• Quote: “So you ended up XY instead of XX. Get over yourself.”

    So you ended up XY instead of XX. Get over yourself. Even conservatives generally stipulate that insurance should protect people from the financial consequences of random events. But they seem not to recognize that being born a woman is a random event. Sorry, dudes, you had no control over that. Allowing insurers to discriminate based on gender means penalizing half the population, just because those folks ended up with one type of chromosome instead of another.

    Of course, if you acknowledge [this point] it has some implications for the rest of the health care debate. If we’re not going to make people pay higher premiums because of genes that determined their gender, then what about people born with genetic abnormalities? Or predisposition to diabetes, heart attack, or cancer? Pretty soon you end up arguing that it’s wrong to charge higher premiums to people who, through no fault of their own, happen to need more medical care—thereby conceding one of Obamacare’s core principles.

    Jon Cohn, The New Republic

    @afrakt (yeah, via an iThingy)

    • I follow the argument pretty well. I won’t say I agree, but I follow it. But then the author makes reference to “Obamacare’s core principles” and I am mystified. Can you provide a reference or a cite for these “principles”.

      • Sure…

        1. No denial of coverage for pre-existing conditions (like being born female, the principle at issue here)

        2. Community rating

        3.. Subsidies for individuals who cannot afford the premium

        3. Mandatory insurance so the healthiest (often young adults) sign up and therefore allow for a reasonable premium under community rating

        You’re welcome.

    • Uncomplicated vaginal deliveries are precisely the type of planned procedures that would see large increases in quality and large decreases in cost if they weren’t covered by insurance at all.

      • @ RC Having given birth at a maternity hospital with a very good reputation (Madonna has one of her kids there) and which turned out not to have a doctor on staff at night and a protocol to call the doctor late in the process. (My doctor didn’t arrive until after my child was born), I question that statement.

        It’s very hard to get good data on hospitals, and much easier to go on reputation, much of which is actively manipulated by advertising and bad outcomes are suppressed to the extent that the hospital can.

        I’d expect private pay for delivery would prop up maternity wards that are cheap, but not quite up to standard for difficult or dangerous births. That’s fine for all the vast majority of women who anticipate an uncomplicated birth and actually go on to have one.

        Insurance companies are in a better position to aggregate data on less-than-ideal outcomes and to bargain down prices.

    • I’m not sure why some people feel that men as a class should be exempt from paying half the cost of female reproductive needs since they are 50% responsible for pregnancies. Cervical cancer screening and treatments costs are also treatments for sexually transmitted disease and it seems only fair that men pay half of those costs too. If anything, paying half is a bargain for men.

      • Who is saying that? I see people arguing that some pregnancy services shouldn’t be covered by insurance. That’s very different than arguing that men shouldn’t pay at all. I agree with you that men should pay their share.

    • The big problem with the argument is that while you can’t help whether you are male or female, women are in charge of their bodies now. Pregnancy and childbirth are not freak accidents. They are not a risk to be insured against but an event to be planned for. I think if you say men must pay half the freight, then you have to yield and also let them have half the say in reproductive rights, abortion, et al. You can’t have it both ways.

      • “I think if you say men must pay half the freight, then you have to yield and also let them have half the say in reproductive rights, abortion, et al.” – Jardinero1

        We have half the say now, it’s just that house rules require a majority of party members — sorry, I meant “partners” — be in support of a resolution before voting can even take place. Well, unless the resolution involves something that the Republican base — sorry, I meant to say “female participant” — supports, in which case the rest of the party — I mean, “other spouse” — will grin and say “whatever you want, dear”.

      • Men do have half of a say in reproductive choices. It’s called a condom.

    • I’ve read this argument by a number of different writers over the last few days. If males who don’t go to the doctor should have to pay subsidies in the private market place to women who, on average, incur higher claims in healthcare, why don’t women have to pay equivalent rates for car or life insurance? I remember in high school, all my male classmates had to pay higher insurance rates than my female classmates, even though no one had any previous driving experience, rates were based on sex(since everyone was the same age).I can understand why insurance companies don’t like this policy, insurance works best when premiums reflect probabilities of expected payouts. Wooden homes are more likely to burn down than brick homes, should homeowners who take greater precuations to build safer homes be required to pay the same insurance premiums as those who don’t?

      • Men pay more for car insurance because of BEHAVIORAL differences that are fully under their control. Last time I checked, women couldn’t decide to just let the man of the house have the baby while she stays at work.

    • Men pay more for car insurance. You take the bad with the good.

    • Hmmm…that young male behavior behind the wheel wouldn’t have anything to do with the relatively higher testosterone production in males than females now would it? No, its all just a conscious behavioral choice a teen boy makes when he wakes up in the morning, just like PMS and, more importantly post-natal depression are behavioral choices that have nothing to do with the hormones that come with genetics…

      What I struggle with is why, if I set up a business that is based on pricing risk according to the probabilities of those risks eventuating, I should be forced to run my business improperly by pricing all risks equally? I am not in business to be fair or to provide a social service. And if you feel my product is not priced appropriately then you don’t have to buy my service. Now you retort that its unfair or unjust that there is not a provider of health insurance that prices risk incorrectly, i.e. provides a subsidy. Ok, then you have defined a social service requiring a subsidy. Governments, not private businesses provide subsidies. So have the government set up a subsidized insurance company that is means tested. Don’t tell a private business it must misprice the risk of a woman developing breast or a young male driving aggressively out of a sense of “fairness.”