My Pre-Existing Condition

Several years ago, the first time I tried to buy insurance, I discovered that I have a pre-existing condition. I was born with this and have no control over it. My parents and siblings always knew about it, but hadn't realized it would affect my insurance costs.

For my specific condition, one has to pay 20 to 100 percent more, depending on age and location. That's a steep price, but my state has adopted an individual mandate, so I have no choice.

Stay Engaged

Receive our weekly emails!

I'm getting married soon and, especially fortunate for me, my fianceé doesn't have this condition.  Despite everything else being the same about us, she pays less for insurance.

I'm not asking for pity though. While my pre-existing condition is the result of random chance, it's extremely widespread. In fact, there's almost a 50-50 chance that any person reading this shares my condition.

I have a Y chromosome.

Yes, I am a male, and when I first tried to purchase car insurance, the lifelong financial impact of this pre-existing condition was made clear to me. From 16 through death, male drivers pay substantially more for auto insurance than our female counterparts.

This "discrimination" is engaged in on the basis of actual experience: Insurance companies recognize that men drive more, and drive more dangerously. They experience more crashes and get more tickets. This means higher repair and medical costs, and so higher insurance costs for men.

While there are some important differences between auto insurance and health insurance, there are similarities, too. For example, just as someone who fails to purchase auto insurance can't  call an insurer after a crash and get those costs covered under a new policy, so a person with no health insurance can't wait until he or she gets sick to buy a policy and expect to pay no more.

At least in most places they can't. New York and Massachusetts are two exceptions. As a result, health insurance costs much more in those places. Many politicians in Congress want to make that the rule nationwide, which means higher costs everywhere.  House Speaker Nancy Pelosi characterized as "scandalous" one health care proposal that that doesn't "end health insurance companies' discrimination against people with pre-existing conditions."

The monstrosity that is the health care bill also limits "discriminatory" health insurance price differentials based on age - equivalent to prohibiting auto insurers from charging 16-year-olds much more than 45-year-olds.

However, age-based health insurance price differentials are no more unjust than auto insurers charging young men more than middle-aged women; charging those with pre-existing conditions more for health insurance is no more unjust than auto insurance rates for males being higher than for females.

Charging everyone the same rates makes insurance a lousy value for the people in the groups with predictably lower costs, and a steal for those in the higher cost groups. The former tend to drop their coverage, leaving a greater proportion of high cost customers in the remaining risk pool, and so raising the costs even more.

This process creates a vicious cycle, called an "adverse selection death spiral." Ultimately it will destroy an insurance market, and government mandates can only do so much to relieve it. Besides diminishing individual liberty as well.

And so Congress can mandate an end to these "unfair practices," but that won't change insurance market realities. Making "discrimination" by insurers illegal won't change economic principles.

Not included in this discussion are the unfortunate victims of lifelong chronic health problems that make an individual all but uninsurable at an affordable price. Such people actually represent a relatively small portion of the population, and a plausible case may be made for "socializing" the cost of their heath care. The total cost would not be that great compared to the overall health care market.

Certainly not large enough to justify destroying viable health insurance markets and turning over to the government nearly one-fifth of the nation's economy and the health care choices of every American.


Jarrett Skorup is a 2009 graduate of Grove City College with a dual major in history and political science. He is a research intern at the Mackinac Center for Public Policy, a research and educational institute headquartered in Midland, Mich. Permission to reprint in whole or in part is hereby granted, provided that the author and the Center are properly cited.