Wednesday, January 9, 2013

Adalja on Pre-Existing Conditions

Dr. Amesh Adalja has a new OpEd in the 1/8/2013 Forbes, "If Insurance Companies Can't Utilize Pre-Existing Conditions, Then They're Not In The Insurance Business".

One excerpt:
As part of a way to mitigate against excessive risk, insurance companies may elect to not insure an individual whom they judge possesses a high likelihood of incurring costs because of a pre-existing condition.  When insurance companies are barred -- by law -- from considering pre-existing conditions in their evaluation of potential customers, what is being prohibited is the exercise of judgment. In the place of the expertise of insurance actuaries, government fiat is substituted.

This ability of insurance companies to discriminate is essential because insurance companies are, properly, in the business of making money. It is the very profitability of insurance companies that allows their continued existence and the ability of many individuals to procure insurance policies. If insurance companies ceased to be profitable, their extinction would shortly be forthcoming and all individuals would be worse off.

What this decree of the Affordable Care Act will do, and is designed to do, is completely distort the entire insurance industry by rendering  painstaking risk calculations irrelevant.
Over time, this demonization of profit and forcing insurers to cover risks without compensation will destroy private insurance. Of course, for some single-payer advocates, the destruction of the private insurance industry is a feature not a bug.

(Read the full text of "If Insurance Companies Can't Utilize Pre-Existing Conditions, Then They're Not In The Insurance Business".)