19 February, 2008

Cost of Being Uninsured

A friend emails me this article on health insurance and diagnosis of cancer. From the article:

A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in late stages, often diminishing their chances of survival.

The study’s authors concluded that “individuals without private insurance are not receiving optimum care in terms of cancer screening or timely diagnosis and follow-up with health care providers.”

My thoughts are, "no shit, people!" Individuals without renter's insurance likely suffer more in the event of a break-in, fire, flood, etc. Does this imply that it is ALWAYS rational to get renter's insurance or that government should provide renter's insurance or subsidize its purchase or, in the extreme, that we should mandate that EVERYONE purchase insurance on their rental.

Certainly, this is a valuable study in that it helps to identify and quantify the cost of being uninsured. It is not, however, particularly illuminating in the discussion of what government's role should be in the provision of health insurance.

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9 comments:

Anonymous said...

The implications of lacking renter's insurance have nothing to do with an individual's human capability or capacity to live his or her life. The implications of lacking health insurance (or lack thereof) are related to this concept of human capacity. Regardless of what you think of the appropriateness of government roles in either situation, it is important to make that distinction.

Sure, insurance in both scenarios can make someone better off, but there is something fundamentally different about the situations being insured against in your comparison.

You may not, but many people believe that the government has a legitimate role in protecting and even nurturing the human capacity of its citizens to live their lives fully.

February 20, 2008 at 8:40 AM
KLR said...

I agree that what is being insured is different. But the distinction is trivial. Insurance is a good to be consumed. We may agree that all individuals should have the ability to purchase health insurance and some individuals lack the financial means to do so. That is a poverty issue, not a healthcare one.

February 20, 2008 at 11:03 AM
Anonymous said...

In your post you wrote "It is not, however, particularly illuminating in the discussion of what government's role should be in the provision of health insurance." In fact, this article shows that health insurance does improve quality of life and human capacity to live fully. The difference between health insurance and renter's insurance is not trivial; there may be a role for government in health insurance, as it works towards human capacity, but less so in renter's insurance.

Of course, this depends on whether or not you think that people have an actual right to live fully in terms of this concept of human capacity, and if so whether the government should play any role in protecting that right. I anticipate that we would disagree on this.

Finally (and regardless of the above), the fact that some portion of people cannot afford health insurance is not merely a poverty issue. Part of what's going on is rapidly rising health care costs. Understanding what's going on and why is an important part of the bigger picture. Therefore, the fact that some people can't afford health insurance is both a poverty and a health care issue.

February 20, 2008 at 11:56 AM
KLR said...

Not to disappoint you, but I do not disagree that people have a right to live a full life in terms of human capacity, as you put it. I, however, place the greatest weight on individual liberty and freedom to choose. I do not think another individual or a collective society can define a full life.

Human capacity to live fully is a purely personal decision. I think international travel can enhance an individual's capacity to live a more full life. However, the decision to travel has tradeoffs and is based on individual preferences. Why is it that our society assumes everyone should have the same preferences toward a healthy lifestyle and the consumption of medical treatment? Personally, I am perfectly comfortable with recognizing and accepting diversity in the consumption of healthcare given adequate financial means.

Granted it is difficult to disentangle the issue of poverty from healthcare, assume for a moment we are only talking about people above a certain income threshold (really, we are only talking about those well above poverty). Do you still think lack of health insurance is a concern?

If your answer is "no", then this is purely an issue of poverty.

If your answer is "yes", then what rational do you provide for either (1)telling someone how to spend their income or (2)confiscating other peoples income and redistributing to someone who is not themselves financially strained?

And finally, yes, medical costs are rising. So are the costs of high end televisions. Do you suggest the government get involved with the purchase and distribution of televisions? Or would you prefer to keep competition high so that prices are as low as possible and let individuals choose the quality of the product they consume?

February 20, 2008 at 1:42 PM
Anonymous said...

I don't have time to keep commenting, but wanted to clarify this human capacity thing. It refers to a core, fundamental capability to function in life. You cannot compare it to loss of personal items or world travel.

February 20, 2008 at 2:19 PM
KLR said...

What is this transcendant "core, fundamental capability" you speak of? Are you talking about being alive? Physical health? Mental health?

People make tradeoffs all the time. Driving involves risk of death? Is driving a "core, fundamental" right? I think travel could improve mental health. Does that mean travel is a "core, fundamental" right? Rental insurance costs money--money that could be spent on inputs toward a healthier lifestyle. Does that mean rental insurance is a "core, fundamental" right.

You assume certain decisions lead to a more complete life. In doing so you assume your preferences are right and others' are wrong. And that people are not capable of making decisions for themselves. I am uncomfortable with this assumption.

February 20, 2008 at 3:44 PM
Anonymous said...

Let me try a different term: human dignity. Being able to engage in economic transactions is a component of it, but it is not the only thing that constitutes human dignity. Health is another central component -- or, more specifically, the opportunity to pursue good health. The article that sparked this discussion suggests that having health insurance is central in that pursuit.

I am not concerned about the rising costs of televisions because I don't think that these specific goods are linked to human dignity the way that health/the opportunity for health is.

I believe that everyone should have an equal chance at being healthy. This means having a realistic opportunity to purchase health insurance. Along the same lines, I would find it ideal to protect against poverty to the point that everyone can engage in the market at some level, but I do not extend that to high end televisions. Health is a different ball game.

February 20, 2008 at 4:16 PM
JD B said...

It seems to me that more people are more focused on "a realistic opportunity to purchase health insurance" instead of cheaper health care. There should be more emphasis placed on affordable health care instead of affordable health insurance. If the government subsidizes health insurance, won't health care prices rise? Let's see: The federal government subsidizes State run universities--tuition has risen. The federal government has been subsidizing home loan programs--the price of homes has risen. The government subsidizes farm products (like the sugar that my family grows)--the consumer pays more for their sugar than they would in a free market.

February 20, 2008 at 4:48 PM
KLR said...

If someone is wealthy and obese should we say they lack human dignity? Absent the issue of income, what right do we have to define what behaviors and expeditures define dignity?

February 20, 2008 at 5:14 PM

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