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Ironies of Health Insurance Costs (or “come and see the violence inherent in the system”)

This is a guest post from my DH Micah. He was so eloquent when describing his thoughts on all this that I asked him to write a post about it.

It was last week. I was working on school stuff. Then suddenly I remembered my health insurance bill must be imminently due.

Leaping from my computer onto the nearest pile of mail, I found not only my own bill, but (shock!) Mrs. Micah’s.

We’re insured separately, you see, because I’m certifiably insane.

Not really. I just have a hereditary mental condition.

I’m just kidding. But not really. I do have to take prescription medication for depression. And depression runs in the family.

Anyway. If we applied as a couple, we thought I’d get rejected and that would slow down Mrs. Micah’s acceptance. So we decided to apply as individuals.

In the end we were both accepted. But only after Mrs. Micah was put through a veritable Spanish Inquisition.

I sailed through without the insurance company’s even batting a corporate eye.

Now, back to last week . . .

Checking the due dates, I decided it would be best if I did the check-writing this time. And ASAP. Mrs. Micah normally writes her own checks for her own bills, but she was out running errands.

I was about to make out both checks for the same amount, when I had a stroke of intelligence. I double-checked Mrs. Micah’s bill.

Turns out she has to pay a full eleven dollars more than me per month.

The insurance company knows more about Mrs. Micah than me. They interrogated her and waved me through.

And yet some computer or bureaucrat decided Mrs. Micah and I aren’t even equally risky? She’s $132/year more risky?

A couple days after the bill-paying incident, we went to visit a couple friends. When it comes to health-insurance risk, we and they are practically identical.

And from what they told us during our visit, we’re more the same than we ever thought.

Their insurance company put A (the safe, Mrs. Micah analogue) through the wringer and never broke a sweat about B (the risky, Mr. Micah analogue).

So, who designed this system?! If it happens to you, you think it must be a fluke. If it happens to you and your friends, it’s got to be a conspiracy.

But one of those conspiracies of stupidity. (What was it Greenspan just said about people who’ve failed to master even the basic art of acting in their own self-interest?)

I just find it saddly amusing that the tool with which we’re supposed to manage risk couldn’t pick risk out of a line-up with Bob “Safety” McGoodbet and Sam “Longshot” McNochance.

My response: Maybe it’s because both girls had a history of depression and weren’t currently being treated for it. While you boys both had an even worse history of depression and were….no, you’re right, you should be as risky. There’s always a risk of relapse for me, but I’ll probably never be worse than you. Neither will “A.”

I take comfort that we should be paying the opposite of each other, so we’re paying the same amount total.

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Phoenix_PJS October 27, 2008 at 2:47 pm

Or maybe it’s because both girls are…girls 🙂 (and therefore more likely to be on a Dr. prescribed and insurance covered birth control plan). Or, if the policies cover any maternity expenses, the fact that you are paying a few dollars less each month, actually means that they DID identify you as risky, just not as risky as a pregnant woman.

mrsmicah October 27, 2008 at 2:51 pm

@Phoenix, That’s certainly a possibility too. Though the programs we applied for don’t cover prescriptions until you’ve passed a deductible. And neither of us were on it when we applied.

But the maternity coverage is a good point. Still that doesn’t really explain all the extra paperwork that the guys didn’t have to go through.

Aryn October 27, 2008 at 3:20 pm

I think it’s for a few of reasons:

1. Women see the doctor more often. We’re more likely to go in when we feel something off, while men typically have to be nagged into it by their wives.

2. Women get pregnant. Insurance companies don’t like that.

3. Women take more prescriptions. For some reason, doctors really like to prescribe us stuff.

So, it doesn’t make sense from an actual risk standpoint, but it does make sense from a statistical risk standpoint.

Dad October 27, 2008 at 5:55 pm

It is interesting. I suspect that it is a statistical rating that hits you. For whatever reason, women are more costly for health insurance. Aryn and Phoenix’s explanations are possible causes. But of this I’m fairly sure, they have mathematics behind their rates. Not that insurance companies are idiot proof.

I recall a man at a former job I held related this incident. He needed a dental crown. It was in the back of his mouth. The insurance company declined to pay for an enamel crown and insisted on a gold crown. Up until two years before this, enamel crowns were much more expensive than gold crowns. However, the price of gold has just gone up to $800 to $900 an ounce and a gold crown was several TIMES more expensive. However, the adjusters at this insurance company had not adjusted their view point. The dentist proposed the enamel crown because it was cheaper! Go figure.

BeThisWay October 27, 2008 at 6:16 pm

Actually it’s because women pay more for health insurance than men do.

Why? Women tend to go to the doctor more, get more tests, get more treatment. It costs the insurers more, so they charge more.

It kind of evens out, as because women go to the doctor more they live longer. So life insurance is cheaper for them.


Milehimama October 27, 2008 at 10:06 pm

I always thought women were more expensive than men, because their annual exams are more expensive (also, most insurance covers a physical AND a well-woman exam). Also, the “plumbing” costs more to treat if it gets sick.

LAL October 31, 2008 at 9:18 am

Insurance companies charge women more for maternity. And usually if you have private insurance there is a separate maternity rider.

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