4 ms·

Is the point of health insurance to increase health, or to insure against catastrophic health failure?

nix23 5y ago
Yes exactly, it's written like "when you have insurance you take more medicine which is not healthier" Insurance is normally not for small stuff but big failures...that's why you need insurance (and only for that)..because it's ~impossible to pay for it.
- mohanmcgeek 5y ago
  Yes. Insurance should be for uncontrollable things like treating things like road accidents, super rare medical conditions etc. But in many countries insurance seems to work like a subscription service that covers everything including things that have a 100% probability of happening (like common cold). Quite naturally, the people who are already paying for it would want to go to the doctor's office and the people who would have to pay for it out of pocket, would not.
dunkelheit 5y ago
This is kind of what Hanson is angling at. As I understand it, his thesis is that outside of obvious emergency stuff like infections, tumors, broken bones and such most health impact comes from lifestyle variables such as diet, physical activity, level of stress and quality of sleep. This is not traditionally understood as "medicine" (i.e. something doctors prescribe). But when people have easy access to medicine, they will be compelled to go to doctors more and doctors have an incentive to prescribe more treatments than necessary to maintain the prestige of their profession. So in the end many of these treatments will have either negligible effect on health or even be actively harmful.
- akdor1154 5y ago
  Yeah that seems TFA's take - i think OP's is (and mine is) that the effect of insurance is that if you're really unlucky and have a catastrophic illness/accident/etc, at least you won't be forced into poverty. This should not then be measured by health outcomes, but economic! It's quite plausible that health outcomes would be similar in aggregate. If you need urgent expensive surgery that takes your home deposit, you'll still pay it and live if you have no other option.
sweezyjeezy 5y ago
I had an intermittent chronic pain issue for a few months this year that went untreated because of covid backlogs (UK). It stopped before they had a chance to figure out the issue. Even assuming it never comes back again, and I am now "healthy" again - the impact this had on quality of life was stunning to me, as someone who had never experienced this before. Pain, anxiety, frustration - I would have paid good money to get it treated earlier, and I don't know what I would have done if I was poor + living in the US. I'm not sure if this answers your question - but in general I don't believe health care should just be about preventing death.
- haihaibye 5y ago
  Interesting to consider if they gave you a useless treatment, and your pain went away the same as it did, would you have thought it was because of medicine? I think doctors get a lot of credit for reversion to the mean.

Yes exactly, it's written like "when you have insurance you take more medicine which is not healthier" Insurance is normally not for small stuff but big failures...that's why you need insurance (and only for that)..because it's ~impossible to pay for it.

mohanmcgeek 5y ago
Yes. Insurance should be for uncontrollable things like treating things like road accidents, super rare medical conditions etc. But in many countries insurance seems to work like a subscription service that covers everything including things that have a 100% probability of happening (like common cold). Quite naturally, the people who are already paying for it would want to go to the doctor's office and the people who would have to pay for it out of pocket, would not.

dunkelheit 5y ago

This is kind of what Hanson is angling at. As I understand it, his thesis is that outside of obvious emergency stuff like infections, tumors, broken bones and such most health impact comes from lifestyle variables such as diet, physical activity, level of stress and quality of sleep. This is not traditionally understood as "medicine" (i.e. something doctors prescribe). But when people have easy access to medicine, they will be compelled to go to doctors more and doctors have an incentive to prescribe more treatments than necessary to maintain the prestige of their profession. So in the end many of these treatments will have either negligible effect on health or even be actively harmful.

akdor1154 5y ago
Yeah that seems TFA's take - i think OP's is (and mine is) that the effect of insurance is that if you're really unlucky and have a catastrophic illness/accident/etc, at least you won't be forced into poverty. This should not then be measured by health outcomes, but economic! It's quite plausible that health outcomes would be similar in aggregate. If you need urgent expensive surgery that takes your home deposit, you'll still pay it and live if you have no other option.

sweezyjeezy 5y ago

I had an intermittent chronic pain issue for a few months this year that went untreated because of covid backlogs (UK). It stopped before they had a chance to figure out the issue. Even assuming it never comes back again, and I am now "healthy" again - the impact this had on quality of life was stunning to me, as someone who had never experienced this before. Pain, anxiety, frustration - I would have paid good money to get it treated earlier, and I don't know what I would have done if I was poor + living in the US. I'm not sure if this answers your question - but in general I don't believe health care should just be about preventing death.

haihaibye 5y ago
Interesting to consider if they gave you a useless treatment, and your pain went away the same as it did, would you have thought it was because of medicine? I think doctors get a lot of credit for reversion to the mean.