4 ms·

You are right that misaligned incentives is the #1 problem in healthcare. Health and wellness need to be something that is paid for differently. I think there i

You are right that misaligned incentives is the #1 problem in healthcare. Health and wellness need to be something that is paid for differently. I think there is no reason that this can't be more like some kind of government funded healthcare. We also need move healthcare insurance away from employment. This is a relic of WWII labor shortages and not something we see for life/house/fire/etc kinds of insurance. When these companies have to compete on an open market, we'll have better competition and prices. Additionally, we can start charging people more for poor choices. Life insurance charges more for smokers and health insurance should too. Again, I'm talking about choices not pre-existing conditions. We will still need that protection and I admit that some conditions are the result of systemic bad choices. It could be that we can find a reasonable measure (HA1C?) for tracking poor nutrition and lifestyle to price that in as well.

ceejayoz 7y ago
> Life insurance charges more for smokers and health insurance should too. It does. (It didn't help.) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589079/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589079/ > To account for tobacco users' excess health care costs and encourage cessation, the Affordable Care Act (ACA) allowed marketplace plans to impose a surcharge on tobacco users' premiums. In fact, it appears to be actively counter-productive: > Relative to those facing no surcharges, smokers facing medium or high surcharges had significantly reduced insurance coverage (-4.3 to -11.6 percentage points), but no significant differences in smoking cessation. In contrast, those facing low surcharges showed significantly reduced smoking cessation. Taken together, these findings suggest that tobacco surcharges conflicted with a major goal of the ACA – increased financial protection – without increasing smoking cessation.

ceejayoz 7y ago

> Life insurance charges more for smokers and health insurance should too. It does. (It didn't help.) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589079/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589079/ > To account for tobacco users' excess health care costs and encourage cessation, the Affordable Care Act (ACA) allowed marketplace plans to impose a surcharge on tobacco users' premiums. In fact, it appears to be actively counter-productive: > Relative to those facing no surcharges, smokers facing medium or high surcharges had significantly reduced insurance coverage (-4.3 to -11.6 percentage points), but no significant differences in smoking cessation. In contrast, those facing low surcharges showed significantly reduced smoking cessation. Taken together, these findings suggest that tobacco surcharges conflicted with a major goal of the ACA – increased financial protection – without increasing smoking cessation.