This is a great example of why most "health insurance" (or dental or vision "insurance") isn't really insurance. It's a bundled prepayment model, similar to se

This is a great example of why most "health insurance" (or dental or vision "insurance") isn't really insurance. It's a bundled prepayment model, similar to selling gift certificates/cards or the like. Basically making money on breakage / float. Real casualty insurance wants to reduce the number/magnitude of casualty losses. So the theft insurer wants you to get good locks and an alarm, the fire insurer wants you to get sprinklers, and they all want nice orderly public services with good response times and suitable building codes. Win-win-win. Nobody would ever be unhappy if they paid their whole life for fire insurance and their house never burned down. But health "insurance" can't really reduce the amount they pay out (the "medical losses") because the customer is expecting to consume healthcare. It's also more complicated because one of the best ways to reduce medium term healthcare costs is to spend more on short term healthcare costs. Can you imagine if the best way to prevent a house fire was to have a little house fire every year? (Well, that's not so crazy in terms of wildfires, perhaps.) Then, there's the fact that in the very long term, everyone will die and many will get really sick just before that. And the private health "insurance" companies do their damnedest to avoid that group entirely, having effectively shunted them all off onto the commonwealth (Medicare). Health insurance is not like other insurance and we need a new word for what it really is.