I don’t like the Kimmel test. Republicans have an easy out if they shovel twenty or thirty billion dollars at presumptive eligibility for birth to three months or birth to six months. It also feeds into the idea of the deserving and underserving poor. I meant to say the deserving or undeserving unwell.
OMB Director Mulvaney explicitly makes this argument:
— Zachary Tracer (@ZTracer) May 12, 2017
Dennis Shea makes a very good point. This turns insurance companies back to optimizing on not covering people instead of managing high cost chronic conditions.
— Dennis Shea (@DennisG_Shea) May 13, 2017
I want to personalize for a bit about the administrative complexities of attributing disease states to genetics or lifestyle. There is a very good chance that I have the genetic defect that is Lynch Syndrome given past family history. Lynch Syndrome significantly increases the chance that a carrier will have an gastro-intestinal tract cancer at relatively early ages. My family is slowly and haphazardly doing rule out testing and frequent colonoscopies. I’m not sure if I have it yet as I have not undergone genetic testing.
But let’s assume that I do have a genetic defect that predisposes me to increased risk of colon cancer. I also like to eat red meat. I’m slowly moving my diet towards a good colon health diet.
In the future potential case that I am diagnosed with colon cancer, what proportion of the costs should be covered because I was unlucky to have a genetic combination that predisposed me to this type of cancer, and what proportion of the costs should not be covered by society because I chose to have a good burger in Boston last week with a fellow health policy nerd?
Yeah, it gets messy really fast as soon as we as a society decide that some diseases should be treated by telling people that they can either pay for treatment themselves or that they should die quietly in the corner.