Giuliani wrong on health care

Martin, J. (2007). Rudy: It’s time to unmask Romney. Politico. November 26, 2007. Available online:

After months of provocation, Mayor Giuliani has finally responded to Governor Romney’s attacks. Sadly, one of his counter-attacks misses the mark, badly.

“The one thing he’s known for is health care,” Giuliani said, referring to Romney’s signature initiative aimed at insuring all Massachusetts citizens. “And the health care is the thing he’s now abandoned for the rest of the country. It contained a very big mistake, which he realizes is a very big mistake, the mandate.”

The Massachusetts health care plan compels citizens to sign up for their choice of coverage and levies what Giuliani deemed “a tax” on those who don’t. The health care proposal Romney has laid out in the presidential contest includes no such mandate.

“That’s not the way to expand health care,” Giuliani continued. “The way to expand health care is through the program that I’ve talked about, which Mitt Romney has now adopted.”

While I previously applauded Giuliani on health care, here Rudy misses the point of insurance: the pooling of risk. Better and better bioscience, however, will reveal more and more risk, either allowing health care companeis to discriminate against the riskier, or allowing the less risky to opt-out of the system all together, or both. While this has always happened, this will be happening with a far higher degree of precision in the future as the cost of genome sequencing falls to around a thousand dollars.

One thought on “Giuliani wrong on health care”

  1. I think health insurance should go the way of the dodo. I buy insurance for things that are not yet broken – car, house, etc. But as you point out, insurance companies will be able to forecast individual's health futures via genetic testing. No car insurance company would insure me knowing that my car will fall apart in 3 years. No health insurance company would insure me knowing that my kidneys will stop when I turn 40.

    I want health coverage, not health insurance!

  2. Interesting that you bring up car insurance. Credit score can be a better predictor of future accidents than past driving record.

    A lot of insurance has a bastardized version of “fairness” lurking as its justification somewhere, when in reality fairness can have little to do with risk at all…

  3. I had not heard that credit score can be a better predictor than past driving record – although it certainly makes sense in terms of size of 'n' giving better accuracy. Got a link? When I searched, all I got was people outraged over paying higher car insurance premiums due to their credit score, not the data/logic behind it.

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