Becca linked to an article about a woman who was annoyed at having to pay largely out of pocked when she had a baby. Lately, I’ve been thinking a lot about the difference between insurance and a health care plan. Insurance, per google’s definitions, is either “promise of reimbursement in the case of loss” or “A means of indemnity against occurrence of a uncertain event” or ” form of risk management primarily used to hedge against the risk of a contingent loss.” In other words, it’s money you pay to someone in case you have a problem with your health. It’s not a system where you give someone $10 a month to pay your $100 monthly health bills. You give someone $10 a month to pay your $5 a month health bills in case they become $100. If they’re already $100, the health care company is going to want at least $105 a month and perhaps $200 a month if initially high bills imply a higher risk of increase.
Anyway, what health insurance company in their right mind would pay to “insure” a married childless 25 year old woman against the risk of pregnancy? It doesn’t make any sense. Let’s assume 50% of privately insured couples between 25 and 35 will have a baby in that time period. Either everyone can pay $10000 for those babies, or the 50% that have the babies can pay $20000. I’m not sure the former method necessarily makes more sense than the latter.
Next, the author says, “After several years in Europe—where coverage was, as goes the cliché, comprehensive and nearly free . . . .” Coverage in Europe is *not* free. Everyone pays for it with extremely high taxes. And perhaps that’s right and reasonable. However, calling it free is ridiculous. In fact, I would say anyone who moves to Europe for a few years to have a baby or other expensive health care events is ripping off their fellow citizens, since they skipped paying the taxes their entire lives that pay for this stuff.
It seems like people should form cooperatives to negotiate better deals with insurance companies. These cooperatives could be extended the same rights as employers. I know my employer re-negotiates our healthcare every year, and my payments haven’t gone up at all in the last 3 years despite constant benefits as we’ve grown larger and our bargaining power has increased. Negotiating to become a member of a cooperative would be interesting since the cooperatives would obviously want to seek out young healthy members. Anyway, some kind of negotiating power is obviously needed.
Society should probably bear the cost of childbirth, and that’s how employee-based health care works. A company has a mix of old and young, single and married, so only a few people are having children at a time. Everyone pays for it. However, an individual planning imminently to have a child railing against an insurance company for not wanting to pay for it is silly. Insurance companies are for-profit establishments. I read so often about people complaining about not being able to find “insurance” for existing problems or complaints. Insurance is protection against future catastrophe, and that’s why you have to buy it when you’re healthy or else expect to at least pay for your existing complaints. Let’s not blame the insurance company. Blame the government for not mandating coverage, perhaps.
Also, the writer says she shows up at the hospital thinking she’s covered. Apparently they had to search for a company with maternity coverage – and they didn’t check what the limit was? My insurance comes with a little book explaining what my benefits are. It’s 30 pages with large writing and really not all that complicated. Some things are covered; other’s aren’t. I’m surprised this clearly articulate journalist shouldn’t figure it out.