Santorum’s Hypocrisy – and Ignorance – on Health Insurance

Being the week before the New Hampshire Primary, it is hard to go grab a loaf of bread in this state without running into some campaign entourage. Rick Santorum, after being booed off the stage for his anti-Marriage Equality screed yesterday, and having missed a traditional “must stop” at Lindy’s Diner this morning, finally showed at the Community Room of the Keene Public Library to press the flesh. In the most interesting exchange of the morning, Santorum tried to defend the practice of charging higher health insurance premiums to people with pre-existing conditions, and criticized the clause in the Affordable Care Act (“Obamacare”) that prohibits insurers from denying coverage to those with pre-existing conditions.

In explaining this position to one member of the audience, he stated that "Americans need to be educated” about health care costs. This condescension was met with expertise greater than his: he was speaking with a woman who had been a nurse for over 30 years, and whose son was a childhood cancer survivor. She asked Santorum why her son should have to pay higher health premiums, or even go without insurance for the rest of his life.

Santorum’s answer: “Insurance works when people who are higher risk end up having to pay more, as they should.”

Not only does Santorum lack basic compassion, his answer shows that he fundamentally misunderstands the nature of most illnesses, and, worse, is a hypocrite to boot.

If we take him at his word, then those who statistically have a higher risk of incurring health care costs should pay higher premiums. If he really believes that, then he should look at his own family size.

Rick Santorum and his wife had seven children (one died soon after birth.) As any doctor’s office or hospital can verify, the more children one has, statistically, the higher the health costs associated with those children. This blogger has 6 children, and we used to joke that the local hospital ought to have a room reserved just for our family.

But most major Health Insurance Plans do not charge “per child.” Insurers generally provide plans for singles, married couples, single parent/child plans, and family plans. The Family Plans are without regard to the size of the family or number of children. Rick Santorum's Congressional Family Plan does not charge for additional chidlren.

So does Rick Santorum support increasing health premiums for families with large numbers of children? Doubtful: in Iowa, he proposed tripling the income tax deduction for each dependent child (from $3,500 to $10,500), which would virtually make the largest families exempt from income tax at the expense of single people and smaller families. This massive distortion of the tax code would accomplish the very thing he opposes when it comes to health care: subsidizing those who receive the most services with dollars paid by those who receive the least services. The hypocrisy is palpable.

It also shows that Santorum’s understanding of Insurance Pools is crude at best, and simply parroting Corporate Insurance Lobbyists at worst.

Insurance pools are based on the notion that everyone’s risk is shared. The first known successful Insurance pools existed as far back as 1235 with the birth of the "Hanseatic League," an alliance of shipowner-merchants along the Baltic Sea. Because this was the height of the era when Vikings ruled and pillaged the seas, there was always a good chance that a merchant's ship – and along with it, the merchant's life investment – would be captured by marauding Danes. Members of League chose to each take an ownership stake in all the other members’ ships to prevent against the possibility of a total loss. Shipowners forced to sail closer to Denmark were not thrown out of the pool in favor of those who plied waters further away; each shared equally in the losses – and surpluses – recorded by the entire group of merchants. It was a system that lasted for 300 years.

An insurance pool that favors the low-risk members, and penalizes the higher-risk members (as Santorum defends), is not an insurance pool at all, but a profit-making engine that distorts and misrepresents its purpose.

Fortunately for those with large families, most Americans really do understand this concept, and Mr. Santorum has benefitted from it.

Perhaps it is Mr. Santorum, not the American people, who need to be educated about health care costs.