Valentine: Health insurance is a matter of personal responsibility

Monday, September 28, 2009

Broward County in Florida is joining the ranks of other municipalities and some states that are charging government workers more for health insurance if they smoke. The move has some Broward County employees raising the roof. Sion Mansoor, a longtime smoker who works in the county's records division, talked to the Sun-Sentinel about the move. "How can they tell us how to live our lives?" Mansoor asked. "Even if I wasn't a smoker, I'd feel that way. It's totally against what America's about."

I beg to differ. This is exactly what America is, and should be, about -- personal responsibility.

I've often asked why health insurance providers can't ask the same questions life insurance providers ask. When you apply for life insurance they assess your risk, going so far as to get a blood and urine sample. The higher the risk, the higher the premium. If you want to lower your premium you lower your risk.

In Broward County they will begin adding a surcharge of $520 per year. That's 43 bucks a month, hardly an undue burden on someone who, statistics show, drives up the cost of health insurance for everyone.

The assumption that such surcharges are telling employees how to run their lives assumes that having your employer pay for your health insurance is somehow a right. It isn't and it never should be. However, that's exactly what the Democrats are trying to do in their national healthcare bill. Forcing your employer to pay for your health insurance makes no more sense than forcing them to pay for your groceries.

The only way to hold down healthcare costs is to reconnect the consumer with the product. That means we should be moving towards personal responsibility instead of away from it. Does that mean that no one will be allowed to smoke? Of course, not. What it means is if you choose to smoke, which everyone agrees puts you at a greater risk for all sorts of health problems, then you will pay for the risk. Just like smokers pay more for life insurance; as do private pilots, skydivers and motorcyclists. If you're going to be a greater risk to the insurance company then you should pay more in premiums.

But Broward County isn't stopping at smokers. They plan to assess a surcharge to overweight workers starting next year. I'm sure many more will complain about that but it's all about the risk. Risky behavior should mean higher premiums instead of forcing those who choose healthier lifestyles to subsidize the risky behavior. It's all a matter of getting back to personal responsibility and that's the only way costs will come down.

Personal responsibility also entails paying for routine doctor's office visits and tests. I've often equated this to auto insurance. If you were able to pay a $20 co-pay and put new tires on your car how long would it be before all auto insurance rates were through the roof?

Health insurance used to be called hospitalization, and for a reason. It was meant to pay for serious health problems that required admission to the hospital. Costs began to skyrocket when we began using the insurance to pay for things like the common cold. What Broward and other municipalities are doing is turning the issue back on the consumer. It's like anything else in life that you purchase. If you want more you'll have to pay more.

As for me, I have a $4,000 deductible. That means I'm responsible for the first 4 grand spent on my healthcare. It's made me a more cost-conscience consumer. And that's a good thing.