Thursday, January 29, 2009

Gender discrimination in insurance

In CA, as in most states, the State says it's okay for insurers to charge more to women, as long as the determination is backed with statistics. This is known as "gender rating." In San Francisco, the city attorney's office has brought suit against state insurance regulators for this practice.

Market says: gender discrimination is legit, state sanctioned, and
makes financial sense.


Rights advocates say: discrimination is bad, m'kay?


The fact that women generally pay more than men for the same insurance is a great illustration of dichotomy between free market health care solutions and more equality-based health-care-as-a-right, universal ("socialist")-types of solutions.

Industry people say that the reason for the discrimination is that women are more likely to use health services. Blue Shield spokesman Tom Epstein put it this way:

"women [are] more accident-prone than men and more likely to break bones or get
sick"


Okay, I'll buy that women use health services more, but Tom sounds like an abusive husband. And funny, Tom doesn't mention that women are more likely to get pregnant than men, which also requires some doctor care.

There is a comparison made to auto insurance: on the whole, men pay more than women because they're more likely to file claims (wait, who's more accident prone?). But, as the same article points out, this is a faulty comparison. Utilization of the health care insurance product is preventative (saving money in the long run), while utilization on the auto side is catastrophic and reactionary (only spending money).

Here's the deal. Insurance is a business. Business has the privilege to incorporate when a State says so. States (not the federal government) regulate insurance. The State is society's mouthpiece. As a member of society, what do you want your State to say to this business that has the privilege of taking your money, and your neighbor's money with the State's blessing? What do you want your State to say to the nation (and beyond) about your value system as reflected in this regulation?

Currently, what States are saying is that it's okay to charge more (and in health care speak this means "make less accessible") to people that utilize care more. But the State is actually saying more. It's saying
"It's okay to charge more for people that utilize the care more no matter
what the reason
."

Even if that reason is prevention, which creates a healthy, more productive society on the whole. Even if that reason is specific to 50% of the population but not the other (though the other half certainly benefits).

Is that what you want to say? Balance it with a free market (if that's important to you). One could make the argument that allowing more preventative care would be better for the economy (see above argument on more healthy, productive society), even though it may restrict insurers in the immediate sense.

Any Friedman-ites out there wanna chime in? I'm all ears.

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