Tuesday, March 30, 2010

The Morality of Insurance

Oooo...that's a heavy title.

I think – and worry – about health care a lot because I use it. A lot. Matt, on the other hand, couldn’t tell you what type of insurance plan he has, co-pay and deductable amounts, or if he has a primary care physician. Insurance companies must love him: he is pure profit. This is just another way we balance one another out.

And that is the crux of insurance: to balance and spread the risk. Sometimes you take more than your share of the draw, and other times you give. But it is all for the collective well-being of society. I’ve been thinking a lot about the accompanying opinion piece: it discusses charging people with unhealthy habits more. Along the lines of, “You smoke, so why should I have to pay for your treatment when you get lung cancer?” and “Well, you’re obese, so you’re at a greater risk of heart disease and diabetes and I work hard to maintain my weight” and the list goes on and on. Although, on the surface, I agree (I am an unyielding snob when it comes to smokers), it’s a damn slippery slope. And like the piece says, we all have bad habits (Oreos, anyone?). I agree, only I should get my hand slapped because I can’t keep my fingers out of the cookie jar. I am an overweight woman and little will power. But it’s so much more than that. I go to the gym, I walk my dog, and I eat my share of vegetables.

The less you make, the more you weigh. Should we blame nutritional ignorance, our education system, or the corn subsidies that make our packaged food that much cheaper? (I’m with the latter.) When do genetics come into play? How can you really ascertain the origins of a condition?

I’m with the article’s author, Dr. Sandeep Jauhar. None of us enjoy paying the cost of illnesses that could have been avoided. But, as a modern society, is that the fix we want? To burden those already burdened?

Read more HERE.


  1. What I like better is the proposal to reward people who are employing healthy habits rather than punishing the ones who have bad ones. The case that Dr Jauhar quotes had their participants sign a "pledge", they didn't track validation from health clubs or collect receit copies from Nicorette gum purchases BEFORE they gave away the free insurance goodies. The West Virginia case deprived people of said goodies just because they wouldn't write on paper that they'd try it. That's where I think their problem is; poor implementation. I like that Dr J acknowledges that punishing people will exacerbate the situation rather than alleviate it, but I wish he would have hunted down a case where a smarter implementation (like those I know I've heard about on NPR) has worked. I know that if compliance measures are made more accessible to patients, they will be more willing to try them.

    This is great, Kathryn -- thanks for sharing :)

  2. Ragamuffin,

    I totally agree and definitely have to read up on the positive incentive plans.

    Easily understood and accessible wellness programs seem like the solution. In fact, I'm doing one through Blue Cross right now! 120 gym visits per year = $150. I simply call the insurance hotline from the gym phone.

    (I wonder how many boxes of Oreos $150 can get me?!)