A few days ago I received in the mail a health questionnaire
from my insurance company asking me a bunch of questions about my general
health, number of prescriptions, health conditions, whether I had visited an
Emergency Room in the last year, and what help I needed taking care of
myself. My first reaction was that it
was none of their business. I wanted to
ignore it and toss it out.
When I thought about it from an economic understanding point
of view, I changed my mind. Unless I am
willing to pay for my own medical costs it is their business. Not only that, it is everyone else’s business
as well.
Years ago thinking changed in America and elsewhere. It was accepted that people should not have
to pay their medical costs. The employer
or the government should cover some or all of the cost. The result was an economic isolation of
doctor and hospital bills. From a very
high level the costs of every office visit, hospital stay, medical procedure
and Emergency Room visit, no matter how urgent or trivial, go into a big
imaginary pot. That pot of medical costs
is then divided up among all the payers - insurance companies, employers who
are self-insured and the government.
From an economic understanding point of view, none of those
primary payers has any money of their own; they just administer, process and
move around the money they collect from us, as taxpayers, customers and premium
payers. There is no magic money tree to cover
any part of those bills. That imaginary
pot is filled with money that gets there indirectly from our pockets. And as was pointed out very bluntly in the aftermath of the Affordable Care Act, healthy people must be forced into the
system to subsidize the unhealthy. No
one is allowed to opt out of coverage that doesn’t apply. That is the only way to keep the overall
costs down.
The only reasonable response then, is that my health and the lifestyle required to maintain it are not only the business of my insurance company, but
also of every other citizen. Do they
have a right to tell me that I should be losing weight or eating more fruits
and vegetables or exercising more? It
certainly seems like they should. Do
they have any mechanism to enforce that right?
Not yet. There probably will
never be a time when your neighbor is obligated or even allowed to stop you at
the checkout and insist you return that bag of chips; but, as the imaginary pot
grows out of control, will the government decide that mandatory labels and sage
advice not enough and begin to ramp up regulations that become more and
more personally restrictive and intrusive? Transfats and soft drink sizes may be just a start. That is more likely to happen and something to seriously consider.
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