I heard a story on NPR this morning about how California is doing something about that evil Obamacare rule that allows insurers to “discriminate” against the most unfortunate of those among us – smokers. Obamacare actually (gasp) allows insurers to charge up to 50% more on premiums to smokers! How unfair, doesn’t Obama understand that these poor smokers have no choice, they are poor helpless victims of the big evil tobacco companies! Apparently smoking is much more prevalent of a lifestyle choice among the “poor” – so where Obamacare provides the “poor” with “affordable” health insurance, the smoking allowance allows insurers to basically add back all the “savings” – yes, that is the world’s smallest violin you hear in the background.
Funny, somehow the “poor” can afford to buy cigarettes (anywhere from $300-$3000/year depending on where they live and how much they smoke), yet they can’t afford the additional premium on their insurance policy attributable solely to something they choose to do. “Affordability” is one of those words thrown around a lot without any thought to what it actually means. Affordable simply means that one prioritizes the expense. Affordability all depends on how you order those things in your life that you value. One could claim a private school education for their child is unaffordable – and that would be true if they choose to spend their money first on a larger fancier house, on fancier cars, on cable TV, on high speed internet, on new clothes every month, then yes, not much is left for a private school education. But, one could pay for the education first, and then with what is left over structure their life around that so that they live in a smaller house, drive older cars and then at that point they would find cable TV and high speed internet become the “unaffordable” goods. To claim that health insurance or any other good is “unaffordable” is to simply be proclaiming it is not the thing you most highly value. Now one might argue that a $10 million mansion is unaffordable to nearly everyone and no amount of prioritization will make it so, true enough. But we are talking about affordability within the context of normal consumer goods and services, not about super luxury goods and services for which their lacking in the market is a concern to anyone. No one is crying about the “unaffordabiilty” of 50 foot yachts among the general public.
Not that I agree with the mandates Obamacare makes upon insurers in terms of what they can charge and how they can determine what they charge but at least I can understand why those who support Obamacare don’t want insurers to discriminate based on characteristics we can not control (i.e. gender, age, health status) – you are who are and there is no choice in the matter. Of course this “equality” mentality just means those who cost insurers less must pay more to subsidize the more costly demographics (witness France, where female drivers must now pay MORE for their auto insurance because in the name of equality it was deemed unfair that safer, more prudent female drivers be charged less than their male counterparts). But come on, cigarettes? Please, this is ENTIRELY the choice of the smoker. Are they addictive? Sure, but it is not IMPOSSIBLE to quit, plenty of people do it all the time. They are treating smokers like they are helpless victims who have no control over themselves. Please, give me a break.
This story highlights all that is wrong with socialized medicine. Those who willfully engage in bad behavior that affects their health must not be made to bear any of the cost of associated with their behavior – that is the job for the rest of society.