Family Issues in Policy and Culture

A Web site of Focus on the Family

Why are my insurance premiums so high?

by Scott DeNicola and Jeff Hooten

CAUGHT IN THE MIDDLE

In the fall of 1994, an HIV-positive patient visited a Bangor, Maine, dentist to have a tooth filled. The dentist, Randon Bragdon, agreed to perform the procedure, but only within the safer confines of a hospital setting.

The patient, Sidney Abbott, claimed she was being discriminated against on the basis of her HIV status. She sued Bragdon, basing her claim on the Americans With Disabilities Act. Last year the 1st U.S. Circuit Court of Appeals ruled unanimously in her favor.

In the age of AIDS, health-care professionals must balance safety with political correctness. Still, extra safeguards are becoming more routine. Health-care workers face a myriad of precautions — the costs of which are passed on to insurance companies, who in turn pass the bill on to their customers.

Many times, these precautions absorb nearly as much manpower as money. For example, the CDC has urged all dentists to go to the extra expense of autoclaving (sterilizing under intense heat) dental handpieces after each use — a procedure that reduces the spread of STDs, yet shortens the lives of expensive medical instruments.

Patients are the primary concern, but doctors and nurses must also watch out for themselves. HIV- and hepatitis B-infected body fluids have transformed simple scalpel nicks into potentially health- and life-threatening injuries. Used syringes must be treated as bio-hazardous waste for fear of contamination and accidental needle pricks.

But there are no guarantees.

Edward Rozar, M.D., had a thriving cardiac surgery practice, a happy marriage, five young adopted children and a new home when, in 1989, he received an unexpected phone call.

“I’d just finished doing an open-heart case, and the words were, ‘Doctor, I don’t know how to tell you this, but your HIV test is positive,’ ” Rozar recalled.

Rozar had already contracted hepatitis from a patient, and he knew that HIV was an ever-present risk.

“Could have been a finger stick ... a splatter in the eye. I could have had an abrasion on my body,” Rozar said, speculating on how he might have caught HIV. “It wasn’t unusual to see blood under [my] gloves.”

Rozar died of complications from AIDS in July 1993.

BLOOD MONEY

The legal expenses associated with illicit sex cost corporate America as well. Blood-product companies face the daunting task of screening HIV-infected donors — no small chore considering that 3.6 million Americans receive transfusions each year. Though screening procedures are extensive, they are not entirely foolproof.

And failure is costly — both in money, and in lives. In May of last year, four companies agreed to pay $600 million to hemophiliacs who acquired HIV using their blood products. When hit with such devastating legal expenses, companies often recoup their losses by increasing the cost of their products and services.

Businesses also suffer from lost productivity when infected employees can no longer work. According to an analysis published by the American Medical Association, the nation’s first 10,000 AIDS cases alone cost U.S. businesses $4.6 billion in terms of work lost.¹

BEHAVIOR INSURANCE

The consequences of promiscuity also weigh heavily on insurance companies, leading to higher insurance premiums. The American Council of Life Insurance and the Health Insurance Association of America in 1996 released an estimate that AIDS-related insurance claims for the previous year totaled about $1.6 billion.²

Insurance analysts, however, suspect that figure is significantly understated since HIV/AIDS is oftentimes not cited on death certificates. Doctors frequently don’t list AIDS as a cause of death, or only make reference to the opportunistic diseases associated with AIDS, such as pneumonia or cancer.

Promiscuity drives up health-insurance costs in plenty of other ways. For example, two-thirds of private-insurance companies surveyed by The Alan Guttmacher Institute routinely cover abortion and 93 percent of the health maintenance organizations (HMOs) surveyed offer contraceptive coverage.³

But leading safe-sex advocates still want more. Sen. Barbara Boxer, D-Calif., introduced the Family Planning and Choice Protection Act of 1997 — legislation that if passed would have required, among other things, health-insurance companies to pay for contraceptives.

A similar measure, the Equity in Prescription and Contraceptive Coverage Act, was introduced last year by Rep. Jim Greenwood, R-Pa., and Sen. Olympia Snowe, R-Maine. This legislation would force many insurance companies to cover contraceptives such as Norplant and Depo-Provera.

SEE YOU IN COURT

Tina Bennis only wanted to get her car back. In 1988, Bennis’ husband was arrested by Detroit police for having sex with a prostitute in the couple’s 1977 Pontiac. A few days later, the city seized the car as a “public nuisance” — even though Tina was listed as co-owner.

Her legal pursuit to regain the car took Tina and her lawyers all the way to the U.S. Supreme Court. After an eight-year legal battle, the high court — comparing the incident to the U.S. seizure of a Spanish pirate ship in the 1820s — ruled 5-4 against Mrs. Bennis.

Thus one man’s promiscuous behavior became a federal case. And who do you think covered the costs of Bennis’ case — indeed, for the entire federal court system?

Your tax dollars at work.

As if kidnappers, thieves and murderers don’t keep them busy enough, America’s police departments and court systems must also track down and dispense justice to a host of sexual criminals.

Prosecution of illicit sex between adults and minors is clogging our court system in growing numbers. California Gov. Pete Wilson in 1996 dedicated $8.4 million to the state’s stepped-up efforts to litigate statutory rape, netting 827 convictions. Juries are routinely summoned to settle disputes over whether certain sexual encounters constitute rape or consensual acts. According to a 1994 survey funded by the National Institute of Mental Health, marital infidelity is the most prevalent cause of divorce.

So many man hours and millions of dollars are spent arresting and arraigning hookers and their johns that a San Francisco Board of Supervisors task force recommended that the city decriminalize prostitution — an action that would surely fuel the already high incidence of extra-marital sex.

Intro — The High Cost of Promiscuity
Part 1 — Prevention or Promotion?
Part 2 — Love Bugs
Part 3 — Family Affairs
Part 4 — The Hidden Costs
Part 5 — Reasons for Hope

Notes

¹ A.M. Hardy, K. Rauch, D. Echenberg, et al, “The Economic Impact of the First 10,000 Cases of Acquired Immunodeficiency Syndrome in the United States,” JAMA, Vol. 225, 1986, pp. 209-211.

² “AIDS-related Claims Survey: Claims Paid in 1995,” American Council of Life Insurance & Health Insurance Association of America, Aug. 1, 1996.

³ Randee Falk, et al, “Uneven & Unequal: Insurance Coverage & Reproductive Health Services,” Alan Guttmacher Institute, New York, 1994.