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.
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.