jesus said, "the poor will always be with us".

JAORE said...

I'm late to this party. Glad to see a few have pointed out the statement concludes with verbiage that negates the impression put forth by the magazine. I wonder if our hostess had seen those words and if they change her position.

Matthew Blaine said...

Cross-subsidization is literally how insurance works. Every other type of insurance offers lower premiums to those who exhibit good behavior.

James K said...

Late as well. One thing virtually all "pre-existing conditions" have in common is a failure to purchase insurance when healthy. (Otherwise they wouldn't be "pre-existing.") That is a choice. An unfortunate one, but a roll of the dice that someone took to save money. (The case of the child born with a problem isn't relevant, as a child would be normally covered under the parents' insurance.) No doubt there are exceptional cases that could be constructed, but these would be rare enough not to be a major problem to handle as welfare cases.

3rdGradePB_GoodPerson said...

Mock,

I can't recall if I only thought about responding to your income stat, or actually did.

Anywho, I was thinking about Lakeside (a Seattle private school, as you, but not others, know) where financial aid is offered to folks making more than $300 grand a year.

The truth is that that makes sense. But, it's interesting that that makes sense.

Anywho, it's a great school, Paul Allan and Bill Gates went there. Aside from those two, I wonder if these threads have any commenters who went there? That'd be quite an honor for y'all.

n.n said...

Why they are not subject to antitrust laws is beyond me!

There is a question of cause and effect, but there is evidence that the medical product is grossly overpriced, and that it occurs through government regulation. Unfortunately, the issue is comprehensive and integrated, ranging from the popular culture to global political, economic, and regulatory activities. Perhaps hiding the inflation through redistribution schemes, compensating through immigration policies, etc. is the only practicable solution. However, that doesn't explain the lies, intimidation, discrimination, and force they use to sustain the status quo, or perhaps it does.

n.n said...
This comment has been removed by the author.
n.n said...

In any case, this issue is being argued through an appeal to emotion and trial by press, as well as through indoctrination of captive audiences in our schools. The issue is affordability, availability, and order of responsibility. Affordable may cost less than free, thus a need to defeat anti-capitalist practices. Availability may increase through the defeat of [class] diversity and other policies that sponsor prejudice and community strife. Corruption may be overcome through a moral and rational distribution of responsibility. Americans are not, in principle, Pro-Choice. So, arguments that they are, including denying life unworthy and care to people in need, are politically motivated lies.

Rick said...

He sounds like the government nudgers trying to shame people.

tim in vermont said...

The only way to get enough money to treat everybody is to tax everybody. Like Canada does, for example.

tim in vermont said...

I have an idea! We could plant TVs in every wall that have cameras in them. On the TV, we will show non-stop propaganda for the one party state, and with the cameras, we can watch people to make sure they do their exercises each and every day! We can call them "tell screens."

tim in vermont said...

Just because something was in 1984 doesn't mean it was a bad idea!

Francisco D said...

My employer has a yearly barimetric screening for health insurance premium discounts. I saved about $75 per month by passing the screening for blood pressure, waist size, hdl/ldl ratio and two other measures that escape my mind.

It not only saves me money that I can afford to spend, it motivates me to stay in shape in order to pass the screening. I am 64 years old and want to be healthy for the rest of my life or as long as possible.

Lost My Cookies said...

Do these people really think that if a baby was delivered in a hospital and needed emergency open heart surgery the hospital would let it die because the parents didn't have TV star money?

rich hahn said...

If insurance rates aren't based on risk assessment, is it really insurance?