[owinebarger]

And what makes you think you aren't lumped in with your neighbor?

Every rational form of insurance relies on distributing risk over groups of independent risks to obtain the benefits of the central limit theorem. There are some very specialized policies, and the Lloyd's syndicate, but anyone wishing to avoid ruin will diversify their risk.

[roboneal]

You missed the critical point...health "insurance" in the traditional workplace is not UNDERWRITTEN on individual basis like life or car insurance.

22-year old single, marathon runners pay the same rate as a 37-year old, single, lazy, 300lb HackerNews commenters.

That and the fact that routine care/services are "paid" for by so called "health insurance" is why it's bogus to compare it to standard insurance.

[owinebarger]

I have no idea what definition you are using for "standard insurance." Health insurance does cover routine care, but that's actually a loss control mechanism in the longer term.

Health insurance sold on a group basis is underwritten on a group basis. That does not have anything to do with whether it is "real insurance." Health insurance sold on an individual basis is underwritten on that basis, but rate differentials may be severely constrained by statute or regulation.

These do not affect whether financial risk is transferred. The routine care issue does impinge on a valid consideration of whether the transferred risk is "insurable", but since these are short-term contracts it is not fatal.

[roboneal]

Does your auto insurance pay for your defensive driving courses? Your homeowner's policy pay for additional smoke detectors? Your life insurance policy pay for a treadmill?

What would those policies cost if they did?

[owinebarger]

To some extent, they do in the form of a premium rebate, though it is unlikely to be large enough to be a substantial reimbursement for a single policy period - perhaps over the life of the policy the cumulative rebate might cover the up-front cost. I haven't worked in casualty, only health, so I can only speculate.

The better comparison would be with Worker's Compensation insurance, where the loss control mechanisms are ongoing.

As far as what the policies would cost, I don't know. Even if routine medical care is fully covered, a lot of people won't take advantage of it for whatever reason. An insurer's actuarial models will build that expected frequency into the projected cost.

If it bothers you sufficiently, you may consider most health plans to be the sum of a "real insurance" policy and a routine health discount plan. There are health plans that truly avoid assuming substantial risk, although they do so by getting providers to assume the risk. Those plans do retain the risk of providers in their network going bankrupt where prepaid capitation would be lost.

[roboneal]

Do the insurance companies pay for safety equipment or training in their customer's workplaces? No.

Employers pay those costs themselves in return for rate reductions. Not sure how that differs from any of my other comparisons (auto, life, homeowner's).

I think you have to admit that one's health care premiums have nothing to do with that individual's "actuarial" risk to the insurance company. There is not a single form of insurance that follows that pattern. NONE.

[owinebarger]

They forego revenue in exchange for the loss control. It's economically equivalent. This is like those discussions of whether taxes that are charged directly to businesses are paid by the business or by their customers.

As for the other, I admit health care insurance has its own peculiarities that make it a distinct field of insurance. And, no, your last assertion is incorrect. I have the advantage of having actually worked in the group pricing department of a major health insurer, so I'm not just speculating here. In lieu of further banging my head against the wall, I'll point out that the syllabi for the SOA's actuarial exams are available to the general public - just look in the "education" section of their site.