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Your comments about Oscar do no make sense. Oscar offers insurance in the individual marketplace. As such they are not selling to companies but to individuals

Your comments about Oscar do no make sense. Oscar offers insurance in the individual marketplace. As such they are not selling to companies but to individuals directly who don't have insurance through their employer. This means their members do not partake in these types of wellness plans. Also, as part of that marketplace, Oscar can't legally use the members previous medical history to underwrite/rate their policy. This means Oscar has little to no insight to whom they are offering their products, their goal is to get enough healthy people to offset the costly ones. Also an insurance company who offers commercial group insurance, i.e. sells insurance to companies, does not have their bottom line really impacted as much as you would think. This is based on the fact that they are currently acting as middleman in the system and any increase in costs is merely passed along, hence continually rising cost of healthcare.

doctorpangloss 8y ago
> This means their members do not partake in these types of wellness plans. Oscar members get discounts for walking a certain number of steps a day, and other somesuch things. They are functionally equivalent to employee wellness programs, in that consumers (be they individuals or business) are offered discounts in exchange for fulfilling some behavioural change that intuitively seems to make people healthier, even though there's little evidence that it does. I'm speaking to their prevalence in the industry. I get that it matters from an accounting point of view that they're an individual marketplace insurer versus a whatever. It doesn't matter from the point of view of why insurers generally like these programs. > Oscar can't legally use the members previous medical history to underwrite/rate their policy. Oscar does a lot of things to select for healthier pools. Their marketing is carefully tuned to a particular kind of healthier customer. You're underestimating how goddamned savvy they are. That's not illegal, but it's effective. There has recently been a rule change that allows insurance pools that are "guild"/union targeted, like only plumbers or insurance offered for the Writers Guild of America (WGA). Surely you see that, if that average writer is 28 years old, and the average plumber is 45 years old, I don't need to look at their medical history or anything to know which pool is healthier? Even if I pick a pair that's the same age, I bet you the average highly paid programmer at 28 (for my hypothetical programmer's insurance) is going to select for a healthier pool than my 28 year old warehouse and teemsters worker insurance. > Oscar has little to no insight to whom they are offering their products. I think when they place an Instagram ad, they're pretty much guaranteed to be "offering" their products to a younger audience than the average American. I don't need to look anything up to get that incredibly cost-impacting insight. Or maybe I'm targeting iPhone versus Android, and iPhone users are just wealthier on average and therefore just healthier on average. I get that ANY American can buy their insurance. I'm not going to litigate the role of marketing, because it's pretty obvious that it matters. > This is based on the fact that they are currently acting as middleman in the system and any increase in costs is merely passed along, hence continually rising cost of healthcare. From the article: > The Cleveland Clinic's Rogen, who credits the wellness program for holding medical costs almost flat for the past five years... I guess I'm just trying to explain why. Your business specifically is a middleman in a system, and you're passing costs along. But there are some actors who, by their accounting have held costs "almost flat," whatever that means. I'm speculating as to the mechanism by which costs can remain flat, DESPITE your accurate picture of a continually rising cost of healthcare.
- chongli 8y ago
  discounts in exchange for fulfilling some behavioural change that intuitively seems to make people healthier I think Oscar is less concerned with whether walking so many steps makes you healthier and more concerned with your ability to walk so many steps as a rough indicator of your health. This is especially useful given the above-mentioned fact that Oscar isn't allowed to underwrite based on your medical history.

doctorpangloss 8y ago

> This means their members do not partake in these types of wellness plans. Oscar members get discounts for walking a certain number of steps a day, and other somesuch things. They are functionally equivalent to employee wellness programs, in that consumers (be they individuals or business) are offered discounts in exchange for fulfilling some behavioural change that intuitively seems to make people healthier, even though there's little evidence that it does. I'm speaking to their prevalence in the industry. I get that it matters from an accounting point of view that they're an individual marketplace insurer versus a whatever. It doesn't matter from the point of view of why insurers generally like these programs. > Oscar can't legally use the members previous medical history to underwrite/rate their policy. Oscar does a lot of things to select for healthier pools. Their marketing is carefully tuned to a particular kind of healthier customer. You're underestimating how goddamned savvy they are. That's not illegal, but it's effective. There has recently been a rule change that allows insurance pools that are "guild"/union targeted, like only plumbers or insurance offered for the Writers Guild of America (WGA). Surely you see that, if that average writer is 28 years old, and the average plumber is 45 years old, I don't need to look at their medical history or anything to know which pool is healthier? Even if I pick a pair that's the same age, I bet you the average highly paid programmer at 28 (for my hypothetical programmer's insurance) is going to select for a healthier pool than my 28 year old warehouse and teemsters worker insurance. > Oscar has little to no insight to whom they are offering their products. I think when they place an Instagram ad, they're pretty much guaranteed to be "offering" their products to a younger audience than the average American. I don't need to look anything up to get that incredibly cost-impacting insight. Or maybe I'm targeting iPhone versus Android, and iPhone users are just wealthier on average and therefore just healthier on average. I get that ANY American can buy their insurance. I'm not going to litigate the role of marketing, because it's pretty obvious that it matters. > This is based on the fact that they are currently acting as middleman in the system and any increase in costs is merely passed along, hence continually rising cost of healthcare. From the article: > The Cleveland Clinic's Rogen, who credits the wellness program for holding medical costs almost flat for the past five years... I guess I'm just trying to explain why. Your business specifically is a middleman in a system, and you're passing costs along. But there are some actors who, by their accounting have held costs "almost flat," whatever that means. I'm speculating as to the mechanism by which costs can remain flat, DESPITE your accurate picture of a continually rising cost of healthcare.

chongli 8y ago
discounts in exchange for fulfilling some behavioural change that intuitively seems to make people healthier I think Oscar is less concerned with whether walking so many steps makes you healthier and more concerned with your ability to walk so many steps as a rough indicator of your health. This is especially useful given the above-mentioned fact that Oscar isn't allowed to underwrite based on your medical history.