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.