Monday, December 13, 2010

Oh Baby, Baby!

The LA Times has this breathtaking lede:

"Before Joanna Joshua and Kyle Winning started a family, they hunted for health insurance to cover the increasingly high cost of having a baby."

Let's reword this, shall we?

"Before Joanna Joshua and Kyle intentionally burned down their house, they hunted for homeowners' insurance to cover the increasingly high cost of rebuilding it."

There, isn't that better?

Of course, both circumstances are silly, but they underscore the principle of risk. Being pregnant is not a disease, and it is easily avoided (we'll leave rape out of the equation, since that is, in fact, an unforeseeable risk). Insurance companies know this, and know that the utilization rate for maternity riders approaches 100%. That's not risk, that's cost-shifting. So to the extent that such riders are available at all, carriers price and configure them to essentially refund (at best) the premium paid.

Here's where it gets dicey, though:

"The dearth of choices forces many would-be mothers into government insurance programs paid for by taxpayers ... All of this drives up costs for hospitals, insurers and consumers buying individual policies."

It's a heads-I-win-tails-you-lose proposition: folks see no problem with mandating birth control, and also want coverage for having a baby. Neither of these pass the test of "medical necessity," and both of them drive up health care costs for everyone. The result? Even more uninsured:

"The industry's trade group, the Assn. of California Life and Health Insurance Cos., pointed to a study that found the most recent maternity bill in Sacramento would drive up insurance rates as much as 28%, and would prompt more than 9,000 mostly young policyholders to give up their insurance."

But don't we want more people to be insured, not less?
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