Gender Rating in Healthcare

Ok, so this is maybe a controversial topic, and I don't have strongly settled beliefs here, but for the sake of solidifying my position, here's where I stand now.

First, the status quo has what many consider to be a very discriminatory provision. According to this article, "[u]ntil now, it has been perfectly legal in most states for companies selling individual health policies...to engage in 'gender rating,' that is, charging a women more than men for the same coverage, even for policies that do not include maternity care. The rationale was that women used the health care system more than men."

My first question is this: do women actually use the health care system more than men? My intuition assumes so, and in a quick google search I found articles with "experts" stating this as fact, but I couldn't find any credible numbers to back it up. So, while I still consider this is an open question, for the sake of argument I will assume that women do, in fact, use the health care system more than men.

This brings my second question, which is whether, as a matter of policy, it is important to subsidize healthcare insurance so that men and women pay similar rates. Given the way the insurance system works, what will happen is that men's rates will rise to counteract women's rate's falling (In other words, the money's not coming from the treasury; for one group to get a subsidized rate, another group will be the subsidizer. No insurance company will be taking a haircut.). From a utilitarian perspective, the answer should be yes if subsidizing women's coverage this way will reduce the cost of healthcare as a whole. While lowering women's rates surely will result in more women covered and a lighter burden to all women covered, the resulting rise in men's rates will result in fewer men with coverage and a heavier burden for those covered. The former will reduce costs, but the latter will increase costs. Intuitively we may assume that the net impact will be reduced costs on average, but I haven't yet seen studies showing this.

However, even assuming that a net economic benefit results from this practice, there are still two issues that seem to be glossed over here. First, that considering only the economic implications of removing gender rating to society marginalizes the issue of the fairness to the individuals involved. And second, given the fix to this issue, that subsidizing women's healthcare should be the burden of men, rather than the burden of society as a whole.

Regarding this first issue, it is important that people respect the law. Government is a societal contract and when people do not respect the use of power by government, they try to remove themselves from the social contract. For example, we get things such as the Hutaree Christian Militia acting out. More likely with the elimination of gender rate, we stoke the flames of Men's Rights Organizations, which often allude to violent retribution for "unfair" laws. While I don't agree with these positions, it is reckless to ignore that any sort of redistributive policy will face resistance on grounds of fairness to the individual. So, even if there is a net economic benefit to society, there also must be a consideration of other, less tactile, results of the elimination of gender rating.

Regarding the second issue, I can't really see a reason to eliminate gender rating unless we decide that this is a societal problem. Given that discrimination certainly has psychic impact on the discriminated-against party, there truly does seem to be a societal rationale for eliminating it when possible. From that perspective, though, it really only makes sense that we should consider societal responses. Removing gender rating in the way it appears it's going to happen seems to me like the consultants in Office Space "fixing the glitch" to eliminate Milton's salary; an appropriate solution should instead deal directly with the issue of higher costs due to the inherent gender differences. In addition, just because there may be an economic benefit resulting from the elimination of gender rating, isn't it important to consider other alternatives that may eliminate this cost issue in more appropriate ways? I personally think it's important that we see healthcare as a societal burden, not an individual one. The elimination of the extra cost of insuring women should be something that we, as a society, think is important. In that vein, it should not be paid for by the other participants in the system, but rather by the federal government.

Finally, I cringe at calling this an issue of gender discrimination in the pejoritive sense. What I see from the effort to elimination gender rating frankly is not a moral argument for or against gender discrimination. While the public statements have always focussed on highlighting that it is discriminatory to gender rate in healthcare insurance, if we are taking a moral stance, how can we simultaneously ignore the same practice in car insurance, where the corrollaries are quite striking. So, no; this is not actually an ideological argument. This is really a cause to benefit society, which should not, by default, require resolution by men, but rather should be resolved by society as a whole.

Change the OLC?

Gerard Magliocca has a very interesting idea: what if we make the OLC career employees rather than political appointees?

http://www.concurringopinions.com/archives/2010/03/reforming-the-olc.html

As I think about this, I can't see any problem with this idea at all.

Yoga Etiquette

I currently take yoga classes twice a week at my work's gym. They provide blocks, straps and yoga mats. They also provide handy-wipes that can be used to wipe down the mats.

Anyway, there are four different mat-care categories that people fall into, and each says something about the person in question:

Category 1 - The Rational Actor:
-These people never wipe down their yoga mats. Maybe they don't know that the wipes exist, but more likely they don't think wiping the mats makes a difference.

Category 2 - The Germaphobe:
-These people wipe down their yoga mats before they use them and again after they use them. They have no interest in any contact with other people's bodily residue, but provide the same courtesy for those who next use the mat.

Category 3 - The Consciencious Citizen:
-These people wipe down their yoga mats after they use them, but not before. They probably don't think wiping the mat makes a difference, but understand that other people value the behavior.

Category 4 - The Selfish Student:
-These people wipe down their yoga mats before use, but not after. Clearly they think that the wipe-down serves a purpose or they wouldn't do it before using the mat. The fact that they don't wipe the mat after use, however, shows a lack of consideration for the next mat user.


It's interesting to me how there isn't even a universal standard of etiquette, even in such a small group of people who see each other routinely. Obviously people have different value systems, but what's shocking is how much you can tell about a person from these differences.

Any idea which category I'm in? =)

Justice Scalia, the Hypocrite

Scalia has long been known as an "originalist;" he allegedly interprets the Constitution in the manner that it would have been interpreted by the original framers of the document. If it weren't already obvious, though, two days ago he made plain that what he really does is goes with the originalist interpretation if it fits his ideology; otherwise, he does whatever he feels like.

Two days ago, of course, was the oral argument in McDonald v. City of Chicago, a case about whether the individual right to gun ownership declared in District of Columbia v. Heller is "incorporated" to the several states.

For some background, the Bill of Rights has always been known to apply against the Federal Government, but not necessarily against the states. Over the years, a doctrine known as "Substantive Due Process" has emerged, by which individual Amendments in the Bill of Rights have been held to apply to state authority in addition to federal authority. The rationale is that a particular phrase from the 14th Amendment suggests that some fundamental rights cannot be abridged by either the Federal Government or by the States. Notably, Scalia and Thomas (and likely Roberts and Alito) strongly disfavor this doctrine.

So again, McDonald presents the question of whether and to what degree the Second Amendment can be used to prevent states from regulating individual gun ownership. The McDonald case (still) has the potential to be fascinating because it shuffles the classic conservative/liberal split on the Supreme Court; the conservatives want to expand individual gun rights, but they are hostile to substantive due process. Liberals don't want to expand individual gun rights (they surely think DC v. Heller was wrongly decided), but are happy with the substantive due process doctrine. So really, no one necessarily knows how this case will be decided because ideologies on both sides of the fence are conflicted by the facts. It seems likely from recent Supreme Court precedent that the Second Amendment will be incorporated, though, so the real issue is how this will occur.

The wrinkle is as follows: Substantive Due Process is the easy way, but not the only way to incorporated the 2nd Amendment to the States. The 14th Amendment has another clause, known as the "Privileges or Immunities Clause," which many, if not most, legal scholars feel is actually a more apporpriate mechanism for incorporation. However, the Privileges or Immunities clause was rendered a "dead letter" by the infamous Slaughterhouse Cases in the 1870s, universally paned as some of the worst Supreme Court precedent in history (in the ballpark of Korematsu v. United States, which was the Japanese internment camp case). But, for various reasons, the plaintiff in McDonald has argued that the Privileges or Immunities clause is actually the appropriate means of incorporated the 2nd Amendment.

My criticism comes from what happened in the oral argument, two of the Justices asked the attorney for McDonald what other rights would be incorporated if the Privileges or Immunities clause were revived. The attorney responded that he was not sure. Scalia, of course, asks "Doesn't that trouble you?" Maybe this is a seemingly innocuous question, but it belies the way that Scalia (and for that matter, the other Justices on the court) wants to analyze the issue in a results-oriented lens. Maybe it is completely obvious that the entire Supreme Court already does this, but Scalia blatantly discusses his originalism with such vigor that, to me, it is now hard to view him as having any actual judicial integrity. How can you claim to be an originalist, while at the same time caring how correcting 140 years of bad law would affect the future?

It seems to be the case nowadays that "idealogue" is a bad word. I have never thought so and feel like I have to defend this position more and more. Since when was it a bad thing to have principled beliefs? I have disliked Scalia's jurisprudence for many reasons for a long time, but he at least seemed to have the courage of his convictions. Unforunately, I think that this is no longer the case. And in the entirety of the coverage of this case I have seen, no one wants to call him on it.