Health insurance is extremely expensive for most people. By having it cover almost everything, it only raises the price. You might think you are getting that $20 prescription for free, but youthe insurance company has overhead and needs to make a profit, so you end up paying much more. I have always thought health insurance should only be for emergencies. Just like you don’t expect your car insurance to buy you oil changes every 3 months.
What makes you think most health insurance policies cover everything? In general, they don’t, not by a long shot.
But if you restrict insurance to only cover emergencies, you end up with people delaying dealing with things until they become emergencies - which are much more expensive to deal with. It’s much more cost effective to prevent problems than to deal with them once they manifest.
Let me offer the flip side of your argument.
By covering health care expenses through insurance, does it make health care more expensive? It removes downward market pressure on price to pay for health care this way. Removing an entity capable of paying X number of thousands for an operation would the healthcare industry find ways of providing the service at a lower price?
Health insurance does not need to turn a profit. A 2012 study found that the highest-ranked plans were non-profits.
Car insurance also doesn’t pay if your engine explodes.
Extended warranties do, and yet they typically don’t include free oil changes. One might think that the warranty company would want to encourage routine maintenance to catch small problems before they become blown engines, but we find that’s not the case.
I’m not sure I buy this notion that if routine care weren’t free or heavily subsidized we’d pay more overall because people would wait until things were emergencies. Is there a GQ answer to this?
A doctor’s visit costs a lot more than a $30 oil change. There’s more incentive to put it off.
Good thing we were not talking about extended warranties then, but insurance.
Besides, most extended warranties required the car owner to perform the manufacture’s recommended maintenance schedule. If you don’t do the maintenance (oil changes and such) then the warranty company can deny the claim, so they are better off with you NOT performing these routine maintenance tasks.
Exactly this. I have had several health insurance companies as clients, and “compliance” is a huge issue, and a behavior that they strongly want their policyholders to engage in – in this context, “compliance” starts with visiting your doctor regularly, so that any health issues can be identified early, before they become more difficult to treat and manage.
Then, if you’ve been diagnosed with a health condition, they want you to follow your doctor’s orders and advice, and manage your condition (particularly if it’s a chronic condition, like high blood pressure, diabetes, etc.)
Paying for those regular doctor visits, and ongoing treatment, is far less expensive than having to handle the effects of unmanaged conditions.
BTW, it’s possible to buy “catastrophic coverage” health insurance, which does essentially what the OP suggests. It’s fairly inexpensive if you’re young and otherwise healthy, but does cover you if something big and horrible happens to you (we sometimes call it “falling off a mountain insurance”).
You could start by eliminating coverage for pseudo-medicine like chiropractic.
In a way health insurance does cover too much, at least in the sense that some people with limited coverage are paying for the extra coverage of others. The cost of an individual’s policy has little to do with the amount of coverage. Better plans charge more, but not in a way related to their additional costs. In general, the less coverage your plan provides, the more you pay for that coverage, while at the same time the those plans cost the insurance companies less.
Even correcting that inequity wouldn’t do much though, the exorbitant fees charged by medical providers is a much bigger problem. In the end the cost of your insurance policy is related to the amount paid to medical providers by the insurance companies, and those payouts are buying new lobbies and parking lots for hospitals instead of reflecting the actual costs of treatment.
To flip that around, a person being taken to a hospital with an about-to-burst appendix is in a very poor negotiating position and is unable to apply downward market pressure by threatening to get up and go to another ER. An insurance company’s interactions with the hospital aren’t all “life or death” situations so it is in a better position to negotiate on their clients’ behalf since the insurance company can credibly threaten to “walk out of negotiations”.
I doubt that parking lots and lobbies are all that significant - it’s not like they get redone every year. Unnecessary tests and ineffective treatments count a lot more. That’s not so easy to solve. Sure you can say don’t do test X - but how many missed diagnoses are you willing to accept by skipping that test? If the cost of not doing it falls on the doctor (through malpractice or just worry about not doing her best) while the cost of doing it falls on the patient/insurance company, what do you think the doctor’s decision will be?
Under Obamacare, catastrophic plans can only be sold to those under age 30. (Or to be completely precise, they can be sold to anyone, but are only subsidized for those under age 30.) Making them available to people of all ages would drive down costs for some, as well as removing unfair age discrimination.
From memory, remuneration for medical professionals are only a small driver of costs. The major ones are over-provision, excessive bureaucracy and duplication of work.
As a woman, I have been criticized for believing that health insurers should be allowed to offer plans to women that do not cover pregnancy-related expenses. People have said things like, “So, should a man who’s had his prostate removed be able to get a cheaper plan that doesn’t cover prostate cancer? How do you pick and choose?”
Because childbirth is the reason insurance costs, and medical costs overall are higher for women aged 15-44, and since not every woman can get pregnant (hysterectomy being a guaranteed way to do this), and I just feel the option should be available.
While we’re on the subject, Medicare and Medicaid do not pay for ED meds if they’re used for sexual dysfunction (they are covered if used for other reasons) and many private insurers have restrictions on them, usually 6 doses per month, and other restrictions too based on age, pre-existing conditions, etc.
Years ago, I went to a meeting at work where they were talking about what the insurer spent their money on. Because it was a company with a lot of young employees, we all assumed that pregnancy and childbirth would be #1, but it wasn’t. It was #4 or #5 on the list. So, what was #1? More than all the others put together: cardiovascular disease, followed by cancer, diabetes, strokes, car accidents (not necessarily in that order).
The don’t need to pay for them. Just try getting an extended warranty claim honored when they find out you never changed your oil.
This is the standard modus operandi of all insurance businesses, and always will be. And you get some very ugly and morally reprehensible situations when human health care is placed into exactly the same bailiwick as car insurance. Every civilized country in the world provides full coverage for all medically necessary health care either as a direct public benefit or through a combination of subsidies and private agencies that are very tightly regulated. The US is the only country in the world that treats health care like a market commodity.
There’s no GQ answer to any issue that is extremely complex with a lot of social values involved. It is, however, a fact that among industrialized countries the US has among the worst rates of infant mortality, lower average life expectancy, and lower average quality of life for the elderly.
No question it does. In fact, “health insurance” is not really insurance in the technical sense of the word. “Insurance” is a risk mitigation tool, typically intended to protect individuals from losing large sums of money due to known but unexpected events. Think auto insurance.
You buy insurance because you don’t want to total your car and be without a car. Your car insurance isn’t designed for smaller risks, like flat tires or changing you air filter. Those smaller costs can be paid out of pocket by the owner or budgeted for.
Today’s copay environment discourages that type of thinking, unless you get into Health Savings Accounts.
Similarly small healthcare costs, like OTC medicines, are the same.
Those you list line up with the top conditions generally driving costs: cardiovascular disease, high blood pressure, diabetes, cancer, asthma, back/neck pain.
Pregnancy probably wasn’t on the list because it only occurs one to three times in most American women’s lives, and is a condition that has a finite end date – unlike the top conditions, which are chronic.