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Ms. Malkin:

In a series of Twitter exchanges reported on Talking Points Memo (see GOP Senator Spars With Michelle Malkin On ‘Obamacare’ published on June 14, 2012) you stated that the requirement that all Americans purchase insurance is a “slacker mandate.”  I believe this statement is ill-advised and would like to offer the following explanation, along with a personal story.  

First, let me establish my credentials.  I am an attorney with a masters in domestic and international tax law.  Most importantly for this conversation, I am author of the book U.S. Captive Insurance Law, a legal specialty which (obviously) requires knowledge of the statistical component of insurance.  

The reason for the requirement that all people purchase insurance is to increase the amount of total risk covered by the US insurance industry.  In doing so, the overall cost of insuring individuals with pre-existing conditions is in fact lowered, as the insurer is now able to spread the cost of risk over a larger number of contributors.  Statistically, this concept is referred to as the “law of large numbers.”

Now, should the law be repealed, it is possible that insurance companies may be allowed to discriminate against individuals with pre-existing conditions by not offering them coverage.  Let me address my personal situation to that point.  First, I am a lawyer who practices in a very lucrative area of law.  Financially, I am not a slacker.  However, I do have a pre-existing condition: I was born with a condition called “hip impingement.”  Put in more pedestrian terms, I was born with bad hips.  No amount of exercise or personal work would cure this problem, which can be easily rectified with one of two surgeries: a “resurfacing” of my hips or a complete joint replacement   Both of these surgeries are now standard.

More to the point, I am in excellent health.  I exercise every day (in the last 10 years, I can count the days I have missed exercising on two hands).  I alternate between aerobic and weight training.  My weight fluctuates between 195 and 200 pounds.  With the exception of a weekly meal from my local Mexican restaurant (on which I refuse to compromise), I watch what I eat.  I also get a yearly physical, under the theory that “an ounce of prevention is better than a pound of cure.”  In short, I am very good at self-managing my risk.

Should the law be repealed, insurance companies may be able to discriminate against me because of a condition which I can do nothing about – being born with bad hips.  More importantly, an available solution – one of the two surgeries previously mentioned -- is available.  However, without insurance I would not be able to afford this solution – despite the fact that I am not, most definitely, a “slacker.”  Without the surgery, I would face a slow debilitation of my hip joints, which would eventually lead to my not being able to walk.

To sum up my points, Ms. Malkin,

1.)    I was born with a condition which, no matter what I do, I cannot prevent from getting worse
2.)    Should this condition not be treated, I would eventually be unable to walk.  This would obviously prevent me from contributing to the economy in a positive way
3.)    I manage my health risk very effectively
4.)    I am not a financial “slacker”
5.)    Without insurance -- despite my financial success – I would be unable to solve this problem
6.)    Under your scenario, insurance companies would be allowed to discriminate against me for a condition over which I have no control, despite extensive efforts to mitigate this condition.

I am curious as to how you would solve my problem – along with the many other Americans (who number in the millions) who have pre-existing conditions.

I would also appreciate it that, if you respond, you please do so in a civil and reasoned manner.

F Hale Stewart, JD, LLM CAM, CWM, CTEP
Attorney at Law

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