Magazine article The Christian Century

Together in the Risk Pool

Magazine article The Christian Century

Together in the Risk Pool

Article excerpt

Days before the House of Representatives passed the American Health Care Act, CNN's Jake Tapper interviewed Representative Mo Brooks. The AHCA bill "will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool," said the Alabama Republican, "reducing the cost to those people who lead good lives, they're healthy, they've done the things to keep their bodies healthy."

It's a statement that raises a list of problems. The most obvious is that a healthy lifestyle very often does not result in good health. Some catastrophic illnesses and injuries are preventable; many are not. The rain falls on the prudent and the reckless alike.

What's more, Brooks's moralizing--his summary of healthy choices as "leading a good life"--is a shaky foundation for public policy. Which choices are good enough, and how consistently must you make them? How often can you skip your workout or cheat on your diet before you no longer deserve the decent insurance enjoyed by the healthy?

And even granting the kernel of truth here--yes, personal choices are a factor--it's quite a leap to single this out as the primary factor. David Ansell, a physician who has worked in public hospitals, argues in The Death Gap that health outcomes are largely tied to class, which determines what level of care particular people can afford. Brooks's implication is that separate insurance pools for the sick will help address health disparities (by incentivizing people to stay among the healthy). …

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