Risky Business

From Elizabeth Edwards at The Wonk Room at Think Progress:

Senator John McCain’s health plan is based on the idea that everyone should be on their own to buy their health insurance on the individual market. And it’s an approach fundamentally at odds with the point of health insurance: that we share risks. People with preexisting conditions, like McCain and myself, would pay much more for health insurance under his health plan, if we could get coverage at all.

Original DVD cover.

Insurance companies have all sorts of characteristics they look at in order to increase premiums, such as preexisting conditions, occupation, age, and residence. But I hadn’t realized that the McCain plan would enable insurers to “rate-up” my insurance bill for not only my status as a breast cancer patient, but also my gender.


The point is that the insurers have given us just another example about how the individual market is fundamentally broken. Embracing it as the solution to our health crisis – as the McCain plan proposes to – will only make matters worse.

From the Los Angeles Times:

When it comes to health insurance, Valencia resident Tova Hack’s first problem is that she works part time and thus needs an individual policy for medical coverage because her employer doesn’t offer one.

Her second problem is that she’s a woman.


[…] this is purely a matter of Blue Shield deciding that women, as a general rule, are more expensive to insure than men.

Perhaps this is partly because women are more likely to seek preventive care, according to the Kaiser Family Foundation. But this should make them better insurance risks. After all, they’re proactively working to stay healthy.

And isn’t that exactly what insurers encourage people to do?

“It doesn’t make any sense,” said Alice Wolfson of United Policyholders, a San Francisco-based advocacy group. “The insurers aren’t assessing risk. They’re assessing how much healthcare is used, even when it’s preventive treatment.”

A spokesman for the California Department of Insurance said there were no regulations preventing gender-based pricing for individual policies.

Vehicle insurers also use gender in determining rates. In their case, though, men often pay more for coverage because they’re viewed as the greater risk. Supposedly guys drive more recklessly and get into more accidents.

Yet men are nevertheless viewed as a lesser medical liability than women, who live longer on average because they tend to eat right, exercise more frequently and take better care of themselves.

Men and women start out as equals in Blue Shield’s eyes. The pricing chart for the insurer’s Balance Plan 1700 — the plan Hack signed up for — shows that 18-year-old men and women are both charged $98 a month.

By age 20, women are paying $119 monthly, while men are charged $110.

When they turn 35, women are paying $174 a month compared with the $162 men are paying. By age 45, women are up to $271 a month, while men pay $25 less, or $246.

The gap persists until women and men reach the age of 60. At this point, women are paying $548 a month for insurance, while menfolk see their premium soar to $589.


[Blue Shield spokesman, Tom] Epstein couldn’t explain the trend, saying again only that Blue Shield’s “egghead actuaries” concocted the numbers.

But he emphasized that Blue Shield wasn’t the first to come up with gender-specific pricing for individual health insurance. Aetna Inc. apparently introduced the idea to California, followed by Anthem Blue Cross.

“We’ve done it because our competitors are doing it,” Epstein said. “We don’t want to get a disproportionate share of high-risk people.”

By “high-risk people,” what he means is “women.”


Individual health insurance typically costs more than group coverage because the risks can’t be spread among a large number of people. Such risk pools allow all people with group policies to be insured equally, without biases for age or gender.

Many individual policies come with high deductibles and are intended primarily to cover major problems.


Filed under 2008 election, Elizabeth Edwards, humor, John McCain, movies, parody, politics, Republicans, snark, Wordpress Political Blogs

13 responses to “Risky Business

  1. jlms qkw - jenn

    this is the perfect mccain laugh-nutsily pic for this cover, nonnie!

    there are so many things wrong with his health care/insurance plan, i cannot even begin tonight.

  2. nightowl724

    We know the kind of medicine CU will practice if he becomes Dr. Preznit…

    Open your mouth and say “aarrgh.” Are you able to hear my flip-flops without straining your ears? Excellent!

    Breathe in. Breathe out. Breathe in. Breath out. Wait. What’s that raspy sound? Oh, never mind, that’s me!

    How many middle fingers am I giving you? Right! OK, now look to the right. No, your other right. Do not, I repeat, do not look to the left. Fine.

    Now, turn to the right. A little further. A little further. Good! Now, drop your drawers, bend over, grab your ankles, and cough. This might hurt a little…

  3. jeb

    McCain and healthplan in the same sentence just makes me sick.

  4. oh, goody, jenn!! 😀
    i was looking for just the right capt underpants pic, and i was hesitant about this one, but then decided that the expression was the correct one. so glad that you approve!

  5. nightowl724

    jeb, geez, whatever you do – don’t get sick!

  6. nightowl,
    that’s just for the men. he will be doing all-day breast exams on the women.

  7. jeb,
    if you get sick, then the terrorists will have won! i don’t know why, but i think i read it somewhere.

  8. jeb

    Nonnie, that’s just the craziest thing I’ve ever hear. Of course terrorists will not win if I get sick because I will have the power of the free market to create my own health savings account. The terrorists will see that and throw up their hands in frustration. If you ladies are on your own, so much the better. How can the terrorists compete with that?

  9. no, no, i am so confused!!! i thought that no matter what the dems do, the terrorists win! but anything that makes huge corporations richer sticks a finger in the terrorists’ eyes. i think i need to go lie down.

  10. jlms qkw - jenn

    but why does al kida want us to vote for the dems? w said so?

  11. i dunno, jenn. i think we need to get one of those magic 8 balls to answer all of our questions. 🙄

  12. oh, dcAp, you make me blush! 😳