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When should health insurance cost more for someone?

(Fill in the blank) People should pay more for health insurance if they _________.


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Jucon

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Fill in the blank.

I'd put more options if there was enough room. If you choose "other", please explain.

Do you think people should pay a set amount, but if someone lives a healthier lifestyle he/she should get discounts on their rates? Or maybe people pay a set amount but the more unhealthy one lives the more they pay? Or maybe some other option? Again, explain.

I personally feel people who live healthier lives should have to pay less, or people who live less healthy lives should pay more. But then, how do doctors gauge someone's overall health? Someone can say they don't smoke but really do. Or say they eat healthy but really don't. Doctors can only work off of what they see once or twice (sometimes less) a year. Not to mention insurance companies never see the patients (to my knowledge), so how do they know the doctor is being honest? And there are so many different ways to live healthy / unhealthy... how would one gauge everything?
 
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MaggieD

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Fill in the blank.

I'd put more options if there was enough room. If you choose "other", please explain.

Do you think people should pay a set amount, but if someone lives a healthier lifestyle he/she should get discounts on their rates? Or maybe people pay a set amount but the more unhealthy one lives the more they pay? Or maybe some other option? Again, explain.

I personally feel people who live healthier lives should have to pay less, or people who live less healthy lives should pay more. But then, how do doctors gauge someone's overall health. Someone can say they don't smoke but really do. Or say they eat healthy but really don't. Doctors can only work off of what they see once or twice (sometimes less) a year. Not to mention insurance companies never see the patients (to my knowledge), so how do they know the doctor is being honest? And there are so many different ways to live healthy/unhealthy... how would one gauge everything?
Health insurance premiums should be based on age.

How about risky lifestyles? Skydiving? SCUBA? Motorcycles? How about family history of disease which is probably the most accurate way to predict disease? Should we start doing DNA analysis? The whole idea behind insurance is that the healthy help pay for the sick. To rate premiums any other way would be a logistical nightmare and a gross invasion of privacy.
 

Harry Guerrilla

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Fill in the blank.

I'd put more options if there was enough room. If you choose "other", please explain.

Do you think people should pay a set amount, but if someone lives a healthier lifestyle he/she should get discounts on their rates? Or maybe people pay a set amount but the more unhealthy one lives the more they pay? Or maybe some other option? Again, explain.

I personally feel people who live healthier lives should have to pay less, or people who live less healthy lives should pay more. But then, how do doctors gauge someone's overall health? Someone can say they don't smoke but really do. Or say they eat healthy but really don't. Doctors can only work off of what they see once or twice (sometimes less) a year. Not to mention insurance companies never see the patients (to my knowledge), so how do they know the doctor is being honest? And there are so many different ways to live healthy / unhealthy... how would one gauge everything?
All those things are potentially valid reasons to increase or decrease insurance premiums.

The key to over all lower premiums, is to get away from copays and coverage for primary and routine care.
You can't insure against those without it costing a lot of money.
 
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spud_meister

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when it's of better quality, i don't think personal factors should play a part.
 

Goobieman

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Insurance is nothing but spreading risk of cost across a number of people. This leads to the natural conclusion that the more of a risk you are, the more you should pay to have your risk covered.

All of the options noted except one represent some potential for additinal risk and therefore support charging an additional cost for coverage.

The exception is, obviously, 'can afford it'.
 

Ikari

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Maybe age, but that's not really the purpose of insurance. Insurance is to aggregate risk over a large population. Therefore, everyone pays the same as we are all pooling our resources to aggregate our risk. The insurance companies may loose out on a few, but it will net on many more. If at some point you start charging more for specific behavior and risk, you've broken the model of aggregated risk. At that point, you're just up front charging based on specific risks involved. That's more a market value for that behavior and if we go that route; there's no point in having insurance. It's not insurance at that point as much as it is a health "savings account"; which won't pay out without a fight when you need it. Pretty useless. So either we use insurance as it's meant to be used, in some chosen aggregation of risk across a large population; or we don't have it at all and try to do something about health costs so that people can address the situation on an individual basis.
 

Goobieman

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Maybe age, but that's not really the purpose of insurance. Insurance is to aggregate risk over a large population. Therefore, everyone pays the same as we are all pooling our resources to aggregate our risk. The insurance companies may loose out on a few, but it will net on many more. If at some point you start charging more for specific behavior and risk, you've broken the model of aggregated risk. At that point, you're just up front charging based on specific risks involved. That's more a market value for that behavior and if we go that route; there's no point in having insurance.
Does this same argument apply to, say, car insurance?

A 19-yr old guy w/ 3 speeding tickets driving a corvette should be charged the same as a 45yr old mother with no tickets for the last 25 years driving a 7-yr old minivan?
 

Kandahar

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I voted for smoking and overweight. These are lifestyle choices that are preventable. But even here, I don't think that insurance providers should be able to charge whatever they want...there should be a limit to how much extra they can charge smokers and overweight people. Maybe twice as much per month.

Regarding the other choices...

Underweight - In the United States, this is usually genetic far more often than it is lifestyle-related. This makes it fundamentally different from being overweight IMO, and people shouldn't be charged extra.

Don't exercise - This is a lifestyle choice, but it's far too subjective and too difficult to enforce. I'm not sure that there's any effective way for insurers to measure this when calculating your premiums. If there is a reliable way to reward an active lifestyle, I don't have a problem with it though.

Don't eat a balanced diet - Same as the previous one.

Have a previous medical condition - Absolutely not. People with medical conditions need insurance more than anyone. The flipside of this, however, is that healthy people should be required to buy insurance to prevent people from gaming the system.

Have a family history of a condition - No. Same reasoning as above...and in this case, it's genetic so people have absolutely no control over it. I think it should be illegal to discriminate against someone based on their genes for almost ANY reason.

Are older - Ideally, no. It would be better to have everyone pay the same amount regardless of age, to smooth out the cost of medical care over the course of one's life instead of cramming the entire cost into the last couple decades. This would help people make better financial plans for their lives. However, realistically this isn't going to happen. Anything that narrows the gap (such as preventing health insurers from charging more than 3 times to older people what they charge to younger people) would be an improvement.

Can afford it - No...at least not directly. Everyone should be charged the same from their health insurer regardless of their income. However, I support programs like Medicaid, and I support having the government subsidize health insurance costs for those who are poor and/or can't afford it.
 

Kandahar

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Does this same argument apply to, say, car insurance?

A 19-yr old guy w/ 3 speeding tickets driving a corvette should be charged the same as a 45yr old mother with no tickets for the last 25 years driving a 7-yr old minivan?
The guy with the speeding tickets CHOSE to drive recklessly. No one chooses to get leukemia.

Regarding the other variables that you mentioned (the age and gender of the applicant, and the type of car), ideally that wouldn't play a factor for auto insurance. For what it's worth, it's NOT fair that insurers would assume that someone is more of a risk based solely on their demographics rather than their actions. However, it's simply not that big of a deal since auto insurance costs are considerably lower and less important than health insurance costs. It just isn't worth the hassle of regulating auto insurance more heavily.
 

Harry Guerrilla

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The guy with the speeding tickets CHOSE to drive recklessly. No one chooses to get leukemia.

Regarding the other variables that you mentioned (the age and gender of the applicant, and the type of car), ideally that wouldn't play a factor for auto insurance. For what it's worth, it's NOT fair that insurers would assume that someone is more of a risk based solely on their demographics rather than their actions. However, it's simply not that big of a deal since auto insurance costs are considerably lower and less important than health insurance costs. It just isn't worth the hassle of regulating auto insurance more heavily.
What about people who mismanage their pre existing conditions?
 

Goobieman

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Regarding the other variables that you mentioned (the age and gender of the applicant, and the type of car), ideally that wouldn't play a factor for auto insurance.
Younger make drivers w/poor records are demonstrably a greater risk than older women w/ clean records.
New sports cars cost more to fix than older minivans.
Why would/should these things not play a factor?

For what it's worth, it's NOT fair that insurers would assume that someone is more of a risk based solely on their demographics rather than their actions.
Actuarial science disagrees.
 

Jucon

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Maybe age, but that's not really the purpose of insurance. Insurance is to aggregate risk over a large population. Therefore, everyone pays the same as we are all pooling our resources to aggregate our risk. The insurance companies may loose out on a few, but it will net on many more. If at some point you start charging more for specific behavior and risk, you've broken the model of aggregated risk. At that point, you're just up front charging based on specific risks involved. That's more a market value for that behavior and if we go that route; there's no point in having insurance. It's not insurance at that point as much as it is a health "savings account"; which won't pay out without a fight when you need it. Pretty useless. So either we use insurance as it's meant to be used, in some chosen aggregation of risk across a large population; or we don't have it at all and try to do something about health costs so that people can address the situation on an individual basis.
I somewhat agree, but I'll use car insurance for example... If you have gotten a ticket, have been in an accident, are younger, or are a male, your rates more than likely will go up. The evidence of a ticket or accident indicates (at least to the insurance company) you are more of a risk. The trouble with health insurance is there is little evidence of your health risk (besides personal/family history, age, and your current condition). I feel this is something that should be addressed. My point is, like driving a car, some people are less of a risk than others... and therefore I believe those who are less of a risk (and will be less of a burden to the insurance company) should pay less. This idea is simply day dreaming however, as unless people are 100% honest (or the health insurance company becomes intrusive into your life) this kind of system would be completely flawed.
 
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Kandahar

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What about people who mismanage their pre existing conditions?
I voted for smoking and obesity as examples of situations where insurers should be allowed to charge people more (within reason). Beyond that, it's too difficult for insurers to police people's lifestyles without invading their privacy IMO. If there's a reasonable way to do it, I don't have a problem with insurers checking to see if people are managing their lifestyle well, and rewarding them for healthy lifestyles and punishing people for unhealthy lifestyles. In fact, it could be a good thing if done correctly. Maybe the financial incentive for healthy living would actually encourage people to be more healthy.

But I think it's important to draw a distinction between an unhealthy lifestyle, and an actual preexisting condition that typically RESULTS from that lifestyle. For example, I think insurers should be able to charge more for smoking, but not for having lung cancer as a preexisting condition. I think insurers should be able to charge overweight people more, but not people who have type II diabetes as a preexisting condition.
 
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Ikari

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Does this same argument apply to, say, car insurance?

A 19-yr old guy w/ 3 speeding tickets driving a corvette should be charged the same as a 45yr old mother with no tickets for the last 25 years driving a 7-yr old minivan?
Yup. Well I did say "maybe age", so there's always that argument. However, it's the same point. We're collectivizing our risks together. Now with car insurance it's a bit tougher because everyone is required to have it. And at that point, you too no longer have insurance. Once everyone is in, the insurance company can no longer bet against the bad risks with the good risks because you have the full complement of both. Of course, even though car wrecks happen often and consume over 3000 lives a year, it's still relatively low probability and often times many people get through life with minimal accidents and tickets. So the insurance company will win big with those guys (since they are required to pay in). However, the purpose of insurance is to spread risk across a huge number of people. It doesn't deal with specific risks to individuals based off of individual action. You're collectivizing all the risk aggregated across a large population.
 

Kandahar

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Younger make drivers w/poor records are demonstrably a greater risk than older women w/ clean records.
The poor driving record is a lifestyle choice that the applicants can control, and should of course be a factor in determining premiums. No one can control their age or (with rare exceptions) their gender. So yes, ideally it isn't fair. But I'm not about to crusade for equal opportunity auto insurance, because frankly I don't care that much.

Goobieman said:
New sports cars cost more to fix than older minivans.
Oh I thought you meant from the perspective of the drivers being more likely to be reckless. If you're just looking at the cost of repairing the vehicle, I agree that insurers should take that into account.

Goobieman said:
Actuarial science disagrees.
Cool.
 
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Jucon

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I voted for smoking and obesity as examples of situations where insurers should be allowed to charge people more (within reason). Beyond that, it's too difficult for insurers to police people's lifestyles without invading their privacy IMO. If there's a reasonable way to do it, I don't have a problem with insurers checking to see if people are managing their lifestyle well, and rewarding them for healthy lifestyles and punishing people for unhealthy lifestyles. In fact, it could be a good thing if done correctly. Maybe the financial incentive for healthy living would actually encourage people to be more healthy.

But I think it's important to draw a distinction between an unhealthy lifestyle, and an actual preexisting condition that typically RESULTS from that lifestyle. For example, I think insurers should be able to charge more for smoking, but not for having lung cancer as a preexisting condition. I think insurers should be able to charge overweight people more, but not people who have type II diabetes as a preexisting condition.
Personally I disagree. I feel that someone with diabetes or many other previous conditions should pay more than someone without them. I'm not saying they should pay an extreme amount more... I'm just saying they should pay more in general.
 

Harry Guerrilla

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I voted for smoking and obesity as examples of situations where insurers should be allowed to charge people more (within reason). Beyond that, it's too difficult for insurers to police people's lifestyles without invading their privacy IMO. If there's a reasonable way to do it, I don't have a problem with insurers checking to see if people are managing their lifestyle well, and rewarding them for healthy lifestyles and punishing people for unhealthy lifestyles. In fact, it could be a good thing if done correctly. Maybe the financial incentive for healthy living would actually encourage people to be more healthy.

But I think it's important to draw a distinction between an unhealthy lifestyle, and an actual preexisting condition that typically RESULTS from that lifestyle. For example, I think insurers should be able to charge more for smoking, but not for having lung cancer as a preexisting condition. I think insurers should be able to charge overweight people more, but not people who have type II diabetes as a preexisting condition.
I'm saying that, if a person has lung cancer and still smokes.
In some cases, diabetes can be controlled through diet.

What about for things like that?
 
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Ikari

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Personally I disagree. I feel that someone with diabetes or many other previous conditions should pay more than someone without them. I'm not saying they should pay an extreme amount more... I'm just saying they should pay more in general.
Then why have insurance? Why not just do something about the market price of medical treatment and allow people to reap the repercussions and consequences of their actions or circumstances?
 

Goobieman

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The poor driving record is a lifestyle choice that the applicants can control, and should of course be a factor in determining premiums. No one can control their age or (with rare exceptions) their gender. So yes, ideally it isn't fair.
As I said - actuarial science disagrees. Older women are, statistically, less of a risk then younger men.
Why should they be charged the same?

But I'm not about to crusade for equal opportunity auto insurance, because frankly I don't care that much.
Its the same thing. An argument for one applies to the other.

Oh I thought you meant from the perspective of the drivers being more likely to be reckless. If you're just looking at it from the cost of repairing the vehicle, I agree that insurers should take that into account.
Good.
Doesnt that also then apply to health insurance?
 

Ikari

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As I said - actuarial science disagrees. Older women are, statistically, less of a risk then younger men.
Why should they be charged the same?
Because that's the point of insurance. Statistically one group may be at more risk than another; but that doesn't speak to the individual and the individual is whom is paying into the system.
 

Jucon

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Then why have insurance? Why not just do something about the market price of medical treatment and allow people to reap the repercussions and consequences of their actions or circumstances?
Like I said, not an extreme amount more... just more in general. I'm not saying $100+ extra a month w/ a previous condition. The amount should be reasonable.
 

Kandahar

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I saying that, if a person has lung cancer and still smokes.
In some cases, diabetes can be controlled through diet.

What about for things like that?
If they're still smoking and/or overweight, by all means charge them more. I'm saying that their particular conditions shouldn't be a factor at all, because it would be too complicated to label specific conditions as resulting from lifestyles and other conditions as unpreventable.
 

Harry Guerrilla

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If they're still smoking and/or overweight, by all means charge them more. I'm saying that their particular conditions shouldn't be a factor at all, because it would be too complicated to label specific conditions as resulting from lifestyles and other conditions as unpreventable.
Just curious.

If we're going to have heavily regulated insurance and all that jazz, we should be heavily punitive to lifestyles that don't benefit the health of a person.

Diabetes is one of them, a great many people could go off medication, if they used the diet control method.
 

Goobieman

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Because that's the point of insurance.
No... the point is to aggregate the cost, as you said.
Charging someone more because they increase that cost doesn't negate that point.
 

Goobieman

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Just curious.
If we're going to have heavily regulated insurance and all that jazz, we should be heavily punitive to lifestyles that don't benefit the health of a person.
You think that's not the eventual plan?
 
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