Oh Look, An Intelligent Question!
The Market Ticker ® - Commentary on The Capital Markets
Posted 2013-01-24 13:43
by Karl Denninger
in Health Reform
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Oh Look, An Intelligent Question!
 

From Marketwatch:

Car insurance companies reward good behavior: Drivers with records free of 15-car pileups and tickets for doing 90 in a 55 pay cheaper premiums. Health insurers, on the other hand, offer people little incentive to stay out of harm’s (and doctor’s) way. But a growing number of health advocates say this is a mistake, and that the system would function better if bodies were treated more like Buicks.

That wouldn't be a bad start.

There are more issues though.

Car insurance doesn't cover oil changes.  Or mechanical breakdowns.  Or ordinary wear and tear, and the consequences thereof.

And further, if you wreck your car you don't have to keep paying from that point forward to get it repaired or replaced -- you simply need to be insured at the time the incident happens.

None of this is true for so-called "health insurance."

If you get sick and stop paying, so will the insurance coverage stop paying even though the "get sick" part happened during the time you were covered.  That's a direct violation of what "insurance" is supposed to be -- the calamtous event happened; you should not need to keep paying to get the benefit.

Health insurance covers things that are "maintenance" issues; for instance, contraception.  There's no disease involved here.  Nor, for that matter, is childbirth a "disease."  That's an entirely-routine and expected outcome from sexual intercourse -- but it's covered.

Health changes coming from "old age" are wear and tear.  But they're covered.  Why?  We all get old.  This isn't an extraordinary event, it's an expected one.

Finally, intentional acts are typically not covered either.  Arson your own house or intentionally wreck your car and you won't get paid.  But if you intentionally go out and get ****faced, and wind up in the hospital, you will get paid.

There are a lot of problems here, eh?

Yeah.

Perhaps we should simply start by demanding that people call things what they really are, and lock them up for fraud when they sell something that isn't what they call it.

We can start with all the "medical insurance" companies and their executives.

Discussion below (registration required to post)
 

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User Info Oh Look, An Intelligent Question! in forum [Market-Ticker]
Capeman
Posts: 3694
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The costs of "Health Insurance" for myself and my employer combined are north of $18K a year. For something that I use perhaps $1K of billed services per year for family checkups and chiropractic for a family of 5 there is no need for the term insurance.

The other $17K goes to everyone else's healthcare costs. It's a joke.

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Erkme73
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My wife, an ER doctor, is the sole provider for my family. She's switching from full-time with insurance benefits ($400/mo) to part time with no benefits.

Consequently, I'm searching for individual family plans from the major insurers. I haven't done that in years, and was surprised at the cost of even the catastrophic plans.

But, in reference to your blog, Karl, one thing I did see on Blue Cross' website was an incentive in the form of a "deductible credit". It says that for every year you do not spend your entire medical deductible, you'll be given a 20% credit towards your next year's deductible - limited to 50% after 3 consecutive years of not meeting the deductible.

In a way, this is an incentive to keep people from using medical services unless warranted.

As an example, if my yearly deductible is $5000, and I don't reach it in each of three consecutive years, that deductible is $2500.
Throxxofvron
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Hyper-Speculative Psycho-Facsistic Parabolic Blow-Off
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Ok, Erkme73: I'll bite.

How much does that plan cost per year?

Are the costs of the plan locked in perpetually or will the plan cost rise at 9%+ just as it has for the last 30 years or so thus providing the Insurance Co. offering the plan with much more than whatever is advertised as a savings incentive?

There is no free lunch...

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DIONYSUS: " Thou hast no knowledge of the life thou art leading; thy very existence is now a mystery to thee. " -from 'The Bacchantes' By Euripides “During times of universal deceit, telling the truth becomes a revolutionary act.” -George Orwell
2dogs
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I like it. Stay fit and live a healthy lifestyle... lower health insurance premiums.

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You can't defeat the combined effects of massive voter fraud, the Free **** Army, and the entire bought and paid for media complex. This nation is done.
Billreilly
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America
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We have a world class medical system that is cheap and subject to all the normal market factors. Further, there is no insurance involved. It is cash and carry. There's very little government regulation either. The doctors and technicians charge what the market will bear. The drug and device makers charge what the market will bear. In every town, consumers have multiple options.

I'm referring to the veterinarian medicine system. Our pets get better health care than the typical Canadian. My cat gets a checkup every year. When he gets sick, I have access to cutting edge medical technology. The costs, compared to human care, is peanuts. I had a pet with a heart problem. The treatment cost five grand. For a human it would have cost 50 grand.

We have a lot of experience with socialism. In all cases, the result is higher costs and reduced supply. We have a lot of experience with insurance. In all cases, it fails as soon as the insurer loses the right to say no. Yet here we are with supposedly intelligent people telling us this time will be different.

We are idiots.
Azengrcat
Posts: 184
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My employer has decided to take the role of health nanny.

If you submit to the blood pressure, lipid count, and BMI test they will put $500 in your HSA (not other options: High Deductible HSA or the highway). The next year they take the people that are not statistically healthy and make them see a primary care doctor to establish a "health plan". Once the health plan is established and approved you can get the $500 deposit in the HSA.

If you declare you are a smoker they pull $500 out of your paycheck per year. If you declare you are a non smoker and get caught: you get canned.

The funniest part of the nanny system is that the burger, fries, and soda combo is the cheapest meal in the cafteria! You weigh a salad on the salad scale and a full meal salad is twice as much cost as the burger combo.
Deckchairs
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The Slightly lessDemocrat -IC People's Rebuplic of Las
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Oh I don't know. If the major or field of study of any Amerikan student has no effect on the interest rate charged on the loan why should your state of health effect your premium prices?
I mean if an undergraduate basket weaving major can pay the same interest rate as a mechanical engineer or accounting major why shouldn't a 500 lbs diabetic man with a heart condition pay the same premiums as a regularly exercising and healthy eating 175lbs man?

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Markgoldman
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Your % of GDP for healthcare is ~50% greater than socialist, single payer Canada...and you leave what, 15% uninsured? Oh, and our vastly cheaper, rationed system is unsustainable...do the math.

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Jack_crabb
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Have you even read any of Karl's writings on health and medical costs, Markgoldman?

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Molon Labe

Where is Henry Bowman when you need him?
Imustbenutz
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First let me point out that it is not a Health Care Industry, it is the Sick Care Industry and the players involved go well beyond primary caregivers and Insurance Companies. Big Pharma, Big Agra, FDA, USDA and countless other actors are in cahoots to make us sick. The fact remains that with sound nutrition from truly organic food production, the human body can (generally) heal itself. Fix the food supply and the need for "health care" plummets.

Second, the "health care" delivery system is broken. Fundementally, it is based on a badly flawed model.

Third, health and nutrition education is abysmally poor if not completely lacking in the public indoctrination education system.

Fourth, the health insurance system is in need of an overhaul. If health insurance was designed and administered with a construct similar to a Universal Life policy it would incentivize people to have a stake in the way they take care of their own health habits. In a nut shell, a Universal Life policy is priced by age and health status at the time of issue as an instrument designed to be with the insured for their entire life. Part of the premium goes toward the pure cost of insurance for a claim, and the remainder goes into a "cash account" designed to accumulate value throughout the life of the insured so that as the pure cost of insurance against a claim increases as the insured ages, the premium can remain the same because part of the cost of the premium is being paid by the growth in the cash account. (Theoretically, that is how it is suppose to operate - however in these days of ZIRP, only the Banksters are making money, but I digress...)

If "health insurance" were based on this kind of a model, where premiums were tied to healthy lifestyle for the life of the policy holder, perhaps the industry would be different.

Markgoldman
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Jack- well duh, no ****. Even need based healthcare is unsustainable, greed based healthcare is nothing short of fraud.

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Cobra2411
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In addition to the already discussed, the people need to accept responsibility for their own lives.

When someone shows up in the hospital with treatable injuries, but without the means to pay, how many would kick and scream about the insensitivity, callousness and coldheartedness should they be allowed to die due to their own lack of planning and forethought.

We need to accept that it is nobodies responsibility but their own. The fact that intentionally or unintentionally they failed to have the means to cover their needs in no way, shape or form makes it anybody else's responsibility. It may be sad and tragic but it's not someone else's responsibility - no matter how close, difficult or painful it may be.

Should Juanita be escorted out of the building when she can't pay for her high risk pregnancy? Yes. Does that mean that a child might die? Yes, and that death falls directly onto Juanita's shoulders. Does it mean they both might die? Possibly and again, it's on Juanita and no one else.

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To err is human. To really **** things up takes government.
Markgoldman
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Cobra, personal responsibility is racist. You Sir, are a racist.

smiley

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Mortgageguymn
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This ship has sailed a couple of elections and a Supreme Court decision ago.
Raxon
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Quote:
We have a world class medical system that is cheap and subject to all the normal market factors. Further, there is no insurance involved. It is cash and carry. There's very little government regulation either. The doctors and technicians charge what the market will bear. The drug and device makers charge what the market will bear. In every town, consumers have multiple options.

I'm referring to the veterinarian medicine system.


My wife is a veterinarian and I can fully corroborate the above. The human medical industry is a horrible joke.

My wife can send bloodwork to a lab for a cat and it costs $200. The same exact bloodwork, at the same exact lab, with the same exact costs within the lab, will get billed at $1000 in our corrupt death care industry. It is highway robbery.
Tz
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I forget which corrupt cronies benefit, but before Obamacare, I simply got a high-deductible policy. I don't even have a medical savings account - I don't go to the doctor (I have enough medical training and there are health fairs that will do a blood screen for free or for a trivial fee). Aquarium antibiotics are stocked away if I ever get a really, really, bad infection or we have an anthrax attack.

True insurance, say with a $5k to $10k deductible should be very affordable, though the problem becomes what if I get something either expensive to treat like cancer or an accident, or worse, something chronic so will need perpetual treatment? But that is proper insurance.

I need to make one comment about the stupidity of insurance ratings. I'm built wide (e.g. my foot is 9.5/5E/high instep). So if I was what the height-weight charts said I'd be emaciated. Worse, they make no distinction between fat and muscle. If I pump iron and gain lean muscle mass, I go into higher risk categories. They need to base health, disability, long-term-care, and the rest on body-mass-index, not height-weight. (I also know of a few people who are very thin, so if they were the "proper weight" they would be morbidly obese).

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Medicdan
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You gave me a great idea. I'm going to lobby for Universal Oil Change and Maintenance insurance. Because a healthy car is a safe car and why should you be on the road if your car isn't safe.

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Marcustullius
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Great idea, Medic!

Six months later, an oil-change and lube will have gone from around $35 to somewhere near $350.

Nine months to a year later, we'll need either a license or a note from a mechanic to buy a quart of oil.

But I could be wrong: I might have OVERestimated the elapsed times above.

Tully

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"It does not require a majority to prevail, but rather an irate, tireless minority keen to set brush fires in people's minds." (Samuel Adams)
Crzymorse
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Maryland
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Taken to an extreme, sex is good for your physical and mental health especially with a partner. So if your single and feel the need to scratch an itch, maybe health insurance should cover it. It can pay for better grooming, new clothes, match.com, free dating advice, social training and in extreme cases prostitutes(with a referral).

If your married well that's whole other post...
Steelhead23
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Portland OR
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Crzymorse, if you find an insurer that would pay for these, er..., services, would you kindly inform the rest of us who desperately seek to improve our "physical and mental health." I understand that red wine is also good for you, so coverage for my nightly Cabernet would also be desired. And let's not forget Karl's sneakers...

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For-profit commercial banks are a menace and should be eradicated
Patriarch
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your account summary
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"But if you intentionally go out and get ****faced, and wind up in the hospital, you will get paid."
I could not agree more, having seen all sorts of people who smash themselves up because of doing stupid and/or risky things while intoxicated, stupid, or just plain reckless. These people cost us many millions of health care dollars monthly.
Gonna do stoooopid things? Pay up, dummy! Don't have the money? Rely on the charity of others, or just suffer the consequences. Actions have consequences.


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Our elected take an oath to serve. Time to add: “I will not serve in a capacity which I am not able to comprehend or am incapable of by mental defect of any kind, nor will I use the excuse of intellective deficiency if found in violation of this oath/affirmation”, which backs charging wayward politicians with treason.
Ponzi_unit
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Florida forces insurance companies to waive the deductible on windshields broken by rocks. Affordable, not many rocks in Florida.

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Taxpayers witnessed a crime and stayed around long enough to get charged with it.
Smacktle
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Somebody spent 5 grand on a pet?! smiley

My wife had to guilt me into spending $2,000 on the dog. Cheaper to get a new one!

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The faults of the burglar are the qualities of the financier.
- George Bernard Shaw

Noodleman
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I think we should be able to pick and choose what diseases or calamities we want to be insured against. For instance, let's say I choose not to drink or smoke. Any disease that the doctors determined were caused by alcohol or smoking is automatically exempted from any claim (yes, medical science is able to determine whether smoking or drinking caused or exaccerbated an illness). Same with injuries that resulted from booze. If I'm blowing a .16 and wrap my car around a tree I assume all financial responsibility. As a result I get an automatic 50% premium discount. If there's a history of cancer in my family I may choose to add that to my policy. As a result my premium is 25% higher than some guy who chooses to drop cancer as a covered benefit.

STD's are a BIG one. If I frequent *****houses and CHOOSE to poke the employees without protection, I may want STD's and any extenuating complications as a covered benefit. But if I am careful and only dip my pen into clean ink, then I may exclude it and get a 5%-10% discount.

If one of my parents or siblings was as nutty as a Christmas fruitcake, I may want to add mental illness as a benefit. But if I don't I save 15%.

See how this works? It's called CAPITALISM and FREE MARKET HEALTH CARE!

When I walk into a grocery store I don't have to buy the whole fracken produce section, do I? I might just want a bunch of banana's and a bag of oranges. What would you tell the register puncher if she indicated that you were unable to purchase the bananas and oranges without buying a bag of apples, grapes and strawberries?

Two words - seven letters total.....right????

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"Ammunition beats persuasion when you are looking for freedom." Will Rogers, 4 Nov 1879 - 15 Aug 1935

Reason: duplicate word
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