Jens 'n' Frens

Comments:

A quick touch on your note on preventatitve maintenance: I understand that a lot of corporate insurance is combined with, if you will, a grant of authority to reduce the moral hazard; a company that insures against warehouse fires will retrofit the building for sprinklers, for example. At some point it becomes less a classical insurance company (just as with health care) and more of a disaster-prevention company that finds itself financially on the hook for failures, whether or not they could have reasonably been avoided.

# posted by

dWj : 3:31 PM

"Insurance is not supposed to cover all expenses, it is supposed to cover surprising expenses."

The concept of life insurance, on first reflection, is amusingly inconsistent with this explanation. (Okay, term life insurance solves the problem.)

# posted by

Rachel : 11:00 AM

Chet here.

Your points are well-taken, and my point was not Viagra coverage necessarily is irrational or discriminatory, but that a Commission ruling that found that Viagra coverage sans birth control was an indicator of male bias would not be an untenable conclusion. The current ruling is untenable though - just because a plan is "comprehensive" requires that birth control be included is far less supportable than the example the Commission uses to support its conclusion (the Viagra discrepancy).

Regardless, I believe that neither Viagra or birth control should generally be covered, since they are ongoing expense that are predictable and not serious expenses, and the insurance invariably costs more than simple private market purchasing of the services/goods. Insurance not only spreads risk out over time, but it spreads costs out over pools of people, so it unfair to make others bear the burden of routine expenses such as these (certain preventative coverage is exception).

Regardless, if we moved our system to cover only catastrophic event and phased to a Health Saving Account benefit package for the remainder (people could use the HSA for almost anything routine, or simply save all of it and cash it in retirement), then almost all these moral and economic issues would disappear, and we'd save hundreds of billions as a society.

# posted by

Anonymous : 12:11 AM

I agree with pretty much everything Chet says in his comment. I'd even allow the Viagra-contraception analogy in a collection of circumstantial evidence that an insurance company is discrimination against women. A tight analogy -- coverage of one symptom and failure to cover another symptom that absolutely can't be explained by means other than sex discrimination -- is unlikely to be found, even if a company were discrimnating irrationally by sex.

My point was just that this, by itself, would not justify a charge of sexism, because there's a quite reasonable case to be made for covering Viagra but not the pill.

# posted by

Steven : 12:30 AM