nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Wednesday, July 22, 2009


Here are a few hypotheticals about healthcare reform:


  1. You are a single adult male.  Should your healthcare premium be the same as that of a couple, or a single female, who are planning a family and need obstetrical care?  That is, should your premium be increased to cover obstetrics?


--This question is an extreme form of the level-playing-field argument in insurance risk analysis, and involves gender equity.  It’s understood that if this male got married, the couple would need to share premiums with others who may need obstetrics.  But what about other risks:  smoking, obesity, heart disease, or history of heart disease.  At bottom these questions test your philosophical outlook on “what we owe to others.”


The current bill:  Congressional testimony on this point was offered that the single male would have to pay extra for obstetrical healthcare he would never require if he remains single.  To not do so would unfairly punish women; to do so levies a fine for being male.  There are arguments either way…although as usual most will justify their pre-existing belief on the point rather than be swayed by argument.


  1. You don’t think you need healthcare insurance, so you wait until just before the end of the calendar year to enroll.  Therefore, when you file a federal tax return with the IRS, you are not charged the tax for not having coverage (the amount varies depending on your income—for most people it will be several thousand dollars).  Immediately after your return is filed, you cancel the policy.


--The individual dodges premium payments for most of the year, thus not paying their fair share.


The current bill:  Nothing in the draft bill disallows this.


  1. You decline to enroll, but find that you need an expensive elective surgical procedure (like having your gall bladder taken out).  You enroll, payment the initial premium, get your sugery done, and once you are well and all costs have been paid by the insurer, you cancel the policy.


--As above, this allow the individual to pay a few hundred dollars to the insurance pool, and get a $20,000-50,000 operation done, the balance being paid by increased premiums for those people who are covered year-round.


The current bill:  Nothing in this draft makes this impossible (I’m about 90% sure on this one; I couldn’t find any lawyer-ese in the bill on it…so…grain of salt).  This IS being done in Massachusetts according to recent articles, and is contributing to the huge cost overruns of their universal care plan.



It takes time for these issues to be discussed and addressed.  None of that has occurred yet.



Doc D


Opinions are entirely my own.  As always, you may share this column, with appropriate attribution (here and in the text) included.  Please do not forward my email address…thanks.

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