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Pyle: Everybody into the (insurance) pool

Published December 6, 2013 4:57 pm

This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

The attraction of becoming a journalist — overcoming (mostly) the long hours, meager pay and low public esteem — is largely found in the thrill, or the honor, of being among the first to know something important and having the means to tell other folks stuff they need to know.

A long time ago, covering a county government far, far away, it was my privilege to inform the members of the county commission that the cost of their employee health insurance plan was about to jump significantly. That is, they read it in the paper.

The board of directors of the county's semi-independent parks and recreation department voted, at a meeting I covered, to exit the county's health insurance plan and buy a different one for their workers.

That was good for the parks department because its employees were primarily young and/or healthy. Even the executive director, who had been in the post for many years, had the look of someone who could do 50 push-ups between meetings. Their insurance claims were mostly broken ankles and childbirth expenses, and the carrier they went with was happy enough to have them that it cut them quite a deal.

Making a decision that was perfectly rational for them, rec board members seized the opportunity to save money, hold the line on their separate property tax levy and end up with improved services and facilities for the taxpayers.

But that was bad, very bad, for the rest of the county government. Because, once the fit and youthful cohort of parks department employees was removed, the population that remained in the county's insurance pool was much older, more sedentary and, quite literally, sclerotic. They had heart attacks, strokes, diabetes, bypass operations and liver problems. They were expensive. Rates went up. Taxpayers absorbed much of the cost.

Covering that was good training for a reporter who would later be an opinion writer, holding forth on health insurance for everybody. For health insurance to provide the greatest good for the greatest number, the pool has to be as large as possible.

To allow carriers to cherry pick healthy cohorts, who won't have many expensive claims, while leaving the old and sick to competitors — or taxpayers — skews the system in an unsustainable manner.

From an overall view, what is even worse is the number of people who could afford to buy health insurance — either on their own or with the subsidies provided by the Affordable Care Act — but elect not to because they don't think they need it.

The excuse that they aren't sick now, and won't be sick later, is wholly irresponsible thinking, both from the person's own perspective and from society's.

Many, maybe the vast majority, will escape at least into middle age with no significant illnesses or injuries. But those who aren't so lucky are liable to bankrupt themselves, and shift the costs of their care onto others, once their illusion of invulnerability comes crashing down.

Choosing to go without insurance, or insisting on the right to keep the kind of junk policies that President Obama was so harshly criticized for cancelling, is highly irresponsible, both as an individual and as a citizen.

But it doesn't feel like it when one is young and healthy and has other ideas about what to do with her own money. That's the delusion some conservative saboteurs — hoping that the ACA pools serve only the old and sick and collapse of their own weight — are playing on as they actively encourage young people to refuse to buy insurance and pay the meager $95 fine, er, tax.

This is all real easy for me, someone with employer-provided health insurance, to say, obviously. But that may not always be true. And I'm old enough now that, quite honestly, I'm going to need to be part of some big pool with healthier people sharing the costs.

And so, someday, are all of you.

George Pyle, a Tribune editorial writer, is feeling just a bit queasy right now.

gpyle@sltrib.com

Twitter: @debatestate