Barebacking tax: Should people who don't use condoms pay higher healthcare premiums?

Congressman Steve Buyer (R-Ind) knows how to fund healthcare reform: charge those who engage in sex without condoms higher insurance premiums. Before we dismiss Buyer as another nut who is just trying to slow down healthcare reform, let's consider the consequences of this proposition.

The first question is how insurance companies would regulate risky sex acts. Would there be a barebacking police who raids your room after a one-night-stand, searching for a used condom?

More than likely barebacking would become incorporated into the health-history/pre-existing-conditions questionnaire that establishes the appropriate insurance premium for your lifestyle. Like me, you've undoubtedly been less than sure about how to answer a few of these questions, like "Do you use tobacco?" and "How heavy of a drinker are you?" I puff on a cigar about twice a year, often times vomiting afterward, but does this put me in the same ranks as chain smokers? I don't think drinking three Busch Lights a night qualifies me as a heavy drinker, because to me Busch Light is basically water, but I doubt my insurance provider would agree. Many of us feel a sense of accomplishment when we get away with lying to our providers until we develop a health problem related to our risky behavior and our insurance refuses coverage.

As with tobacco and alcohol, the barebacking question might be hard to answer honestly. What if you just put the tip in, just for a second? What if you only bareback rarely, when too drunk or love drunk to remember to strap up? What if the condom breaks because it has been crammed in your wallet for years? For others in a monogamous relationship who use alternative forms of birth control, a raincoat may be overkill. Besides, I thought the whole point of submitting to monogamy was so you could have condom-free sex.

Although I doubt Buyer would come straight out and say it, he was more than likely targeting the homosexual community with his suggestion. Gay or straight, anal sex without a condom is particularly risky as it's easier to transmit STDs. So, should the questionnaire ask, how often do you bareback while having anal sex? Even then, HIV rates are much higher among gay men, so would the question become, "How often do you engage in homosexual sex while barebacking?" But lesbians have much lower STD rates than gay or straight couples, so should they receive a discount?

This is a slippery slope. Where do you draw the line between what constitutes risky behavior and what is just behavior? While some of you straight readers may think that your insurance dollars shouldn't go toward the healthcare costs of caring for a homosexual who contracts HIV after barebacking, that is fine. But you shouldn't expect homosexuals to pay for accidental pregnancies, which are much more taxing on the healthcare system than AIDS.

I personally don't know where to draw the line in what insurance companies should be able to ask in order to establish a suitable premium, and what is just discrimination. Should black people be charged more because they are prone to sickle cell anemia, or should white people have higher rates because they're more susceptible to skin cancer? Maybe it should be like car insurance in which you decide if you want to buy addition coverage—coverage that would pay for healthcare costs associated with STDs or pregnancies.

What do you think?

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