7 ms·

Routine dental care is routine, so calling it "insurance" is really odd in my opinion. Insurance isn't mainly providing protection against tail risk when it com

Routine dental care is routine, so calling it "insurance" is really odd in my opinion. Insurance isn't mainly providing protection against tail risk when it comes to eye care, dental care, and even predictable routine checkups. Obvious exceptions exist for accidents that require surgery to eyes or the inside of the mouth, but a dental hygienist (for instance) wouldn't be the healthcare professional involved in those procedures. It could make sense for some categories of routine care to be included in insurance because they reduce risk or are cheap enough to be affordable perks of the insurance product. I just wouldn't call those features insurance. If you're unconcerned about health insurance compared to health care as such, that's also OK. But the US healthcare system is mostly not a single payer healthcare system, at least not right now.

paholg 3y ago
I would love dental insurance that covers that tail risk, but it doesn't seem to exist. Every dental plan I've had covers at most $1500 or $2000 per year. That's meaningless when something comes up that costs ten times as much.
- semiquaver 3y ago
  The problem for insurers is adverse selection and the long timescale of dental problems. The only people likely to sign up for plans that cover $10,000+ dental bills are those who know they have such a bill coming up in their future, which would cause the market price for such a plan to be so high as to make self-insurance a better prospect. This is less of a problem with health insurance since the most expensive ailments can’t generally be put off for an extended period of time (and because of universal coverage requirements, such as they are)
  - panarky 3y ago
    This is market failure. Insurance works best when risk is spread out over a large pool. In private markets, insurers profit by excluding 'bad risks' which leads inevitably to coverage limitations, exclusions, and high costs for those with the greatest need. Universal healthcare systems remove this profit motive and market failure. Everyone contributes, and everyone is covered, regardless of pre-existing conditions. This eliminates adverse selection and allows for better preventative care, ultimately reducing costs and improving overall health outcomes. Markets are great for some use cases, but disastrous for healthcare.
    - bko 3y ago
      > Universal healthcare systems remove this profit motive and market failure. How does universal healthcare system remove profit motive? Are doctors going to stop seeking profit? Maybe if the government knows exactly how much to pay for a service such that there is no profit, but of course information is decentralized and central planning and price controls fails basically every time it has been tried. Plus profit serves a purpose. If I'm a doctor providing a service and there is more demand than I can handle, naturally I raise my prices, signaling to others that there is profit to be made by providing that service. > Everyone contributes, and everyone is covered, regardless of pre-existing conditions Is covered for what and at what price? Presumably you want to reduce overall costs, so total reimbursements will be less. So naturally with a lower price you'll have fewer providers willing to provide that service, which means there will necessarily be a shortage. And now you have to worry about rationing
      - panarky 3y ago
        Do you believe that compensating a doctor for her labor and expertise is the same as an insurance corporation declining care in order to give a larger share of your premium payment to its officers and shareholders? Because in a system with universal care, we would still have doctors who are compensated for their labor and expertise, but we wouldn't need the rent-seeking insurance corporation, or its officers, or its shareholders, all to prevent people from receiving care. How much more care could be provided, for the same cost, without all that waste, fraud, abuse and economic rent?
        6510 3y ago
        You know what would be funny, if the same fund also paid for [part of] their education. Could do student housing, provide a car, cook food, give them some money each month, build a new university. Train lots of doctors. When they get jobs ask donations. I mean, I pay plenty for health care but I never use it. I'd be much more interested in buying lots of physicians. Pampered empathic physicians. But I do want annual speeches from them. A website full of them.
      - 3y ago
bluefirebrand 3y ago
> It could make sense for some categories of routine care to be included in insurance because they reduce risk or are cheap enough to be affordable perks of the insurance product. I just wouldn't call those features insurance It seems to me that "It makes sense to include them with insurance but I wouldn't call them insurance" is needlessly pedantic
jauntywundrkind 3y ago
Routine checkups are part of regular health care too, so I don't grok the assertion here. Maybe insurance isn't the right word for what our medical plans are, but this feels like some serious mental gymnastics to avoid seeing what obviously is.
mint2 3y ago
Annual physical is along the same lines as the 6 month test cleaning, that’s health insurance
joshspankit 3y ago
Regular maintenance is insurance against future problems

paholg 3y ago

I would love dental insurance that covers that tail risk, but it doesn't seem to exist. Every dental plan I've had covers at most $1500 or $2000 per year. That's meaningless when something comes up that costs ten times as much.

semiquaver 3y ago
The problem for insurers is adverse selection and the long timescale of dental problems. The only people likely to sign up for plans that cover $10,000+ dental bills are those who know they have such a bill coming up in their future, which would cause the market price for such a plan to be so high as to make self-insurance a better prospect. This is less of a problem with health insurance since the most expensive ailments can’t generally be put off for an extended period of time (and because of universal coverage requirements, such as they are)
- panarky 3y ago
  This is market failure. Insurance works best when risk is spread out over a large pool. In private markets, insurers profit by excluding 'bad risks' which leads inevitably to coverage limitations, exclusions, and high costs for those with the greatest need. Universal healthcare systems remove this profit motive and market failure. Everyone contributes, and everyone is covered, regardless of pre-existing conditions. This eliminates adverse selection and allows for better preventative care, ultimately reducing costs and improving overall health outcomes. Markets are great for some use cases, but disastrous for healthcare.
  - bko 3y ago
    > Universal healthcare systems remove this profit motive and market failure. How does universal healthcare system remove profit motive? Are doctors going to stop seeking profit? Maybe if the government knows exactly how much to pay for a service such that there is no profit, but of course information is decentralized and central planning and price controls fails basically every time it has been tried. Plus profit serves a purpose. If I'm a doctor providing a service and there is more demand than I can handle, naturally I raise my prices, signaling to others that there is profit to be made by providing that service. > Everyone contributes, and everyone is covered, regardless of pre-existing conditions Is covered for what and at what price? Presumably you want to reduce overall costs, so total reimbursements will be less. So naturally with a lower price you'll have fewer providers willing to provide that service, which means there will necessarily be a shortage. And now you have to worry about rationing
    - panarky 3y ago
      Do you believe that compensating a doctor for her labor and expertise is the same as an insurance corporation declining care in order to give a larger share of your premium payment to its officers and shareholders? Because in a system with universal care, we would still have doctors who are compensated for their labor and expertise, but we wouldn't need the rent-seeking insurance corporation, or its officers, or its shareholders, all to prevent people from receiving care. How much more care could be provided, for the same cost, without all that waste, fraud, abuse and economic rent?
      - 6510 3y ago
        You know what would be funny, if the same fund also paid for [part of] their education. Could do student housing, provide a car, cook food, give them some money each month, build a new university. Train lots of doctors. When they get jobs ask donations. I mean, I pay plenty for health care but I never use it. I'd be much more interested in buying lots of physicians. Pampered empathic physicians. But I do want annual speeches from them. A website full of them.
    - 3y ago

bluefirebrand 3y ago

> It could make sense for some categories of routine care to be included in insurance because they reduce risk or are cheap enough to be affordable perks of the insurance product. I just wouldn't call those features insurance It seems to me that "It makes sense to include them with insurance but I wouldn't call them insurance" is needlessly pedantic

jauntywundrkind 3y ago

Routine checkups are part of regular health care too, so I don't grok the assertion here. Maybe insurance isn't the right word for what our medical plans are, but this feels like some serious mental gymnastics to avoid seeing what obviously is.

mint2 3y ago

Annual physical is along the same lines as the 6 month test cleaning, that’s health insurance

joshspankit 3y ago

Regular maintenance is insurance against future problems