Monday, May 05, 2014

If you applaud “high premiums for smokers”, you're an idiot

Oh well, I may as well stay on-mission for now.

An insidious suggestion from the Commission of Audit is that health insurers be able to abandon community rating, and put a loading on people with elevated risks, citing smoking and obesity as examples.

That not only sounds reasonable, it's the sort of thing that will get a lot of endorsement from people who are incapable of thinking through the aim of the proposal – which, like pretty much all the Commission of Audit proposals regarding health (and the states and taxation), is directed towards an end to the Evil of Universality wherever it may lurk.

“Sure!” people will cry. “Let smokers pay more!”

Let's leave the logistical issue of proving, at a given moment, that someone's telling the truth when they fill out an insurance form, ticking the box “non-smoker”. That's a trifle compared to the naked evil of the commission's drive to end universality.

If you okay one common risk factor to be a premium loading, you okay all of them. Good, you've inflicted a punishment on someone you detest: can you guarantee that you have zero lifestyle choices an actuary can't sling a loading onto? If you think you're okay, you don't know actuaries.

I usually hate “slippery slope” arguments, but it's in play here. Once the insurers hire enough pure math graduates, remove their soul and personality, and turn them into actuaries, it won't end with “let's slug the smokers and the fatties”.

There will be an endless drive to locate “risk factors” and price them into health insurance – as there is over in America, the ideological model of what happens when evil minds command public policy.

Once the easy “risk factors” have been found, there will be an endless actuarial drive to slice the sausage more finely. If you don't believe me, take a look at all the inventions health funds have created to attract members.

In the Australia of “community rating”, health funds don't introduce fringe benefits because they like you: they judge – their actuaries judge – the cost of a token “alternative therapist” is trivial compared to the new customers' premiums.

The actuaries that say “okay, include a Reiki master” in their benefits are the ones that will, within a nanosecond, get redeployed to identify every possible “risk factor” and train newcomers to do the same, so they can create a product with a thousand boxes to tick before you get told that your premium is something you can't afford.

And when you've been turned into “insurable”, “insurable at a premium”, or “forget it”, you'll find yourself turned out into the Commission of Audit's idealised model of a private health system, in which insurers will argue over the treatment they'll approve, instead of – as now – getting the treatment you need on Medicare.

Actuaries look boring: in a health system, they're efficient murderers whose hands are never stained by blood.

This is the purest evil that a mind of malice could conceive. People will die, and if you don't believe it, look only at the graphs that Greg Jericho displays in this article. America – the country whose template is admired only by people like the commission, who have no money worries – can't match Australia's lifespan.

Why is that?

Because people in America die rather than turning their own families out of their homes to get treatment. 

Because people in America can get turned away from a hospital without the right insurance.

Because the toxic ideologues that think shit can be turned into gold if it's processed by the right buzzwords actually like America that way.

Because the kinds of people that resent sharing a taxi with its last occupants so much they create a loophole-as-a-service “app” like Uber that looks wonderful until people die at the hands of loophole-exploiting drivers just do not understand what's good about a universal service.

America is a bad model for everything if you're not rich enough to ignore what's wrong. The same country that will train ideologues to chant “universal healthcare is socialism” will whine like babies that their once-universal Internet service is now modelled on their nasty healthcare model: dying or downloading, America wants you to pay for the fast lane.

That's not Australia, nor is it rational, fair, or an Australia I want.

1 comment:

Unknown said...

Well that was a little bit awesome. Doubt I'll find a analysis as bang-on in the papers tomorrow.