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The moral of having good health is a practically positive universal value. Actions that lead to good health and welfare are considered good. Actions that lead away from health and towards a lower well-being are considered immoral and to be avoided.
A health insurer shares the value of wanting a healthy population. Their primary action is to learn how to manage risk. A good risk to a health insurance company is to select for healthy people. The unhealthy or most likely to soon be unhealthy should be avoided. The process of selection is called adverse selection since the information about each individual is not widely known to the insurance company. For example, they don’t know if you exercise or not. They don’t know if you were feeling really sick right before you bought the policy.
In any case, insurance companies have become very good at risk selection. This is their primary role. They can’t make money unless they are good at this. It is no accident that your insurance is offered through your employer. This is a great way to avoid risky populations. People that work every day are at least in good enough health to work. Really sick people aren’t typically employed. Really old people aren’t usually employed, either.
Then, there are subtle ways to select. You might put your insurance company on the top level of a skyscraper without an elevator. Anybody that can’t make it to the top isn’t a good candidate for insurance. Since poor people aren’t as healthy, these people might also be excluded. People that have had an insurance lapse are a bit scary to insurance companies. They might test your entire family to see if they are a good risk to take. If you are too fat, too thin, high blood pressure, family related diseases, you might be excluded. They only cover a family if they think the premiums will outweigh the medical cost.
If you get an insurance policy, you might feel pretty good about everything. However, it doesn’t mean you are fully covered. Remember, there is still the problem of managing adverse risk. If someone becomes deathly ill, it could cost a fortune. So, insurance companies use formulas to figure out how much each type of illness should cost. The information about how to manage care is what the hospital uses. It tells the hospital how much money they can get for the illness. So, if the hospital day should be three days, that is how long the doctor lets you stay. Doctors can go against the insurance recommendations, but now the patient will have to pay the exhorbitant cost. And, the amount billed at this point will not be the contracted insurance rates. It will be the super high Hospital Chargemaster Price; about 10 times what the insurance would have to pay. Some patients need a little extra time to get well. They normally don’t get it. The decision is technically the doctors, but, yeah, not really. The insurance company is practicing medicine by telling the doctor what to do.
If you get really sick and start costing the insurance company a lot of money, they will assign your case to someone that will review it daily. This is where they start looking for reasons to drop you. The reasons for getting dropped are widely varied. They are looking for anything. Did you lie about something on a form somewhere? Did you omit information? Were you reckless in some way? These are called the insurance hit men. Their job is to take away your insurance. You might die because of it or just lose a lot of quality of life. In any case, this is where a lot of hard working people with insurance actually go bankrupt. Bankruptcy is the number one cause of bankruptcy in America. There are over two million bankruptcies each year because of things like this.
Some people think the hospital has to keep you alive. In fact, they just release patients that can’t pay. They do very little charity work; even the non-profits. Their goal is to just get rid of you after the insurance has fully paid out. If you need something more to get well, it will be denied unless they think you can pay for it.
Insurance is good for several reasons.
Health insurance companies do some good, but they are primarily immoral. Their actions take care away from those that need it most. They take care away from:
Health insurance companies have a perfect business partner. The federal government. The federal government takes all the really sick people, they take the poor people, they take the special needs people, and they take the army people. The government takes all the bad risk and leaves all the good risk for the insurance company so they can make a good profit. It’s a perfect arrangement for the insurance company.
Recently the CEO of United Health Care was paid 102 million for working one year. It’s good to make a nice living, but you know a lot of people were denied coverage so that these profits could be realized by one individual. It is not moral to take an action against another individual to decrease their health and/or well-being. Insurance is not a typical business. It leads to immoral acts because the primary good is to decrease the health of society and to maximize profits. That’s why companies exist. It shouldn’t surprise anyone that their primary goal is to make money. And, the only way to make a lot of money is to be really good at care denial.