gender and health insurance

A story from the New York Times today indicates that women who purchase individual health insurance policies pay more than men who do the same.

More and more people are shopping for individual health insurance policies because they have lost jobs that provided coverage. Politicians of both parties have offered proposals that would expand the role of the individual market, giving people tax credits or other assistance to buy coverage on their own.

“Women often fare worse than men in the individual insurance market,” said Senator Max Baucus, Democrat of Montana and chairman of the Finance Committee.

Insurers say they have a sound reason for charging different premiums: Women ages 19 to 55 tend to cost more than men because they typically use more health care, especially in the childbearing years.

The article goes on to show that even taking childbearing into account, women still pay more, but I find this whole line of argument, and all its derivatives, offensive. The whole point of insurance is to spread the costs of health care over a large population, insuring heavy users against heavy costs. And yet, the health insurance industry gets away with defining the population however it wants. Small workplace? Well, we’re only spreading costs across your workers. Elderly person? You have to pay more. Pre-existing condition? Too costly for us. At a certain point, the insurance part of insurance just disappears, and all you have is a payment plan for health care.

2 thoughts on “gender and health insurance”

  1. Do you find the argument of the NYT reporter offensive, or the fact that women pay more offensive?

    What about car insurance? I would think men would pay higher rates as they tend to drive less carefully than women. And I would think that life insurance would also be higher if it depends on men dying than on women dying.

    It might be greatly beneficial for many more people to buy health insurance to cover the risk of catastrophic illness or injury, and pay for routine stuff out of pocket. I don’t see the point of insurance for routine health care.

    That would encourage people to shop around, and could put downward pressure on doctors’ salaries. Instead of simply opting for a procedure because I want to get my money’s worth for a policy I am paying for, I would ask more questions and shop around. I think its been shown that Americans have many more procedures than Europeans, but their health outcomes aren’t any better for it.


  2. Re @1: There is some very good scholarly work on why the health insurance market doesn’t function as an ideal market. I agree that Americans probably get many unnecessary procedures, but I doubt that the solution is having individuals pay more for preventive care or shop around. Even for routine care, it is highly impractical and unlikely that most people could comparatively shop for these services. Sure, women could call around and compare prices for an annual gynecological exam, but this doesn’t get at the quality issue. It matters to most women who the doctor or NP doing their exam is. Among other reasons, some health professionals may be better at competently executing the exam. Unfortunately, most attempts to make doctor quality indicators more accessible to the public face serious challenges. Beyond rating doctors by number of malpractice suits or whether they follow recommended treatments for certain chronic conditions, there are not many great quality indicators.


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