Time: "Women should pay more for health care"

[lumberjack_jeff]

http://ideas.time.com/2013/08/23/women-should-pay-more-for-health-care/

First, let’s address the obvious. Women carry and deliver babies. Maternity care is expensive, and a rising number of women are taking on these costs without the help of a husband. (Nearly half of American first-child births occur outside of wedlock.)

But childbearing is not the only reason women’s health costs are higher. There are certain non-sex-related ailments that plague women with more frequency. When I sustained my second significant injury from running this year, I learned that stress fractures are more common among women. This also goes for strains and sprains. Women’s bodies tend to be smaller and more prone to wear and tear.

Yet women also tend to live longer. Life expectancy for American women is 81 years, compared with 76 for men. That’s great news for women who get to enjoy more life, but it’s also five more years of costly doctor’s visits and treatments. Men have a shorter lifespan, in part because they are three times more likely to die in accidents (13 times more likely to be killed while at work) and three times more likely to be murder victims. Unexpected and sudden deaths are tragic, but they are also cheap compared with deaths due to long-term health conditions. End-of-life care can be the most expensive kind of health care, and women survive to consume more of it.

Women’s greater attentiveness to their own health likely also contributes to their longevity. Pregnancy and childbearing aside, women seek preventive care and visit doctors more often. But these additional screenings cost money, and the person receiving the care should pay for it, not other members of her insurance pool (community-rated or not). After all, women may reap the benefits of this behavior by living longer lives; they should also take on the costs.

Although I think it's important to acknowledge the underlying facts she describes, I don't agree with the author's conclusion. I think the fewer rating criteria the better, and personally I think age is the only appropriate one.

Reasonable people can disagree with the appropriate solution.

It requires an odd definition of "oppression" when the oppressors agree to pay more to guarantee the longer lives of those they oppress.

[TreasonousBastard]

1. Having spent most of my working life as an insurance underwriter and...

being very familiar with risk analysis and experience rating, I agree that women's health costs more. Maybe.

Men are more accident prone, which is not cheap, and have more cancers and long-term disabilities. Also not cheap.

But, even if we were to come up with a more exact risk analysis, there is a more important point-- regardless of the small (and they are small) differences in overall costs between men and women (excluding maternity, and health insurance already charges extra for maternity) who cares?

Group and family plans don't always go into this detail, and what we're aiming for is one humongous group plan-- everyone.

Women do go to the doctor more and therefore have more things taken care of earlier, costing more. But is this good? Don't we want men to see the doctor and maintain their health, maybe living as long or longer than women?

End of life care for both is ridiculously expensive and will have to be dealt with. Another 30 million of us looking at our 70s and 80s mean really big bucks unless we find a way to lighten the load. Preferably without just killing us all off. It makes no difference splitting gender hairs here.

Rather than pointing fingers at who piles up the bills, spend the time finding out ways to get us all more efficient care.

The author is an economic troll.

[lumberjack_jeff]

3. Is 34% more than men a small difference? YMMV.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/

Principal Findings
Per capita lifetime expenditure is $316,600, a third higher for females ($361,200) than males ($268,700). Two-fifths of this difference owes to women's longer life expectancy. Nearly one-third of lifetime expenditures is incurred during middle age, and nearly half during the senior years. For survivors to age 85, more than one-third of their lifetime expenditures will accrue in their remaining years.

Everything else being equal, one would expect insurance premiums for men to go up 17% and women's to go down 17% as a direct consequence of HCR.

[TreasonousBastard]

6. That number includes maternity...

Although we were able to estimate the role of females' longevity on their greater lifetime expenditures, our age-specific expenditure data did not come with diagnostic codes. Thus, the data did not permit us to assess the other obvious source of male–female difference: pregnancy and the childbirth process. Presumably, much of the male–female difference in expenditures during the reproductive years is attributable to pregnancy and childbirth. Using different methods, Mustard et al. (1998) concluded that differences in mortality-related expenditures combined with women's sex-specific health care conditions account for nearly all of the male–female difference.

And I suggested that without maternity, already accounted for in most premium systems, the differences are small.

And again, the ultimate goal is not premium equivalence, but efficiency in health delivery. I dealt with, and am still dealing with, my mother's bills in the year or so before her death, and they are staggering.

[smirkymonkey]

11. Um, women do not get themselves pregnant. This is not a women's issue.

It takes both a woman and a man to bring a child into the world.

[TreasonousBastard]

12. Who said it's a woman's issue? You seem to be leading up to saying...

if not artificial insemination, the guy she had sex with should share the expenses.

The point of this thread is more how society should share the expenses.

[Major Nikon]

2. I believe health care should be financed the way the French do it

If you work, you pay for health insurance. It's deducted from your pay just like SS and IIRC the premiums are based on your income, not your health care liability. That is path for universal coverage. Then if you want a higher level coverage than what the basic government plan provides, you buy a supplemental policy pretty much the same way Medicare works here.

[lumberjack_jeff]

4. Fully agree.

French men can expect to live to 78.7

[Warren DeMontague]

5. The entire point of health insurance -lost on many, it seems- is that the healthy pay for the sick.

I mean, that's how it works. That's how it's supposed to work. That's why a SPHC system- with the largest pool possible, and everyone paid in through the tax code- makes the most sense. Evens out the bumps to the maximum possible extent.

It's only because we have this fuck-jockeyed Ayn Randian crap shoehorned into our national psyche, that we've got people going "Heyyyyy! I don't wanna pay for someone else!"

Guess what, Jack- if you have insurance, you ARE paying for someone else. Your allergic reaction to the thought of funding someone "undeserving" is beside the point.

(in case it's not obvious, I'm arguing with an imaginary teabagger, here, and not anyone in this thread. )

And it's also why- even though I think health is important, exercise is important, good nutrition is important and not doing detrimental stuff like smoking- all important, all good life advice- but to go down the rabbit hole of picking and choosing which groups or which behaviors or which illnesses don't "deserve" to be funded... it's inane.

Put everyone in the pool. Let them all pay in, let them all benefit. It's the most fair, and simplest answer.

[TreasonousBastard]

7. That's the way it works in fire insurance, but...

it's a little more complicated with health insurance, simply because while only one house in "x" will have a fire, pretty much everyone will be sick at some point.

And, with other insurances, higher risks can be declined, or thrown into an expensive pool. Underwriting to "pre-existing conditions" with health care and essentially cutting loose the sick, is considered to be against public policy. Or should be.

The real problem we have, which is not addressed by any of the suggestions made here or in Washington, is fee for service. Doctors wandering into a hospital room and dropping off a "consultation" bill for 500 bucks, charging for meds by the pill, duplicating overpriced tests...

And that won't be easy to fix.

[Warren DeMontague]

8. did you read the Time article on Health Care about, I dunno, 6 months ago?

http://content.time.com/time/magazine/article/0,9171,2136864,00.html

it did a great job of running down the challenges, probably the #1 being this "cost master" or whatever it is, the list hospitals etc. use to determine their prices- which are, apparently, almost 100% arbitrary.

[TreasonousBastard]

9. Paywall! Later I'll get around to figuring out...

if it's a better deal subscribing on my Nook.

[Warren DeMontague]

10. Yeah, I seem to remember seeing a non-walled version at some point, but they may have pulled it.

It was really well done, much higher quality than I usually expect from them.

[Doctor_J]

13. Doctor_J: No one should pay anything for health care

except as part of their income tax

[Joel thakkar]

14. No I don't think

that women should pay more....if we accept this argument...we are also inviting arguments that poor people should pay more because they get more disease...

I think healthcare should be single payer and should be tax funded progressively. Rich women and men both should pay more.