Saturday, October 9, 2010

On Health Insurance and Fire Departments

This last week, the blogs were alive with the sound of a house burning down. The fire department allowed the fire to reduce the Cranick family home in Obion County to embers because the owners had failed to pay the $75 fire service subscription fee to the nearby town of South Fulton. Firefighters did not respond to the scene when the fire was first reported because the family had not paid for the fire prevention service. When a neighbor who had paid his firefighting fee called, the firefighters loaded up their trucks and drove out to the site to prevent the fire from spreading to the neighbor's property.

I would assume that the family also did not have fire insurance on their house. And even if they had, it would likely be void. Failing to take the needful steps to protect your house from fire is certainly negligent. The refusal to pay a fire subscription fee is tantamount to failing to and I suspect that homeowners' insurance would not cover such willful negligence.

Fire insurance pays to replace possessions and real estate that was damaged by fire. However, health insurance does not compensate the patient for the damage that a disease causes her. Health insurance is used to pay for the procedures which prevent the disease from wreaking havoc on the body. It is in a way a medical tool which determines the outcome of a health problem. Similarly, paying for fire service subscription determines the outcome of a fire threatening your house.

An NPR reporter collected opinions from residents of South Fulton, two of whom replied that it would be wrong to let a house burn to the ground, regardless of whether the owner has paid for fire prevention service.

So how do you solve the moral conundrum of having to decide whether to put out the fire or sacrifice the meaning of the fire subscription fee? Well, you could mandate fire coverage, like every city does. Fire is a dangerous phenomenon, and its effects are not limited to those who choose to accept its risk. Cities desperately need to prevent fires from spreading building-to-building, so they do not allow a fire to get out of hand. City dwellers are mandated to pay for fire service. Municipalities tax their residents to ensure the public safety.

When a disease becomes an epidemic, the common saying is that it is "spreading like wildfire". Public health has the same goals as fire prevention: to provide security to citizens. To further this goal, it is sometimes necessary to restrict the set of decisions that a person can make. A person with a highly infectious disease cannot be allowed to promenade through a city. She must be treated. There are times when living in a society requires significant sacrifices of "individual liberty". Health is one of these areas, as is fire.

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