By Kevin D. Williamson
Friday, May 05, 2017
The Democrats, and progressives in general, like to boast
of being the partisans of science.
(Science!)
Most of them, like most people, do not know the first
thing about science, but they enjoy the preening. They are, they insist,
“reality-based,” empiricists who follow the evidence wherever it may lead . . .
until they figure out that it sometimes leads them in directions they’d rather
not think too much about.
“For Republicans, being a woman is a preexisting
condition!” This is the Democratic talking point of the week as Republicans
work on trying to fix the mess of a health-care program created by Democrats. A
typical example of this stupidity is this
column by Slate’s Christina Cauterucci, who dutifully repeats the formula:
“Read closely, the American Health Care Act, or Trumpcare, also reveals the
basic theory that underlies the GOP’s entire legislative wishlist on health
care: the idea that being a woman is a chronic medical condition and a
liability.”
(Did she read it closely? When, I wonder?)
Her complaints are familiar: The Affordable Care Act
enacted pricing rules that largely prohibited charging women higher
health-insurance premiums than men, and the Republican plan would relax some of
those restrictions, which probably would result in women’s paying higher
premiums.
But nowhere in the piece does she consider the actual
facts of the case: Women have radically
higher lifetime medical expenses than men do, about one-third higher, on
average.
(At the risk of committing hate crime, I’ll be using
“women” in the old-fashioned sense, the way Bill Nye used to before the
Minitrue men at Netflix memory-holed all that chromosome talk.)
According to “The Lifetime
Distribution of Health Care Costs,” (published in Health Services Research and made available online by the National
Institutes of Health) per-capita lifetime health-care expenditures for women
run $361,200, or nearly $100,000 more than per-capita lifetime health-care
expenditures for men. Part of that is related to the fact that women live longer
on average, but that does not account for the majority of the difference. If
you want to call yourselves “reality-based,” how about taking a little reality
into account? You don’t necessarily have to interpret the facts in any
particular way, but you ought at least to take note of them.
The usual rhetorical strategy is at work here: Ignore the
relevant facts and, if someone forces them into the conversation, retreat into
high dudgeon. “Harrumph! Sexism! Harrumph!”
But maybe the dudgeon here ought not be too high. Yes,
you could make a very persuasive argument that women ought not be expected to
bear the burden of their higher medical expenses, or at least not the entire
burden. But you could also make a pretty compelling case that poor working people
in the South Bronx ought not be forced to subsidize the lifestyles of the
multi-millionaire vanden Heuvels out in the Hamptons or the multi-millionaire
Clintons in Chappaqua (does Mrs. Clinton still pretend to live in Chappaqua?)
just to satisfy some gender-studies graduate from Bryn Mawr. The higher
premiums charged to women are not rooted in the malice of wicked insurance
executives but in the thing that our progressive friends claim to love: science
— in this case, actuarial science. The argument for charging women higher
premiums may not be persuasive to you, but it has some basis in reality. The
argument against doing so has no obvious basis in anything other than
preference.
We all support evidence-based medicine. Why not support
evidence-based health insurance, too?
Which is not to say that we can’t or shouldn’t subsidize
some health-insurance consumers. Of course we can, and will. But why subsidize
them based on biological sex (seriously, call the hate-crime hotline!) rather
than on some other more subsidy-relevant metric such as income or wealth?
I know it is a downer to start thinking about the facts
when you’re right in the middle of a very pleasurable episode of moral
grandstanding, but the facts will still be there when you’re done.
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