March 23, 2017
When we have a guy in the White House who imagines that millions of non-citizens are illegally voting and going undetected and that the former president tapped his phones, we know we are in the crazy season. Therefore it is not surprising to see George Will touting some bizarre principle of “universal access” to health insurance in his Washington Post column. There is no price tag associated with Will’s “access” so an insurance policy that is completely unaffordable to almost everyone would satisfy Will’s moral principle.
This is not a philosophical debate over various hypotheticals in the world. Obamacare was designed so that plans were mandated to cover a large range of conditions. This meant that the vast majority of the population, who don’t have expensive health care conditions, were subsidizing the relatively small group of people who do.
However, if we allow insurers to slice and dice plans, so that people who don’t suffer from certain conditions and are unlikely to in the future (e.g. women will not get prostate cancer and men won’t get pregnant) don’t have to pay the costs for those who do, then we can end up with a situation where some plans only have people with expensive health conditions and therefore are very expensive.
We could envision, for example, that plans would exclude pancreatic cancer, which is believed to be largely hereditary. People without a history of pancreatic cancer in their family would face little risk getting insurance that excludes this coverage. On the other hand, those with a history would be able to buy a plan that covered pancreatic cancer, but they would just have to pay an extremely high price since the insurers would know there was a high probability that anyone buying the plan would get pancreatic cancer.
In George Will’s world, all is good, since the principle of universal access has been met. Of course, in the world where the rest of us live, almost no one with a family history of pancreatic cancer would actually have health insurance.
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