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Disability Insurance Observer: Burlesque

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I’ve just been too swamped with writing about Patient Protection and Affordable Care Act Version 1.0 minutiae to write much about PPACA 2.0 efforts, but, clearly, PPACA 2.0 efforts are heating up.

Either PPACA Version 1.0 just plain goes away, or it evolves pretty quickly into 2.0. (Maybe 1.5 by, say, March 31.)

It seems to me that disability insurers have a stake in protecting the PPACA provisions that keep health insurers from using personal health information other than age to adjust health insurance prices, or to use any personal health information to decide whether people get coverage.

In the short run, those provisions will jack up medical insurance prices. When (if?) the market settles down, and insurers and consumers get used to the new rules, maybe the rules will increase prices modestly but make life a lot easier for people with health problems.

The good thing for life and disability insurers is that the medical underwriting rules will give smart, relatively well-educated people with health problems — the sorts of people with chronic health problems and nagging risk factors who are quite familiar with the desirability of personal protection insurance — a financial reason to be honest about their health and not try to “clean sheet” themselves.

The PPACA underwriting rules use affordable (well, theoretically affordable) health insurance premiums to pay people to tell their doctors about their high blood pressure and the uncle who died of leprosy.

That thought came to me as I was going through the written witness testimony posted today for the Senate Commerce, Science and Transportation Committee hearing on data brokers.

The brokers can, for example, sell you a mailing list full of people who have HIV.

At first, even reading about that list made me queasy.

Then, I saw some pointing out that the people buying that kind of list are, generally, managers of drug testing programs and other health research programs. The programs are, in effect, paying the people on the lists for being on the lists by helping researchers improve their health.

We all want privacy, but most of us want many other things, too. We may balance the cost of privacy against the cost of other goods and services we want. Many of us are willing to make a deal, at least if we don’t have to think too directly about the deal.

If you want a show, you pay for the show.

Maybe, for underwriters of some kinds of protection products, PPACA will help pay for underwriters of health-related products other than major medical coverage to see a much better show.

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