CDR: Re: why should it be trusted?

[Riad S. Wahby]

Nathan Saper <natedog at well.com> wrote:
> I think the government has a right to do whatever it needs to do to maintain
> the health and well-being of its population.  That is the purpose of
> the government.

This is, predictably, the difference between your position and those
of the people with whom you have been arguing.  As far as I'm
concerned (and I know many agree with me), government should not have
anything to do with the provision of health care for its people; it
simply exists to make sure the rules of the private market are
followed, contracts are honored, a military exists to protect the
people (and their ability to do business, etc) from foreign powers,
etc.  Compelling private business to be charitable doesn't fall within
what I consider to be acceptable powers of the government.

> That is one way of defining freedom.  I view freedom as the right of
> people to live happy, productive lives.  A discriminatory policy such
> as this one would infringe on that freedom.

This is not discrimination; it is exactly the opposite.  The insurance
company has a standard of risk they are willing to take when they
enter into a contract with a policy holder.  This standard is applied
in the same way to everyone.  

I know I've given this example in the past, but here it is again: if
you are a smoker and have three times the chance of developing heart
disease, the insurance company will not insure you.  If I have a
genetic defect that causes me to have three times the chance of
developing heart disease, they won't insure me.  In both cases, the
reason that they don't offer a policy is because we have elevated
risks of heart disease; they don't care that you smoke and I have a
genetic disorder--this fact makes no difference to the success or
failure of their business.  

The insurance company plays a game of probable ends, not of means; the
cause of my heart's likelihood of failure is of no consequence to how
much risk the insurance company is taking on me, so it shouldn't be a
factor in deciding whether or not to insure me.  In fact, if it
becomes a factor, the insurance company is no longer able to
effectively control their risk, and thus they are not longer effective
in their real purpose--making money.

If it sounds heartless to say that they're making money, then you just
have your head buried in the sand.  Everyone's out to make money.  If
you expect anything else, you will be sorely disappointed, and if you
try to use force to make companies compassionate, you are perpetrating
a greater injustice than you could ever hope to prevent.

My biggest problem with your argument is that nowhere in it is there
any need for the group bearing the burden to be the insurance
companies.  That is, you say that 'people should have health care,' and
you say that 'insurance companies have a lot of money.'  You conclude
that insurance companies should provide for the care of those who are
at high risks for certain types of illnesses or who can't afford a
policy that will cover them at their risk level.  It would be just as
easy to say 'lawyers have a lot of money,' combine this with the first
statement above, and conclude that lawyers should pay for the
health care of people who are at high risk, although I don't support
this claim either.

In fact, what you're arguing for can be generalized with no
modification of your argument to 'those who are successful should be
made responsible for the care of those who are not.'  I wholeheartedly
reject this claim and all like it; people have a right to decide how
they spend their money no matter how much they have managed to acquire.

--
Riad Wahby
rsw at mit.edu
MIT VI-2/A 2002

5105
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