Gambling with people’s health

December 16, 2014

Rutland Herald: In the next few months — maybe much longer — Vermonters will be discussing and debating the future of health care in Vermont. Will we stick with the current model of insurance-provided health care, or move to a “single-payer” plan as suggested by the Legislature in 2011 and supported by Gov. Peter Shumlin?

In my judgment, insurance is the wrong model for health care.

Providing for your well-being with insurance is putting your health in the hands of gamblers. Insurance is a form of legalized, high-stakes gambling. Underwriters bet that you will not need health care, and if you should, they will do their best to deny or reduce paying for it. Underwriters collect premiums and do their best to deny claims.

The premium is, in theory, a reflection of risk, but is more likely a reflection of interest rates. If underwriters can get a good return on their investment they are not as concerned about risk-reduction — your health. When interest rates are low — as they are now — they raise premiums or deny coverage. And until recently, underwriters deny coverage for any “pre-existing” condition.

So is gambling — insurance — really the way to pay for your wellness and health care? I think not.

For historical context, it is important to understand that insurance originated in its modern form as a means to indemnify ship owners for lost cargo and that is a form of legal, high-stakes gambling. Ship owners enjoying a cup of tea at Lloyd’s Tea shop in London bet with “underwriters” that their cargo might be lost; the underwriters (those signing under the policy) bet that the cargo would make it safely to its destination. Further, if the ship owner suffered a loss, the underwriter would use every clause in the policy to deny payment. Las Vegas could not have come up with a better scheme.

More recently, “60 Minutes” (Dec. 14) broadcast a scathing segment aptly entitled “Denied” highlighting several cases where underwriters denied coverage to patients in need of long-term care. Why? Because they convinced themselves that the patient could get by with cheaper care.

So I repeat: Do you want to put your health in the hands of high-stakes gamblers? I believe it is time for a new model — one that concerns itself with patients’ health and well-being, not the profits of a faceless insurer.

It’s time to support the plan laid out in Act 48 for a publicly financed health care system based on the idea of health care as a public good, not a high stakes gamble.