What If Health Insurance Was Like Car Insurance
Posted by Joe Rivett on 11.03.2009
Who needs a public option when you can have GEICO cover your health...
Recently I had to get my car inspected. I was surprised to find out that my 95,000 mile car did not require anything. However, while it was there I decided to change the oil, coolant, and transmission fluid. Not surprisingly, while GEICO may have saved me more than 15%, it didn't cover my maintenance. Shit!
Yeah I had to pay cash. But it was okay because I saved money assuming I was going to need new tires and/or brakes. Even if I did need these items, GEICO would not have covered anything. In fact, the only thing it will cover is collision and liability. You know, it covers the areas that I may not be able to afford if shit hits the fan.
So my question is: Why can't my health insurance be like this? Does my health insurance need to cover my yearly physical? Does my health insurance need to be billed when I spend five minutes with my doctor for a stuffy nose and she tells me what I already know that I have a sinus infection. Does my health insurance need to cover the antibiotics? I know my car insurance doesn't cover synthetic oil.
I take good care of my car because I don't want to lose it prematurely. I don't want to pay for something that could have been prevented. I have an incentive to keep my car healthy. Yet, I have no incentive other than a longer life to keep my body healthy because I know health insurance will cover anything. I can eat donuts every day and when I get a heart attack, they'll pay for the surgery and the Lipitor after. No wonder why this country is so fat and unhealthy.
In a perfect world, we wouldn't have any health insurance. But I understand this is not heaven. But why can't we treat health insurance like car insurance:
• Mandate coverage for everyone (Increase the pool to decrease the cost).
• Require yearly physicals and other preventative measures.
• Don't cover every little service and instead cover us when shit hits the fan such as cancer.
• Offer rewards to people for getting healthy the way car insurance takes 10% off for taking a class.
• And because I have a heart and realize we are more important than a car, assist those who can't afford a physical.
Maybe health care costs have gone up because we use insurance too much. We expect health insurance to cover our bad behaviors but something tells me GEICO isn't covering a repeat drunk driver. Instead of taking Lipitor, people should eat less cholesterol. If we had to buy our own medication we would probably take the generic cholesterol medication over Lipitor. Maybe this would make health care cheaper, easier, and oh yeah… maybe we'd be healthier. Because part of me is sickened by those in Congress that care more about government role and cost over how can we be healthier so that we can extend our life, liberty and happiness.
There are a lot of non-employer based policies that are high-deductible like you are talking about. But because the tax treatment is different between getting insurance through your employer vs. getting your own, not a lot of people get them.
I do have to disagree on mandating coverage. MA has already shown that will do nothing to lower costs.
I also have a problem with telling people they have to get a physical. You can't talk about mandatory doctor visits in one paragraph and protection of liberty in the next my friend.
Posted By: Chris Connolly (Guest) on November 03, 2009 at 12:49 AM
And dude, if you aren't running a fever, don't go to the doc for a sinus infection. Antibiotics are over-prescribed for that shit.
Posted By: Chris Connolly (Guest) on November 03, 2009 at 12:52 AM
We already have a system that covers you when shit hits the fan. EMTALA ensures you can receive emergency medical treatment even if you cannot afford it.
You do raise a great way to control costs though, which is to make people pay them. This is how capitalism keeps the costs down for everything else, so it would also work with health care.
I disagree with you on one point. There is no need to mandate coverage. If we make it illegal for insurers to drop coverage or increase rates by an absurd amount, the incentive is already present for people to be insured: they could be denied coverage if they ever got sick, or have to pay more by not locking in current rates.
Posted By: Richard (Guest) on November 03, 2009 at 01:25 AM
You can't talk about mandatory doctor visits in one paragraph and protection of liberty in the next my friend.
Because telling someone to go to the doctor to get looked at once a year - which they should be doing anyway - would start the downfall of The US as we know it?? Are you joking??
Oh I see because the mandatory doctor visit will turn into socialism in your mind....I uh...understand. Perhaps we should require mandatory mental health sessions as well.
Posted By: billy (Guest) on November 03, 2009 at 08:17 AM
Intelligent - well thought out - and quite acceptable.
Which means, of course, that the extreme right will scream about the lack of profits and the left will scream because it would hold people personally responsible for their deviant behaviour.
Posted By: Mikel (too lazy to log in) (Guest) on November 03, 2009 at 09:21 AM
I think a big difference is that Geico competes to get your business with other companies. This is not apparent with Health insurance.
Posted By: Captain_America (Guest) on November 03, 2009 at 09:35 AM
"If we had to buy our own medication we would probably take the generic cholesterol medication over Lipitor."
Or maybe you'd look at the price, realise you can't afford it, and hope your death isn't too painful. The reason health insurance covers "the little things" is because even the little things are horrically expensive. Next time you're at the doctor, ask him/her how much the visit would have cost if you were paying out of pocket.
Posted By: BringTheNoise (Guest) on November 03, 2009 at 10:57 AM
Joe,
I basically agree but I guess one difference is that auto insurance protects you from the costs of what you do to someone else or they do to you. Unless your into single-car accidents of course.
Yes Billy, the mandatory mental health program won't be far away.
Anyone else find it odd that those in favor of mandatory compulsory health care policies are also the same good folks that want to keep government out of abortion. I always here the argument that the decision to abort should only be between a woman and her doctor?
Posted By: AdmChesterMynutz (Guest) on November 03, 2009 at 01:13 PM
Next time you're at the doctor, ask him/her how much the visit would have cost if you were paying out of pocket.
Posted By: BringTheNoise
I belong to a PPO which requires me to pay the first $350 each year for all medical care. After years of good health, I got really sick and had to make an "emergency" doctor visit. The bill was $270. That's a week's income for some people. My last scheduled checkup cost $120. For many people that's enough to skip annual physicals and hope for the best, especially if they have kids.
We either need a system like public transportation, where the bulk of the cost comes from tax dollars and an affordable amount from users, or more practically a full single payer system where the current medical infrastructure would remain intact. You still pick your doctor, but he mails the bill to Uncle Sam rather than to you. Your doctor wouldn't be a government employee, so the government couldn't set his salary nor would you be disallowed from suing for malpractice. Damages would be limited to lost wages, since any needed care from the mistake is already paid for. Doctors and independent medical boards would decide what care is needed. Drug prices would be negotiated by the government to maximize savings. If you have filed your taxes electronically, you've seen how streamlined the process has become. Medicine could be just as efficient if allowed.
Posted By: Jason Douglas (Registered) on November 03, 2009 at 02:04 PM
While going to the doctor is a good idea, it doesn't mean that I should be compelled by the state to do so. It's an invasion of privacy and my right to live my life as I see fit.
Eating your veggies is a good idea too. Should the government force me to eat them?
Posted By: Chris Connolly (Guest) on November 03, 2009 at 02:27 PM
Hey Adm,
You example is flawed. The reason people want the decision between a women and the doctor is because if the government got involved it would be because it was made illegal to have an abortion in this country. Why else would they get involved? People would go to jail if it was illegal and they offered or received the abortion.
I'm pretty sure nobody would be going to jail for failing to meet a mandatory yearly visit to the doctor...and besides who WOULDN'T want to go and get a checkup every year anyway...especially if its free?
Providing coverage to people and getting them to go to the doctor to get looked at for a checkup is WAAAAY different than the abortion issue.
One - the checkup - is providing a positive service for people that everyone should get regardless of government involvement
The other is, even if you are pro choice like I am, and i think we would agree is a negative service and something that is best avoided if at all possible.
If you want to try for another example that may be close go for it...but this one is off base
Posted By: billy (Guest) on November 03, 2009 at 02:47 PM
Government is already strangling the system we have now, so for all of you complaining about how bad it is now, look to your government. Their tentacles are ensnared all over the health care system as it is, and yet you look to MORE government to solve the existing problems you complain about. It’s like telling a guy halfway in a shark’s mouth that if he can just get to the cell phone the shark swallowed earlier he can call for help. Utterly ridiculous. Your faith in the moronic politicians, Republican or Democrat, to centrally plan your health care fate is one of the most baffling policy stances I have ever seen and frankly, it threatens this country's well-being as a free society.
Posted By: Da Man (Guest) on November 03, 2009 at 03:52 PM
Jason, I hear you. Let's not forget the amount that more and more people are having taken form their paychecks for HC. I used to have none come out, then a couple years ago, it became $5 a check come out. No biggie. Last year, it was $ 7.50. I can handle that. This year, it became $45. HOLY SHIT! THAT'S A FIVE HUNDRED PERCENT INCREASE! I can only picture what it might be next year. When the price goes up that quickly, it is a systemic problem, not a personal problem. Copays and such cost more and you have less money to pay for it. Something has got to give. This isn't a "poor me" comment, because I know that there are many people who have it worse than I do and I'm really scared for them.
Posted By: The Great Capt. Smooth (Guest) on November 03, 2009 at 05:21 PM
Next time you're at the doctor, ask him/her how much the visit would have cost if you were paying out of pocket.
Posted By: BringTheNoise
And the next time you're in an 'evil socialist' country like Canada or the UK ask them how much is saved with non-brand name drugs and doctors not operating in a free market.
Posted By: elgrannoche (Guest) on November 04, 2009 at 03:12 AM
Joe,
you hot the nail on the head, Remember when John Stossel got in a fight with ABC about his report on health care . Well on eof the things was Health Insurance covers too much stuff. A physical should never be billed to your insurance. You should be able to call the doctor ask him how much he charges and when he says $200 you'd find a doctor that would do it cheaper, How great would thta work.
However insurance gets over billed for stuff. A family member of mine is in a wheelchair. His insurance will only replace his chair after a certain number of years, why? Because it's 5 - 6 grand. But why is a wheelchair so expensive. It's not built with much more effort or material then a new bike. But hey insurance covers it so they get over billed. The price is driven up instead of down like it should be.
This is the problem when we cover too much. Imagine how much gas would be if are insurance was billed for every fill up.
When need to insure less things and the price will drop down, why because you'll be soaking the consumer instead of just another big business.
Too bad Washington will never figure this out.
Posted By: Guest (Guest) on November 04, 2009 at 03:39 AM
"If we had to buy our own medication we would probably take the generic cholesterol medication over Lipitor."
I am a person who takes alot of medication. My lousy health insurance would barely cover %25 of the cost. SO what solution did I do. Well I dropped my insurance and it's medication plan. Saving me alot of money. I then went and took my business to Walmart. Under it's $4 perscription plan. I saved another $600 a year on the medication I was taking, as well as the money I was no longer giving to my insurance. That's how the free market can help fix health care
Posted By: SStrout (Guest) on November 04, 2009 at 03:48 AM
just take a look at the German Health System, imo. one of the best in the world today
Posted By: Guest#2746 (Guest) on November 04, 2009 at 06:04 AM
Calling your agent could have answered alot of these questions before you typed this up.
But when you order your insurance by phone or email who do you call when you need those answers?
Just take a higher Health Insurance deductible. That lowers cost. Or go without eye and prescription. That lowers cost. Its not like we have just one set plan and everyone must follow it. Your protection can be tailored to meet your needs.
Posted By: Jason (Guest) on November 04, 2009 at 09:10 AM
Proof positive that any 3 year old with a keyboard can post comments on the internet.
Posted By: Chris Connolly (Guest) on November 04, 2009 at 12:55 PM
You completely ignore the fact that you cannot mandate anyone to buy insurance. In your "well reasoned and well thought out" piece a commenter said, you failed to point out where in the US Constitution it authorizes Congress to force someone to buy a product. Before you say "car insurance is mandated," you have to realize no one forces anyone to buy a car or use the roads in question. That is also a state mandate, not a federal one. What if I don't want a physical? Are you going to fine me? If I don't pay, are you going to imprison me for not having a physical? What if I want to go to a doctor that doesn't accept your plan, will you force that doctor out of business? Will you fine him? Revoke his medical license?
Covering everyone does NOT make it cheaper. When you cover everyone, it means costs go up due to the influx of people having and using insurance. In Wisconsin, which is not yet mandated car insurance, our rates are half of the states around us with compulsory insurance. You need to actually research your arguments before writing such a piece as you did.
Posted By: Guest#8305 (Guest) on November 04, 2009 at 02:56 PM
My favorite quote from Jon Stewart in the past few months.
health care is not required by car insurance is...because cars are important.
Posted By: the danger stranger (Guest) on November 04, 2009 at 03:43 PM
Intelligent - well thought out - and quite acceptable.
Which means, of course, that the extreme right will scream about the lack of profits and the left will scream because it would hold people personally responsible for their deviant behaviour.
Posted By: Mikel (too lazy to log in) (Guest) on November 03, 2009 at 09:21 AM
I totally agree with the article. He was making a example not a comparison! I do agree with the fact if you have had good health you should get reward:-), that would indeed be nice.
And for the one's that are saying ask the doctor how much would this cost if I didnt have insurance,you all are dumb. Think about it back to the car example when you go to get it fix the man or woman charges you for tires and labor. So the shit the doctor is doing by telling you something you should know is a rip off! Because you just paid a person labor, to look in your ear and exam your eye and check your breathing!
Posted By: pmoore (Guest) on November 04, 2009 at 04:52 PM
You're missing the point of car insurance. Its not required to protect you, its required to protect everybody else in case you hit them. This doesn't really work as a comparison.
Furthermore, if you don't want to pay car insurance, then you don't have to own a car and can take public transportation if you live in a city with it, or walk or bum rides if you don't. You would be making anyone with a pulse get health insurance, regardless of whether they can afford it or want it. If we're going to do that why don't we just create universal health care and pay for it through taxes instead of a monthly insurance bill? There's no difference except where the money goes, since its coming straight out of your check either way.
The problem here is that, and this is an over-simplification, Democrats want universal health care and Republicans want free-market insurance with no government interference, and the Democrats are trying to compromise. THERE IS NO COMPROMISE, THEY'RE TWO COMPLETELY DIFFERENT THINGS. If you create a compromise, it's going to fail and we waste billions (or trillions) of dollars in the process. We need to decide, as a people, whether we want universal health care or not and quit dicking around trying to make everybody happy because any compromise is almost certainly destined to fail and make no one happy.
Government provided universal health care has its pros and cons, but overall it works as a system much better in Canada and parts of Europe than conservatives make it out to be. Likewise, free market health insurance also has pros and cons and generally works out better than liberals make out (the fat baby denied coverage is an odd exception to the rule and rare, but people getting dropped by their insurance for technicalities or pre-existing conditions is a MAJOR problem that needs fixing regardless of what else we do).
I'm an independent and normally I'm all for compromise, but on this one issue it doesn't work.
Posted By: General Sandoval (Guest) on November 04, 2009 at 04:59 PM
"Government is already strangling the system we have now, so for all of you complaining about how bad it is now, look to your government."
Example?
Posted By: J.D. Dunn (Registered) on November 04, 2009 at 05:11 PM
Billy,
Thank you for your thoughts but I wasn't presenting an example of anything. I posed a question; hence the use of a question mark to punctuate the sentence. From your comments I infer that you would answer the question, "no, that doesn't seem odd...."
Why do I think it odd?
Government mandate that a woman carry her fetus to full term or government mandate that a woman must participate in an "annual check-up" are consistent in one most important aspect. In each case the government is deciding how the individual will allocate their resources. You will carry fetus to term, or else. You will visit doctor annually, or else. Both use the coercive power of the State to limit a person's freedom of choice. In addition, how can a program be mandatory without sanction for non-compliance?
Positive service/Negative Services? Who are you to determine what is a positive or negative use of my resources. In both cases, the government is limiting an individual's freedom of self-determination?
"especially if its free?" Are you serious. Nothing in this world is free. If you have a different example of a valuable good or service that can be produced and consumed for free, go for it. I'd love to hear about it.
Huggie
Posted By: AdmChesterMynutz (Guest) on November 04, 2009 at 05:30 PM
"Government provided universal health care has its pros and cons, but overall it works as a system much better in Canada and parts of Europe than conservatives make it out to be....."
There is only 25million people in all of Canada with the population of Saskatchewan being less that the two largest Alberta cities, therefore the management of a public system is relatively easy.
But to try it with a population of 250million and change a system that was driven by sheer profits over coverage is an insurmountable task.
I don't think the same system would work and simply become a bureaucratic nightmare unseen in America.
To be honest, I wouldn't have a clue what would work to the benefit of all Americans..
Good luck
Posted By: Mikel (Guest) on November 04, 2009 at 05:35 PM
Dunn,
How about the inability to buy insurance across state lines? How about Doctors refusing to treat patients who use Medicare/aid because they don't pay close to what the actual cost of a procedure actually is? How about because of that the ones that do have to pass those uncovered costs on to people who use private insurance or pay out of pocket? How about the disparate tax treatment that keeps people in employer-based plans? How about the ever-growing list of things insurers are forced to cover by states that drive up the cost of premiums?
Posted By: Chris Connolly (Guest) on November 04, 2009 at 05:45 PM
JD,
Medicare and Medicaid, to start. Imposing lower payment rates on doctors who accept Medicaid/Medicare payments has pushed the costs for everyone else higher. If you add more government to the mix, you have more price controls,which basic economics tells us leads to less supply (i.e. doctors) which will lead to less care.
Also, government mandates insurance companies cover all sorts of conditions. So start-up insurance companies who might pop up hoping to offer niche coverage for people, are killed off by the big boys because they can't afford to cover all those conditions. Government, in this case, leads to the bigger, less responsive insurance companies maintaing monopoly power. Again, though, that monopoly power starts with dictates from government. Did they mean well? Probably. But like most centrally planned government ventures, the law of unintended consequences usually far outweighs the benefit the initial regulation hoped to provide.
Posted By: Da Man (Guest) on November 04, 2009 at 05:54 PM
So a couple weeks ago I had a really sore throat and a fever, and even the mighty NyQuil wasn't even helping. So I went to my doctor's (for free), in a few minutes he determined that it was strep throat. So I left, making an appointment for a few weeks from now (also free) and got my antibiotics for like ten bucks. How did I do this? I live in Canada. The only slight downside? I waited almost an hour to see my doctor, but hey it was a walk-in on friday morning.
Posted By: :D (Guest) on November 04, 2009 at 07:51 PM
It ain't free dude. And we can do the same thing here and the actual cost is probably less.
Posted By: Chris Connolly (Guest) on November 04, 2009 at 09:18 PM
" So I went to my doctor's (for free), in a few minutes he determined that it was strep throat. So I left, making an appointment for a few weeks from now (also free) and got my antibiotics for like ten bucks. How did I do this? I live in Canada. "
:D
So you don't pay taxes? No one in the country pays taxes? For the record there are atleast 5 Free Clinics within driving distance to me and I live in Tampa, FL. If I go there I only pay for my prescription... what's the difference?
Posted By: DeimosMasque (Guest) on November 05, 2009 at 03:19 AM
STAY CURRENT