Insurance Battles to Come

I left off last post with the statement that "morality sneaks in here."  Actually, "sneaking" might be a poor choice of word, but it nevertheless makes its presence felt.  It is a Kantian notion that choice and morality are intimately bound, and so freedom and morality are intimately bound.  A simplistic version goes something like this -- we cannot hold a person morally or ethically responsible for an action if he did not choose that action freely.

This, of course, is fraught with difficulty.  The banality of Adolf Eichmann's evil, for example, lies in his participation in an institution, a form of life, one governing intentionality of which we want to call "evil."  It wished to free itself from an ethnic impurity.  As a manager within that institution, Eichmann made generally competent instrumental decisions, banal decisions, relative to what was given as a governing intentionality.

Here is another example, one closer to home.  The governing intentionality of "insurance" as an industry is to make money, to improve profits.  They take money in the form of "premiums" and pay out money in the form of "claims."  Within this basic set of "rules," there is a strong incentive to maximize "premiums" and minimize "claims."   At the furthest extreme, they would collect money from everyone and pay out money to no one.  Assuming that people have a choice in the purchase of insurance, itself arguable, there are "market based" checks and balances within the basic rules.  People would cease paying premiums if there were no opportunity to make a claim.  Nevertheless, the basic rule within the insurance industry prevails, and one expects that executives within the institution spend considerable time "minimizing risk," and the insurance operative who spends his day poring over claims looking for defensible ways to deny them, is behaving how?  He is simply making, one assumes, generally competent instrumental decision, banal decisions, relative to what was given institutionally as a governing intentionality.

There are a number of implications within the example above, the first being the principle of intermediacy.  One might imagine a morally neutral institution whose governing intentionality is "getting the trains to run on time," but that same institution becomes morally suspect when it is instrumental to another morally suspect institution whose governing intentionality is "ethnic cleansing." 

Likewise, one might imagine a morally neutral institution whose governing intentionality is "making money."  Personally, I find it a bit difficult to imagine as much, and that perhaps was a motivation for Marx to find a post-capitalist society, but be that as it may for the moment, we can make the assumption  that there are morally neutral institutions dedicated to "making money."  Likewise, we can imagine a morally positive institution whose governing intentionality is "healing the sick."  A moment's reflection should reveal that the institutions of insurance and healthcare have many fracture points where their governing intentionality, their values, so to speak, compete.  The insurance industry may be morally neutral, considered in the abstract, but when it becomes instrumental within the institution for "healing the sick," it becomes morally suspect.  

You can imagine that I'm pondering this in anticipation of "insurance wars to come," as we struggle to find ways to pay for my wife's health care ...