While this may make sense from the perspective of why people get insurance (to mitigate a catastrophic loss), it doesn't consider the insurer's incentives. No insurance company will want to underwrite a plan that doesn't bundle routine services, since those clearly reduce risk of complications down the road. A yearly checkup is cheap compared to missing a disease and letting it get worse.
> No insurance company will want to underwrite a plan that doesn't bundle routine services, since those clearly reduce risk of complications down the road
But current plans don't require you to get routine services like an annual physical; they just cover them if you get them. That doesn't make sense if the insurer's incentives that you describe are driving the plan.
Also, these incentives don't seem to be operating in other insurance markets. For example, auto insurance doesn't cover routine maintenance like oil changes or tire rotation.
I’m sure they would require you to get routine services if they could.
Car insurance doesn’t cover routine maintenance because they also don’t cover problems that arise from not getting routine maintenance. I’d you neglect oil changes and blow up your engine, they don’t care, they don’t have to pay for it.
Maybe we should have two separate kinds of health insurance?
One for true emergencies (like car accidents), and rare life threatening diseases (like cancer before 60).
Another for routine things, but as others have said, routine things shouldn't be so expensive.
I like the idea of structuring it like a term life insurance policy. If you die, you get money, and in some policies you even get some percentage before you die to have fun.
So, if you get cancer or whatever, perhaps you'd have a pool of funds available to you to deal with the disease, and you can use that money how you want, and perhaps even keep the remainder (or a portion of it) to incentivize keeping cost down.
Also, it would make sense for the pool of funds available to someone to be based on remaining years. If you get cancer when you 20 it makes sense to spend a million dollars trying to cure that. If you're 90, maybe it makes sense to treat it but not as aggressively or in as costly of ways.
From the perspective of building a society that you would be willing to be in, assuming you were randomly born into that society without knowing to what parents, I still think many people would agree they'd rather spend heavily on younger people than older.
> Maybe we should have two separate kinds of health insurance?
I agree we should have two different types of "plans". The one for emergencies and rare conditions would be insurance. The other would not. :-)
One key objective of the "other" plan (the one that's not insurance) should be to make the actual costs of services visible to the patients, who are the ones in the best position to assess the value of those services to them. One of the biggest inefficiencies in our current system is that people get all kinds of health care services without any idea of what they actually cost. That means nobody really knows whether those services are worth what they actually cost. That's a recipe for huge inefficiency and high costs, and so it's no surprise that that's what we have.
> Another for routine things, but as others have said, routine things shouldn't be so expensive.
This is basically a subscription. But this is also how health insurance already works in part today. A certain portion of your premium is paying for routine doctor's office visits - the insurance company is basically just acting as a payment processor for this portion of your healthcare expenditure. You could separate it from health insurance, but it likely won't make a huge difference in costs or access to care.
Sorry, but annual physical exams for asymptomatic adults do not reduce mortality or morbidity and certainly do not "clearly reduce risk of complications down the road"
The idea of the "annual physical" in general is a little odd because there's no standard on what an annual physical actually entails. I've been to doctors that order every blood test under the sun and don't touch me AT ALL to doctors who order zero blood tests but feel up all my organs in detail.
you need to go to both docs apparently, or find one who does both.
So you are saying that detecting early that you have high cholesterol and treats it, or a doctor noting gastrointestinal problems and tells you to get a colonoscopy, or that you have a blood sugar problem noting early onset diabetes - none of these thing will save money long term?
Is it? Here in Hong Kong, a health checkup once a year for 10 years will cost 5000 USD, which is also comparable with the cost of treating a moderately serious disease. Checkups are very expensive, and are not even remotely guaranteed to find some critical diseases.
So I would suggest that prevention is not necessarily cheaper than the cure for insurance companies, and largely their health programs like free checkups or fitness coupons are just marketing.
