Expect more of this

Insurance companies may see a chance for a win-win situation with frenzy and confusion over government health care reform. Similar happens in consumer markets. We know that predictions of bad weather somewhere in the world can cause a surge in prices for crop harvests there even before any shortage can begin. Think coffee. So maybe the health insurance industry is stockpiling for the worst. If the government plan is scuttled, they sit on a gold mine.

Then so-called "gouging laws" that any knowledgeable state AG would seek damages. Either for its citizens or state employees as well. I realize that those with pre-existing conditions usually pay more, but its no longer decent to screw a dying person or one of dire need even understood as a business action, then what does that say of "us" as a God abiding/believing country or even a legal(as in fair) one. -----Willy

At least it's a private company she's suing and not in the position of sueing the govt, even if that would be allowed under a national health care program. It would be nice if there were health insurance companies which were less profit driven and more for broad sharing of health costs, where some paid more than they ever used (like we've done) and others paying the same benefit more than they've paid by reason of health needs. My problem though with that sort of system is knowing those who cause health care costs to increase because of the lifestyle they engage in, from homosexual HIV, Cirrhosis from excessive alcohol consumption, fast life by adrenalin junkies, various venereal diseases from promiscuity, etc. In truth the only "fair" health coverage is what each person or family pays out of pocket for themselves, along with family and friends helping with expense when needed.

There is NO 'fair' way to pay for health care. Life isn't fair. Many diseases take their victims at random. Other diseases have risks determined by lifestyle, but there is no reason to stop with the life choices you listed. People who eat too much, who don't exercise or who have lousy personal hygiene have increased risk of some diseases. People who do exercise, who eat too little or have idiosyncratic diets of various types, or who are too obsessive about cleanliness have increased risk of other diseases. Disease risk also sometimes depends on your mother's diet, your parents' employement and lifestyle, your occupation, where you were born, where you live now, your family's countries of origins and sometimes on the time of year. I suspect that there are diseases for which the risk depends on which season you were born in, though none come immediately to mind.

As we learn more and more about disease and genetics it will be increasingly possible to determine risk of disease for such a variety of risk factors that the population could be subdivided into ridiculously tiny groups. Do you suggest that the insurance companies should be able to assign insurance rates based on hundreds of different risk factors? That would completely negate the value of insurance as a viable risk sharing proposition.

I don't like the fact that somebody else's lousy lifestyle choices increase my health insurance premiums but there is no getting around the fact that allowing that sort of inequity is the ONLY way insurance can work well.

Ultimately, the only strategy that even comes close to being 'fair' is to put everybody in the population into one risk pool. It is not perfect, but it is far better than allowing insurance companies to cherry pick low risk patients and leave the high risk people with no options.

Which is based largely on risk factors. Unfair that a hot rod teenager with a lead foot should pay twice what the sedate middle aged soccer mom down the road driving the children around in a minivan pays?

With car insurance the risk is generally to other people, and the insurance companies know from their own statistics that young male drivers are many times more likely to cause accidents than other groups.

So in answer to your question, personally I don't think it is unfair to load the insurance premiums onto young male drivers. But it's a different question to that of health insurance. I tend to go with Bill on this one.

Mark

As has been noted already, car insurance is rather different. From the car insurance company's perspective the only things that seem to matter much are age, gender and driving record. That sort of crude classification creates relatively large groups of people with stable risks. Since there are relatively few risk stratifications and since the risks that do come up in connection with driving record are almost completely under the control of the driver I don't have as many concerns about the risk stratification.
Even in the case of health insurance I don't object to basing the premiums to some extent on age, gender and lifestyle choices that have obvious, direct bearing on health outcomes (eg: smoking) - at least to a point - but there are complexities. I would feel better about charging more for insurance for smokers if we actually had an effective treatment to help smokers quit. The available treatments are all lousy.
Driving like a teenager is not an addictive process. People can exercise good judgment whenever they decide to. Quitting smoking or losing weight or starting exercise are considerably more complex. And don't even get me started on risks based on gender (it's way more than just pregnancy related costs) or race or nationality.
That said, my main objection to current health insurance underwriting practices is the problem of pre-existing conditions. Chronic diseases are frequently expensive to care for, they are not necessarily under the control of the patient and even when they are related to life choices they are not necessarily choices made by the patient him/herself or made during adulthood.
There is NO fair way to assign risk, but IMCO spreading the risk over the entire population is much closer to being fair when it comes to health insurance.

decades tends to indicate that inheritance is a huge factor in morbidity and mortality. Why do average sized healthy seeming slim people like the jogging guy keel over at 55 when the hyper-indulgent exercise shy Winston Churchill carried on into his 90's.

What virtually all Universal plans show is a downward pressure on costs, and an emphasis on prevention, which is why they result in better life spans, and lower infant mortality (i.e better pre-natal care, and better post natal care, better preventive care throughout life, early intervention in health care challenges, and specialist consultations quickly, if not quite as quickly as in the US for people with great Health Insurance or lots of money).

Health Insurance doesn't function the way that Fire insurance or Car Insurance functions. It provides continuous assessment and care in a timely fashion unless the person is the Unabomber and is opposed to all technology. What happens is that the risk pool becomes 100%, and there are economies of scale first in buying insurance, and then on the part of hospitals and doctors. It actually saves money where populations are no longer played off against one another, which is why the whole rest of the world is cheaper for Health Care than is the US.

I'd recommend finding unbiased research on the US system versus Universal systems in Industrialized Countries. Something not funded by the Insurance Industry who have flooded the US with bogus research. Unfortunately this is influenced by fixed points of view. There are doctors in the US who advocate Universal Health Care and a Single Payer System, but again this runs into political positions and points of view set in granite. I grant that the legislation the US is looking at right now is very poor, but it is a beginning, and if Universality can be included it will make a huge change. If every man woman and child can be included and the risk distributed equitably among insurers, the system can work very well if one is to judge by all those countries who have a Universal System, and will reduce costs and can produce better results.

I hope somebody will listen.

Rob

I don't recall saying anything at all about payment methods or payer systems or system costs. I did, however, conclude with this:
Ultimately, the only strategy that even comes close to being 'fair' is to put everybody in the population into one risk pool. It is not perfect, but it is far better than allowing insurance companies to cherry pick low risk patients and leave the high risk people with no options.
The system you have been advocating is one (though not necessarily the only) way to accomplish what I recommend. In any event, I don't see much, if any, connection between your post and the one you were replying to.

Now you're catching on. So much more one can reply to when not reading it beforehand.

You responded To Dr. Bill with How do you feel about car insurance?

He made no mention of car insurance.

Dr. Bill mentioned "genetics" and Rob mentions "tends to indicate that inheritance is a huge factor in morbidity and mortality." I see a linkage.

And he also mentions health insurance, Car Insurance AND Fire insurance.

So you have 1 Off topic and Rob has 2?

Speakeasy is 'off Topic"

...reasonably competent. Maybe. We were talking about insurance you must pay for, such as health insurance, and whether it should be based on risk. That of course demands comparison to how insurance is done in other areas of life, and the answer is it's based on risk. Dr Bill seemed to understand that.

before it gets too off kilter!

Mark