[anubistheta]

That's why I liked catastrophic health care plans. Insurance works best when it covers rare, expensive events. Otherwise, it interferes with the process. My car insurance doesn't cover oil changes or new tires, but if I get I crash and injure someone, it kicks in. Homeowners insurance doesn't cover a routine roof replacement, but it will if there's storm damage. That's how health insurance should work.

A catastrophic health care plan has low premiums and high deductibles. You also get access to a tax advantaged savings account to save up for future events. So you can take the money you saved on premiums and pay for medical expenses tax free. Or let the money accumulate to cover future medical expenses or even retirement!

[giantg2]

"A catastrophic health care plan has low premiums and high deductibles."

Except they don't really exist anymore. You can get really high deductibles, but the premiums are still ridiculous. The plans have to cover many non-catastrophic events now by law.

The other problem is that the cost and frequency of things like auto accidents or home damage is generally much lower than for health events, and generally include much lower caps on how much they will payout.

[bombcar]

This was the intent of the insurance agencies, they sold catastrophic plans but didn't really make a ton on them, so they negotiated basically not being able to sell them anymore.

Self-insurance is the final catastrophic plan and the numbers keep looking better every day.

[patja]

I would like to get a catastrophic plan that doesn't cover things I would categorize as consequences of bad choices. I get that covering these things is less costly for society than just letting things run their course, but it does drive costs onto everyone else's premium.

Catastrophic plans are still quite costly because they aren't really a pure insurance product. Mine is over 2k/month for 3 people on an ACA Bronze plan with HSA.

[JumpCrisscross]

> would like to get a catastrophic plan that doesn't cover things I would categorize as consequences of bad choices

Like what?

[patja]

Things that are largely caused by lifestyle choices.

[JumpCrisscross]

Could you give any examples?

The challenge with such carve-outs is it incentivises broadly defining the offending lifestyle choice. So the specifics matter, because otherwise, insufficient diet and exercise (or, for the exceptions, overexertion) is a lifestyle choice that can be positively linked to pretty much any issue for any person.

[ben_w]

To add to your point:

Even if everyone's fit and has a good diet, maternity care is medically important and starting a family in a free country** definitely counts as a lifestyle choice because some choose not to do it.

Human childbirth without any care has quite a high fatality rate*; no childbirth, no next generation to cover the pensions of today's taxpayers.

* I don't know if South Sudan had something weird going on to push their lifetime rate of fatal complications from maternity to 35% in the worst years, but even if they're an outlier there were plenty of other countries trending at around 10% in 1985: https://ourworldindata.org/grapher/lifetime-risk-of-maternal...

** Not so in places without women's reproductive rights.

[BobaFloutist]

Maybe if car insurance discounted new tires and oil changes on a reasonable interval, people would crash less, and insurance rates wouldn't even have to go up that much.