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A Congresswoman’s Dumb Question to Sebelius

Joel Pollak of Breitbart.com doesn’t seem to be too bright a fellow. For some reason, he seems to think that a line of questioning from Rep. Renee Ellmers to HHS Secretary Kathleen Sebelius was brilliant. In fact, gives it an “award for best line of questioning.” Here’s the exchange:

Rep. Ellmers: You also brought up the issue, when you were in Kansas [as governor and health insurance commissioner], that you fought against discriminatory issues. Now I–you know, as far as the essential health benefits [of Obamacare], correct me if I’m wrong, do men not have to buy maternity coverage?
Sec. Sebelius: Policies will cover maternity coverage for young and healthy–
Rep. Ellmers: Including men?
Sec. Sebelius: Under 30-year-olds will have a choice also of a catastrophic plan which has no maternity coverage.
Rep. Ellmers: The men are required to purchase–
Sec. Sebelius: Well, an insurance policy has a series of benefits, whether you use them or not. And one of the benefits will be–
Rep. Ellmers: And that is why the health care premiums are increasing this high, because we’re forcing them to buy things they will never need. Thank you, madam chairman.
Sec. Sebelius: The individual policies cover families. Men often do need maternity coverage for their spouses and for their families, yes.
Rep. Ellmers: Single male, age 32, does not need maternity coverage.
[Crosstalk]
Rep. Ellmers: To the best of your knowledge has a man ever delivered a baby?
Sec. Sebelius: I don’t think so.
Chair: The gentlelady’s time has expired.

Pollak says Ellmers was “on her ‘A’ game” and that Sebelius “tried to squirm away.” Boy, she really trapped the secretary, didn’t she? Well no, she didn’t. This line of questioning is utterly idiotic. Does he think that insurance companies sell policies just for men or just for women now? Does he think that when someone joins a group policy at work or buys an individual policy, they get to decide whether to cover maternity or not? Can he name any insurance policy that does not cover maternity? I doubt it.

I have an individual policy and it covers the full range of health problems that women incur but not men, just as women have policies that cover prostate screenings that they don’t need. Obamacare changes absolutely nothing in this regard. Policies do not specify gender now and they won’t in the health care exchanges either. Is he an idiot? Or does he just think his readers are?

Comments

  1. throwaway, never proofreads, every post a gamble says

    Is he an idiot? Or does he just think his readers are?

    He’s a malevolent toad hellbent on muddying the waters of public discourse. Not that there is much hope of discourse in this polarised post-9/11, post-Bush America. The right wingers have been pretty successful at forming their facts around their opinions. It’s the bubble. Always the bubble. So it’s not really an “or” situation.

  2. throwaway, never proofreads, every post a gamble says

    He pretty much counts on the latter, is what I’m driving at. Cognitive dissonance precludes him from applying it to himself. They all literally think themselves Machiavelli and wank over that idea.

  3. karmacat says

    I am betting Ellmers is pro-life. Of course these people don’t recognize their hypocrisy. But I also suspect that this is not so much about maternity care as it is about trying to find ways to oppose Obamacare

  4. tuibguy says

    Totally ignorant of what insurance does, this Ellmers is. I have a policy that covers chiropractic, and I object strongly but can do jack-all; however I don’t view one of my co-insureds going to a chiro that I am personally paying for it.

    Pooling, it’s called pooling risk.

  5. sunsangnim says

    Actually, many individual policies did not cover maternity before the ACA. Luckily, this has changed. I can’t imagine anyone (other than an insurance executive) believing that this is a change for the worse. Women previously had to buy extra coverage for pregnancy before becoming pregnant. So you had to plan your pregnancy ahead of time. And if you tried to get a new policy after becoming pregnant, they’d consider the pregnancy a pre-existing condition. There’s simply no end to ways insurance companies have found to fuck people over. And tea party assclowns will never stop defending the “freedom” of these companies to do so.

    My foreign friends can’t believe we’re having battles over shit like this. Making sure pregnant women get access to health care is sort of a no-brainer.

    http://www.kaiserhealthnews.org/features/insuring-your-health/maternity-expenses.aspx
    http://www.consumerreports.org/cro/news/2008/08/when-health-insurance-won-t-cover-your-pregnancy/index.htm

  6. skinnercitycyclist says

    Matt G, see, Ellmers is on to something here. My plan covers prostate exams, and my daughter has never once had such an exam. And when do I get my mammogram?

  7. says

    This stupid line of question is typical from those who fail to understand (or willingly refuse to acknowledge that they understand) the whole underlying premise of insurance systems; that is, that all who participate share the cost of risk (with “risk” here being the cost of health care).

    All of us who participate in health insurance – regardless of gender, age, or need – pay for all health care for all people. It’s always been that way. ACA changes nothing in this regard.

    It’s just like auto insurance – we all pay in so that we can all derive benefits when we need them. I never text while I’m driving, and never will, but my premiums contribute to the funds that will be available to cover the crashes and injuries of those who do.

  8. haitied says

    That kind of questioning has been the theme of the Republican party for a while, Willful ignorance is still ignorance. Too bad their constituents were prob sitting at home in their soiled undergarments with a beer in hand screaming “Yeah stick it to that b***h”

  9. dingojack says

    Also there’s the issue of family members signed up on the same plan. I might never need to have a mammogram (but my wife or daughter might), but why should I have to pay for things that others on my plan might need? It’s all about ME.
    As I (nearly) stated on an earlier thread: it’s just typical PoG behaviour obfuscation, obscurantism and delay.
    Dingo

  10. machintelligence says

    Is he an idiot? Or does he just think his readers are?

    I assume you are using the inclusive “or”.
    I vote for both.

  11. hunter says

    Ellmers may very well be stupid — given other comments of hers I’ve seen, that’s certainly not out of the realm of possibility — but in Pollak’s case, I’d say it’s the wrong question: you’re expecting a reasoned, intelligent response from an ideologue writing on a fellow ideologue. He’s smart enough for what he needs to do, which is get the message framed and out there.

    Which is exactly what Ellmers is doing.

  12. says

    Woman without appendix still has appendectomy coverage. Child allergic to antibiotic has policy that pays for antibiotic. Man without legs has podiatry coverage. I haven’t had tonsils since I was age 4, and the insurance company knows that, but I have coverage for tonsillectomy. It’s madness, I tell you.

    @Modusoperandi:

    Republicans only need healthcare insurance that covers one thing: asshole.

    See! I’m not a Republican, yet I have to subsidize healthcare for assholes.

  13. tbp1 says

    I’ve said this elsewhere, but conservatives in general just don’t seem to understand how insurance works, at all. The concept of shared risk seems completely beyond them. It’s like they imagine an insurance policy is a laundry list, and they can decide to get cancer coverage, but opt out of diabetes coverage, etc.

  14. says

    tbp1 “I’ve said this elsewhere, but conservatives in general just don’t seem to understand how insurance works, at all. The concept of shared risk seems completely beyond them.”
    Lies! We conservatives understand insurance perfectly fine. I pay to cover me. You moochers expecting your various sinful parts, areas and crevices to be covered is Socialism(*1) and, frankly, that disgusts and offends me greatly, as it did the Founding Fathers(*2).

    *1. SOCIALISM!!!
    *2. “If we don’t hang separately, by Heavens we shall hang together.” ~ Benjamin Franklin, Senator (R-S.C.)

  15. caseloweraz says

    tbp1: It’s like they imagine an insurance policy is a laundry list, and they can decide to get cancer coverage, but opt out of diabetes coverage, etc.

    This fits their pattern of cherry-picking just whatever fits their ideology — from the Bible, the Constitution, etc. The pattern extends to Congressional hearings, where they try to pick friendly witnesses (e.g. Michael Crichton and TVMOB on climate change) and interrupt and berate those they regard as unfriendly witnesses. A hearing is supposed to uncover facts, but that’s not how they use them.

  16. matty1 says

    OK, I’m asking this because I’m an ignorant foreigner not because I have any sympathy with her but why doesn’t your insurance system let you exclude cover for certain risks? Note I’m not talking here about pooled risk – should the insurance company offer cover for X but about the cover you buy.

    Let’s give a concrete example I can get car insurance that is either third party only -“if I cause an accident the insurers will pay for the other party’s repairs but I get nothing” or fully comprehensive “covers my repair costs as well”. If I go for third party only it doesn’t mean the insurer isn’t selling fully comp to other customers it doesn’t even mean money from my premiums won’t end up meeting their costs but it does limit what I can claim and, yes, it does reduce my premium.*

    So why doesn’t health insurance work like this? Why can’t you say “I’m going to pay less and not get cover for prostate exams” given that doing so would not stop the insurers selling prostate cover to anyone else or paying out to them for the pooled funds you had paid into?

    *hypothetically, I do actually have fully comp

  17. says

    matty1 “OK, I’m asking this because I’m an ignorant foreigner not because I have any sympathy with her but why doesn’t your insurance system let you exclude cover for certain risks?”
    As far as I can tell (and, also being a foreigner, I can’t tell much. It’s all blurry from this distance. Granted, part of that is the alcohol), it did. Not so much now.
    The problem with “I got insurance that doesn’t cover my prostate” is that when my prostate explodes, as prostates often do, you get to pay for it. Prostate.

    And the reason lady issues are covered even for men (and man issues for women) is that insurance companies charged ladies more (the “ovary surcharge”), which was done, I assume, because their plumbling is statistically unreliable compared to the male equivalent. I say “I assume” because I tried asking some of them, but was met with stern silence and looks that were also stern. Plus, they kicked me out of their book club.

  18. tbp1 says

    @#20, Not in the insurance business so this is speculation, but:

    I suspect that, for one thing, calculating how much to charge for each kind of coverage, while probably not impossible, would be a big, expensive pain. Just deciding how to break it down would be a problem. Do you have one category for “cancer” or categorize by type of cancer?

    Similarly, generating hundreds of thousands of individualized polices instead of a few standard policies (with a few options built in, perhaps) would also be a big, expensive pain, and much more open to post-need second guessing. If you opt not to have prostate exams, but do opt for cancer coverage, what happens if you get prostate cancer? It’s likely that treating your cancer would be harder and more expensive to great if it’s caught later when you start bleeding, rather than early on by a simple, inexpensive prostate exam.

    All kinds of things like this would have to addressed, and would, I think, just end up driving up costs for everyone. It also undermines the whole idea of shared risk.

    I’m not sure the analogy with car insurance is a good one. Driving is not mandatory (although goodness knows not driving makes things difficult in most American cities). At some point or other in everyone’s life, health care is not optional, if you want live a reasonable life, or in many cases, just go on living.

    I’m actually in favor of universal, single-payer health care, like every other first-world nation has, but I’m not holding my breath…

  19. matty1 says

    @22 That would make sense, if it costs more to set up varied policies than to have a generic one than is saved by some people opting for lower cover then insurers would offer the one size fits all policy because it is actually cheaper.

  20. Michael Heath says

    karmacat writes:

    I am betting Ellmers is pro-life.

    I’m confident he’s not even remotely ‘pro-life'; I do know he’s anti-abortion rights. That group is a demonstrated and effective enemy to life and therefore doesn’t deserve the label.

  21. says

    Matty,

    Employer group policies cannot discriminate based on conditions. Every employee in the policy group gets the same coverage at the same price. Employers can offer different policies based on non-condition related factors, e.g., full-versus p.t. employment, length of tenure or even department. Family members can be covered under different policies, but comparable employees cannot be priced differently or covered for different conditions. Pregnancy is considered a condition, so all employees who are members of a policy group that has pregnancy coverage offered are under the same policy at the same cost. One price assessed per employee. All risk-costs are evenly shared within the group.

    Back to me, I don’t have tonsils, but tonsilectomy covered for a group I’m part of would cover me, as well. It would not be legal to craft a special policy with a no-tonsils discount just for me. Think about it. If everyone in a covereage group could tailor their own policies, the risk sharing is narrowed and suddenly you’d have the equivalent of an individual market rather than a group policy.

    Of course, men are effectively not covered for pregnancy and women aren’t covered for prostate conditions, except perhaps if we’re talking about a transgendered man who decides to have a baby (it happened).

  22. says

    Michael Heath “I’m confident he’s not even remotely ‘pro-life’; I do know he’s anti-abortion rights.”
    Well, she’s a Teabagger so, as someone dedicated to Freedom, Liberty and Small Government, of course she’s Pro-Life™ (0% rating from NARAL).
    And also, despite her voting record, she’s a she. I’m guessing that, as a she, her parts are quite rebellious and require the full power of the state to keep under control.

    Dr X “Pregnancy is considered a condition”
    Condition: Pregnancy (2002-2007), starring Barry Van Dyke, was a Diagnosis: Murder spin-off about an OB-GYN who solved paternity suits in his spare time. True story.

  23. tbp1 says

    Matty, Some coverage does include some room for individualizing your plan to a certain extent. My employer offers a few choices. When I was younger I opted for lower-premium, higher-deductible plans because it was a reasonably good bet. Now that I’m middle-aged, I do the opposite. But still, the plans themselves are standardized, and there are only a few such options. But that’s a long, long way from the kind of checklist approach you seem to be suggesting.

  24. matty1 says

    Ah, I don’t think I had realised the extent to which these were group plans offered by employers. That does make varying the policies less practical and basically kills my analogy with car insurance which is a one off contract between me and the insurer, albeit with them setting the terms.

    I should of course reiterate that none of my confusion should be read as being against medical support for pregnancy or proper funding for it.

  25. matty1 says

    Modusoperandi

    I’m guessing that, as a she, her parts are quite rebellious and require the full power of the state to keep under control.

    Rebellious Parts was a drama about the French resistance wasn’t it?

  26. scienceavenger says

    Insurance actuary here. Allowing people to choose health insurance from a menu would lead to increased costs due to to the increased difficulty of pricing and application. Fights over errors would add to that. More importantly, it would lead to negative selection, where those more likely to make claims for specific care would be more likely to choose insurance for it, thus reducing our ability to spread risk, and ultimately making the cost of said coverage formidably expensive. Think flood insurance. This problem would only get worse with time as we get more and more relevant genetic information. It’s similar to the much-discussed problem the program will have if too many young healthy people opt out and too many older, more sickly people sign up.

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