The need for medical insurance

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Rationing is alive and well in healthcare. It isn’t even that controversial these days: everyone accepts that there isn’t enough money for everything we want. It just gets messy when we disagree over where the money should be spent.

Monday, July 11th 2011, 2:02PM

by Russell Hutchinson

A couple of years back I met a woman who had been offered cover with a loading - not astronomical - but like many clients a "100% loading" sounds awfully high.

She was worried - "does that mean I am twice as likely to die?" I said it means the insurance company wants double the premium, which isn't quite the same thing. Trying to be reassuring I looked at the numbers "Besides. Fewer than two people out of every thousand your age dies, so if you chance is either three in 1000 or four in 1000 that's still very low."

But this wasn't the problem. The problem was what her doctor had told her.

"My doctor says I don't need any treatment, so the insurance company must have got it wrong."

Ah, perhaps. Or maybe to doctor doesn't have to deal in probabilities, or maybe the doctor didn't want to say "In the US, if you were insured, we'd correct this with surgery. Here in New Zealand, we don't consider this worth correcting, because it increases your risk of death by only about 50% to 100% a year".

In truth there is another possibility - that the client doesn't well remember what the doctor said.

In matters of health sometimes the strangest things are the things we tell ourselves. But assuming her recollection was good, then "don't need any treatment" is at best a highly relative statement, and at worst, a lie.

It disturbs me that rationing care, even to a woman in her early 30s, is perhaps so normal that it is not even questioned by the people that do it.

There is no better advertisement for medical insurance.

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