[throw10920]

> And by and large, I suspect the insurance companies will be found to be at the root of it.

At least in the US, this is true. The pervasiveness of interaction with insurance and the power they wield turns them into a rent-seeking layer with the massively negative economic effects of socialism.

Insurance is meant to insure you against massive economic damage caused by unlikely events, like breaking your spine. It is not meant to be used for routine care appointments. It's meant to be risk-pooling, not cost-sharing. The very fact that you have to pull out your insurance card at a yearly doctor checkup should tell us that something is very wrong.

[throwway120385]

> Insurance is meant to insure you against massive economic damage caused by unlikely events, like breaking your spine. It is not meant to be used for routine care appointments. It's meant to be risk-pooling, not cost-sharing. The very fact that you have to pull out your insurance card at a yearly doctor checkup should tell us that something is very wrong.

The problem with this model is that often very catastrophic things can be caught during routine care, so it actually makes a lot of sense for insurance to pay for a yearly physical. Otherwise a lot of people are going to wait until their spine is blown out and their knees need replacement to seek any kind of care at all, at which point their care is 100x more expensive than if they did a yearly.

Any other kind of care like going to the doctor because you're sick is entirely the point of insurance. It covers your medical care for unanticipated problems.

[phil21]

Getting sick is not an unanticipated problem. A major illness or injury is.

Insurance has no business paying out for you going in for strep throat or the Flu or an annual checkup. These are normal things everyone gets multiple times throughout your lifetime, and should easily be taken care of via market forces for a very reasonable fee.

The problem with US healthcare can be entirely boiled down to a principle agent problem. Someone else is always paying, so no one actually really cares that much about the cost of things and the incentives always are to increase costs and use more services since there is no actual market competition.

[bluGill]

Worse than that, nobody gets a choice anyway. If don't have to take the insurance my boss offers me - but if I don't I'm throwing away more than ten thousand dollars in subsidies they offer. It is really hard for anyone to compete with that deal - there are things I don't like about my insurance but it isn't worth shopping around as nobody can come close to the price/service they are giving me.

I have long wanted to get rid of the insurance/employer tie, but I'm a minority and so nothing gets done.

[throwway120385]

What are you saying? That because I can take steps to avoid getting a cold that I should just avoid getting a cold and insurance should not pay out on it? That's a big stretch considering you can literally get diseases from mosquitos and wild animals.

You're making a bald assertion that "insurance has no business paying out for you going in for strep throat or the flu or an annual checkup." Imagine, for a moment, that you run an insurance company, and you have a lot of people who need knee surgery or hip replacements or spinal surgery or who have triple bypasses or COPD or name any chronic or acute disease that requires expensive treatment.

Think about how many of those people wouldn't need that treatment if they went to the doctor every year. If your company had to pay out for treatment on every single one of those cases, wouldn't it be smart to spend a small amount every year to try to prevent people from becoming one of those serious cases?

What are the "market forces" that you cite here? Is this another one of those magical invisible hand arguments? Have you considered that insurance companies offering these yearly physicals is a result of some market force where business-people figured out that it was cheaper to do that then let peoples' minor problems blow up into major problems and then pay out on that instead?

[bluGill]

It is valid for insurance to give you a discount if you get your yearly checkup. They can even calculate how much discount you should get for this.