Health insurance for dead people

January 02, 1996|By Steven Miles

MINNEAPOLIS -- There are a million dead Americans lying around with health insurance. They are an untapped resource for a Congress that wants to cut health-care spending, avoid health-care reform and find a politically safe, cheap way to insure a few more Americans.

Prepayment is the market miracle by which America insures a million dead people while leaving 45 million without health insurance. Insurers require a month's premium in advance. People who die on the first of the month have 30 days of insurance -- coverage that continues after they are buried. The average insured person dies on the 15th of the month. Though the number of insured dead people is highest at the end of each month, I calculate that there are a little more than a million dead-policyholder-years in the U.S. health system.

Insurers don't like to talk about it, but dead people are great policyholders. They are prepaid. They don't get hospitalized or go to clinics. The most costly pre-existing condition, life, is cured. Their genes don't bother them. Excepting Timothy Leary, who wants his head frozen to be resurrected to inhale in the future, they don't clamor for experimental treatments. They don't complain about health insurers in letters to the editor.

Happy insurers

Insurers are so happy with dead policyholders that death is the only major change in health status for which insurers provide coverage without asking policyholders to fill out more forms or get a second opinion.

A lot of people would die to get pre-owned health insurance for their families. There is a better way. I got this idea from ''Dead Souls,'' in which Nikolai Gogol described how Pavel Chichikov used Russian peasants whose deaths were unregistered as collateral for bank loans.

Dead people's health insurance should be transferred to living people. After all, these policies were intended for living people. The insurance company did not know the policyholder was going to die. Why should insurers get a free ''float'' on a prepaid policy just because the policyholder died?

Who should get this bounty? A million dead people's insurance won't cover America's 45 million uninsured living people. It won't even cover the 7 million people who will become uninsured from the feds' proposed Medicaid cuts. We could use it for kids who are uninsured, but Congress says that it does not want to make kids think they are entitled to health care.

The legislators, candidates and governors who tabled the idea that the United States should join the rest of the civilized world and assure health care for its people are already insured. It would be easy to transfer these policies to executives, lobbyists or the Harry and Louise ad-writers in the health-care industry, but they have spent too much time washing their hands to want to pick up a dead person's insurance.

Insurance lottery

Congress could require states to distribute this insurance as state lottery prizes. This would get insurance to some people who need it. It would free more lottery revenues for public schools so we could cut taxes some more. It would not be welfare because people would have the dignity of paying for a chance at a $200,000 policy. It would promote choice because people could choose slots or pull tabs with mental-health coverage, clinics or just basic hospitalization.

And, after all, health is often a matter of luck and prayers. Shouldn't access to doctors, clinics and hospitals be the same?

Steven Miles is with the University of Minnesota's Center for Biomedical Ethics.

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