Health Insurance 101 -- yet again

I just cannot understand why it is so difficult to get people to grasp what seems to me a simple idea. Let's try one more time.

The purpose of insurance is to spread risk. That's the essence of the concept. Health insurance (or health care insurance as some prefer to say) is different from other kinds of insurance in some ways, so let's just talk about health insurance.

Health care costs are unpredictable. It is true that there are risk factors associated with some conditions, most notably smoking tobacco. Nevertheless, no matter how healthful your lifestyle, you still just might need expensive health care. You might be hit by a bus. You might get breast cancer, or multiple sclerosis, or Type 1 diabetes or some other autoimmune disease. Most lung cancer is associated with smoking but some people who have never smoked get lung cancer. Your son might develop a substance use disorder, no matter how regularly your family attends church and how fervently you pray. It happens.

So-called Health Sharing Ministries are not insurance. They are unregulated and they do not guarantee payment. What is more, they explicitly cap annual and lifetime costs at a fairly low level. That's why they are cheap!* Yes, they are also cheap because they enroll only people who are healthy and don't need expensive health care, and they explicitly exclude certain risk behaviors. But even if you scrupulously obey your religious prohibition against tobacco and having unprotected sex with various people, you might eat a lot of red meat, be physically inactive, and be obese.


Not that any of that matters, because you may still be diagnosed with diabetes or MS or cancer, or get hit by a bus, whereupon you will go to the exchange and enroll in real health insurance, because now you need it and your health sharing ministry won't cover your costs. You can do that because the ACA requires the insurance companies to sell you insurance regardless of any pre-existing conditions, and they can't charge you more for it. Thanks Obama!

The only problem is that you weren't paying in like everybody else when you were healthy and didn't need a lot of expensive health care. That means real insurance is more expensive for everybody, because you are a freeloader, and you are stealing from everybody who isn't a member of your hypocritical, sanctimonious cult.

There is a commandment about stealing, I believe. Funny thing though, the Ten Commandments that "Christians" like Roy Moore want to post in courtrooms and classrooms are heavily redacted. Yep, that's the word. They are edited to omit all the embarrassing parts. You also have to pick which of the three different versions of the Ten Commandments you want to show in edited form. We'll get to that in the Sunday Sermonette series in a few weeks, but you may be very surprised by what we find.


* I made an error in the comments. HSM membership did provide exemption from the individual mandate in the original version of the ACA. Of course now with no more individual mandate it really doesn't matter.