December 21, 2024

Health Care Insurance: Thinking Outside the Box

Hospital

In American life there are a number of different “insurances” that one can or has to purchase.

  • Life Insurance: Based on your age and health you are insurance for a certain dollar amount against your death.
  • Auto Insurance: Based on the car’s age and replacement value, you are insurance a certain dollar amount against damage or loss of your vehicle.
  • Home Owner’s/Renter’s Insurance: Based on the replacement value of your house and its contents, you insure a certain dollar amount against loss or destruction.
  • Health Insurance: Companies and groups bind together to give insurance to employees based on the risk pool that they are in, and pay a combination of premiums, copays, coinsurance to pay for routine and emergency trips to the doctor.

So why is it that one part of the insurance industry works differently than every other?

Think Outside the Box

Why is it that every plan for Health Insurance that is coming out the government today has at its core the current system.  We say that the current system doesn’t work.  We want more people to participate.  But the best we have is some idea to create yet another insurance company (backed by the government, no less) that will create competition.

Now, I don’t necessarily have a problem with mandating some kind of insurance be carried.  Philosophically I can make an argument, but practically I can see a “some kind of coverage” mandate.

What I can’t see is why this has to be so complicated.

The Comparison

If you boil the insurance problem down to money, each year individuals and families will spend a certain amount of dollars in health care1 and that is something that many other insurances handle.  For example, life insurance takes some health concepts and age into consideration when it figures out how much it will pay as a death benefit.

So, why not allow people to purchase different levels of health insurance, or different amounts of money for health insurance, after which they would be liable for the rest?

You wouldn’t be paying all out of pocket, as most people would rather be over protected than under, and with a mandate (with a lower bound, of course), there would be people that wouldn’t be having any expenses.

The Young

For example, I am the one of the family that has probably been to the doctor the least—I know, typical male.  However, I’ve not had much to complain about, and I’ve been blessed.  But I’ve also paid into the system.

Having children is expensive—and with us expecting #4, we’ve had our share of expenses.  However, it’s not that uneven because we’ve paid for more than it’s cost us.

But It’s Going to Happen

It’s true, most people are going to go to the doctor in a year.  Most will go to the dentist, or the optometrist.  However, all people will die, and most will get in a car accident.  These are not unknown or unpredictable things.  There are tables of data that will predict these thing, and with some control, families can save money in years they do not predict that they will have a child etc.

Since a lot of the uninsured deaths have to deal with people not getting routine care because they’re trying to save a buck on insurance, or are not in a big enough pool to get a low premium, by leveling the pools (one big one) and allowing more people to get in.

Let’s face it, health care costs money.  We all use it.  We all want it to be the best.  We have to control costs, but we have to pay.  Let’s work to make it more affordable from both ends, but let’s get rid of the silly way that these employee groups are made and that will take some of the cost out, even without a public “option.”

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  1. Let’s put aside the cost control for a moment.  Though cost control of some kind should be in place (for example, tort reform, competition, etc.) the concept I’m trying to build here is concerned with the payment end rather than the cost end. []

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