Cross-post from Nancy Metcalf at Consumer Reports. See the original post here. My hat is off to Ms. Metcalf – this is the best short moral and policy explanation of why we have health insurance that I have read in a long time. It’s worth reading all the way to the end.
Q. I’m a middle-aged man with no intention of having children. Why should I have to pay for maternity or pediatric dental coverage?
A. I’ve been getting this question a lot (most recently from Dr. Sanjay Gupta during a recent appearance on his weekly program). It refers to the fact that as of 2014, all individual and small group insurance plans sold in the U.S. must cover those services as “essential health benefits.” Here’s why.
Health insurance, like all insurance, works by pooling risks. The healthy subsidize the sick, who could be somebody else this year and you next year. Those risks include any kind of health care a person might need from birth to death—prenatal care through hospice. No individual is likely to need all of it, but we will all need some of it eventually.
So, as a middle-aged childless man you resent having to pay for maternity care or kids’ dental care. Shouldn’t turnabout be fair play? Shouldn’t pregnant women and kids be able to say, “Fine, but in that case why should we have to pay for your Viagra, or prostate cancer tests, or the heart attack and high blood pressure you are many times more likely to suffer from than we are?” Once you start down that road, it’s hard to know where to stop. If you slice and dice risks, eventually you don’t have a risk pool at all, and the whole idea of insurance falls apart.
It’s worth noting that virtually all employer plans cover maternity care for exactly this reason: a unified risk pool. And no one seems to complain about that, for some reason. Moreover, we are all paying taxes to support Medicaid, which foots the bill for nearly half of all live births in the U.S.