6 ms·

Health insurance is such a weird thing. It shouldn't exist. You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly

Health insurance is such a weird thing. It shouldn't exist. You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. And insurance doesn't want to pay out, that is their business, which actually goes against the whole idea of healthcare. You need to spend money now to prevent higher cost later. (on the other hand, car insurance weirdly doesn't penalize you for buying cheap tires, even though the difference between 4 cheap tires and 4 Michelin tires is less than the cost of a deductible for you when miss out on those 10 ft of breaking distance). I'm about to switch healthcare plans and I'm already mentally preparing (i.e. stressing out) to file appeals for some medications I need that they will deny-by-default.

josefresco 2y ago
I get your point but Michelin is a global company, that manufacturers in over 60 countries. Maybe leave the "Chinese" part out and go with just "cheap tires".
- efesfseegseg 2y ago
  [dead]
- schmookeeg 2y ago
  I think those two are colloquially synonymous to most people. Particularly those with Amazon Prime accounts :)
- dotancohen 2y ago
  I used to work at the Vehicle Engineering Lab at the Technion in Israel. China is the only place where large volume of tires are manufactured and distributed to worldwide retailers, which documents their tires using the DOT standard yet consistently fails all DOT tests when tested. As the DOT requires tires to be tested only after a certain number of failures, the DOT standard is meaningless when the factory can change owners and name on a whim. That consistently happens only in China.
hervature 2y ago
> You insure yourself against exceptional things. This isn't strictly true. We insure against the unexceptional as well. With regards to your specific example, I think refunding the flu shot is perfectly reasonable and an elegant solution to solving the social problem of getting people to be healthy. We all pay higher premiums but only those that actually do the preventative stuff get any benefit. Put another way, if health care plans were $1/month cheaper and the cost of the flu vaccine was $12, I'm pretty sure we'd see our already lackluster yearly vaccination rate plummet.
- GolDDranks 2y ago
  You are correct but not taking it far enough. Vaccines are (often) cheap and preventative for diseases that are not cheap to treat. I bet there are many cases where taking the vaccine should not just be refundable, but actually discount your rate.
- MajimasEyepatch 2y ago
  On the other hand, imagine if you had to go through your car insurance every time you had your oil changed or your tires rotated (going for an annual wellness check). Or worse, every time you had to fill up your gas tank (picking up a regular prescription). Ideally this sort of routine "maintenance" work would be affordable and accessible to anyone, but we have layers of middlemen in the way because the entire healthcare industry in this country is designed to run everything through insurance.
  - HarryHirsch 2y ago
    And then you have phenomena like a restaurant being closed for deep cleaning because an outbreak of Hepatitis A was traced back to it - a sick employee dragged himself to work instead of being at home curing their disease. So you go and take personal responsibility for your liver and take the Hep A shot yourself. One wishes the government supported life, liberty and happiness of its people and offered labour protection, sick leave and healthcare to its weakest citizens. Vaccinations are a few hundred per shot, and the part-time worker hasn't got insurance or the spare cash.
Buttons840 2y ago
> Health insurance is such a weird thing. It shouldn't exist. You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. I knew this in theory, but never really thought much about it. I need a flu shot, so the company that makes the flu shot needs to be compensated (paid), and the nurse that knows how to inject it into my arm needs to be compensated, and that's it. The manufacturer and nurses provided a sufficient infrastructure to administer flu shots. But in America, I also have to pay a bunch of insurance companies. I used to make 6 figures as a programmer in the insurance industry. I knew my salary ultimately came from the high medical bills everyone pays, and while I didn't blame myself personally for a nation wide problem, I would have been happy to see my job and my company rendered obsolete and all of us move onto more useful jobs. I want to see a political cartoon where someone gets a flu shot and then does their patriotic duty, opens their wallet, and starts handing out money to half the nation. In the end, there's even a few bucks left for the nurse. I exaggerate a bit. In truth I think about 20% of US workers are involved with the healthcare industry and the surrounding insurance and other supporting industries (if I remember correctly). I really do have to pay all those people every time I have a medical bill. Fixing healthcare costs will require a lot of people losing their job, and that wont be popular.
- mgkimsal 2y ago
  > Fixing healthcare costs will require a lot of people losing their job, and that wont be popular. And going to a 'single payer' model would also reduce jobs. And the whole "they want to get rid of your insurance and raise your taxes!". Well, the taxes would be raised, but almost certainly to a smaller extent than the price of the insurance policy you pay for. A middle of the road health insurance policy for me right now is around $1k/month. Whether I pay for it, or an employer offsets some of it - it's beside the point. That's $12k/year that is effectively a 'health tax', it's just not called a 'tax'. Somehow, weirdly, we use the term 'benefit', without with I may more easily and quickly die or languish in pain. Some benefit ;) But yes... if my taxes go up by $10k year, but I don't have to pay for a health insurance policy... I'm still ahead. If I pay for it all, and the employer is out of the loop, it'll feel 'wrong' to many employed folks, but the employer will have more money - they should either pay people more, or hire more people (who used to work in private insurance companies).
jrockway 2y ago
I really think that health insurance is this. Your premiums cover the yearly risk of getting cancer plus a constant amount for preventative care; a couple vaccines (get your HPV vaccine if you haven't!) and a physical exam. I'm looking at my EOBs for this year, and all insurance has done by their own documentation is negotiate discounts for care I've received. I think they have paid $0 of their own money. Meanwhile, I'm still paying premiums, but I don't know for what!
PaulDavisThe1st 2y ago
The problem with this analysis is (at least) two fold: 1. health care is a mixture of the predictable and the utterly unpredictable. It is vaccines, regular exams, and minor trauma care. But it is also cancer, severe trauma, rare diseases. 2. insurance in its purest form is not a business but a way of pooling resources and distributing risk. Even in some countries with socialized health insurance, it is still called "insurance" for that very reason. We could get rid of every for-profit health insurance company in the USA tomorrow, and we'd still want something that is in every way just like "insurance" and would likely still be called that.
- Terr_ 2y ago
  > Even in some countries with socialized health insurance, it is still called "insurance" To add another data-point: In the US, the real name for the law behind "Social Security" is "Old-Age, Survivors, and Disability Insurance". That said, it is frequently mis-characterized in our political discourse, with people making apples-to-oranges comparisons to investment accounts. I blame that on bank lobbyists' attempts to take the money for themselves. Anyway, if one views it as "old and unable to support yourself" insurance, many of its "weird quirks" make perfect sense.
throwaway-blaze 2y ago
The weirdest thing about health insurance in the US is how tied it is to employment, Obamacare helped a little with this. The second weirdest thing is that insurance companies can't offer more tightly defined plans for, say, young people who never go to the doctor except for critical/emergency care vs me who goes a couple times a year for various things. Obamacare did not help with this, at all.
- Retric 2y ago
  Age impacts health insurance costs, but health insurance is specifically excluded for considering existing conditions because people can’t get long term coverage. If someone gets a chronic condition while covered the company isn’t paying out a lifetime benefit, so they soon need to renegotiate rates while sick even though they had insurance while they got sick.
- ceejayoz 2y ago
  > The second weirdest thing is that insurance companies can't offer more tightly defined plans for, say, young people who never go to the doctor except for critical/emergency care vs me who goes a couple times a year for various things. That's not weird; it's essential for the system to work, because you can rapidly move from "never go to the doctor" into "seven figures of healthcare spend" without much warning. We used to have "high risk pools"; it was horrific. https://www.kff.org/affordable-care-act/issue-brief/high-risk-pools-for-uninsurable-individuals/ https://www.kff.org/affordable-care-act/issue-brief/high-ris...
- SkyPuncher 2y ago
  One the second point, they essentially offer this with high deductible plans. Essentially, these plans really only make sense if you only expect to have emergency care (like young people).
  - HarryHirsch 2y ago
    These things don't make sense even for young people because at a young age people tend not to have savings, and a medical emergency can totally wipe out your finances. Remember what they told you about burial insurance: it's a scam, except for young people who don't have savings
golergka 2y ago
> Health insurance is such a weird thing. It shouldn't exist. You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. I treat it more like a subscription. I pay a little over $100 a month for health insurance. A doctor visit would cost around $10-20 out of pocket, so it wouldn't be worth it. However, the insurance also costs with 50% discount on medicine, which ends up right about $80 a month (in discount), so it pays itself back more or less.
- kaibee 2y ago
  > I pay a little over $100 a month for health insurance. Sorry friend, your total comp likely something like $800~$1400 lighter per month due to health insurance. The fact is that your company is paying the vast majority of your actual premium and you just never see that money as coming out of your paycheck. https://www.completepayrollsolutions.com/blog/how-much-does-health-insurance-cost-an-employer https://www.completepayrollsolutions.com/blog/how-much-does-...
  - golergka 2y ago
    I work as a contractor. My company is one country, my legal entity that receives SWIFT transfers, invoiced every week, is in a second country, and I live and pay medical insurance in a third country.
amarshall 2y ago
Health Insurance pays for vaccines and other preventative care in part because they believe that doing so will cost them less money in the long run. Somewhat similarly, car insurance will often give discounts for completing defensive driving classes, and home insurance for having an alarm system.
alphazard 2y ago
Insurance isn't weird. We have been trading risk for thousands of years, and modern insurance companies have existed for hundreds of years. What's weird about health insurance in the US is that it's often tied to an employer, and you can't freely switch between insurance providers on a whim. It's a way worse experience than insuring a car, which can be done on a phone in a few minutes.
- jacobsenscott 2y ago
  It's weird you use your insurance to get a routine shot or exam. I don't use my car insurance to put gas in my car, or get the brake pads changed. I use it when someone does thousands of dollars of damage to my car.
  - throwway120385 2y ago
    If the type of fuel or the type of brake pads you put on had a direct impact on your likelihood of getting in a giant accident in the future they would regulate that and require you to buy from insurance-approved brake companies. In effect this is how home appliances are regulated. You have companies like ETL Intertek and Underwriters Laboratories performing fire and electrical safety testing of home appliances, originally on behalf of homeowner's insurance companies(See the definition of "Underwriter"). It's effectively self-regulating because the Intertek or UL stamp implies a certain degree of care. And based on some lease provisions I've seen the insurance companies for buildings do require use of certified equipment as a condition of coverage in many cases.
  - DennisP 2y ago
    It's not weird if you consider that paying for preventive care tends to be profitable for the insurance companies, because it's cheaper than paying for the problems that arise if you skip preventive care. Auto insurance doesn't pay for your gas because they don't have to pay a claim if you run out of gas.
    - chimeracoder 2y ago
      > It's not weird if you consider that paying for preventive care tends to be profitable for the insurance companies, because it's cheaper than paying for the problems that arise if you skip preventive care. This is often repeated, but it's simply not true. Preventive care is better for patients in the long run, but at a population scale it is more expensive than foregoing it. And that is before you account for the fact that patient churn is quite high (especially since most plans are linked to employment). An intervention that cost money today and may increase costs within the next few years (due to followup care) is much more expensive for insurers if the savings will only be realized in 10+ years, when the patient has moved on to another job and so is no longer on their plan. Very few medical interventions save money in the short- and medium-term at a population level. That's reflected in the fact that health insurers didn't cover most preventive care until required to by law (the ACA), and even then they routinely simply ignore this provision of the law. If it were profitable for them to follow the law, why would they go out of their way to break it?
gnopgnip 2y ago
>You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. Insurance makes it free to get a flu shot because it makes everyone healthier and lowers their expenses. Similar to how you get a discount on car for installing a theft prevention device. Insurance isn't just about insuring for exceptional events either. It results in a better allocation of resources. By incentivizing reducing risk to reduce premiums. Insurance is also a huge boon to providers who would otherwise need to spend much more time pursuing non payment, or entirely deny services to financially risky patients. And then this goes back to the outcomes for society at large.
deleted 2y ago
[deleted]
Terr_ 2y ago
> Health insurance is such a weird thing. It shouldn't exist. Half-disagree: "Health insurance" is a big group that includes a whole ton of things, and only a subset of those don't make much sense. There are plenty of other maladies/treatments which should be insurable because not everyone will get/need them but everyone has a risk that can be understood mathematically. > Yet we use insurance for our yearly flu-shot, hardly exceptional. In isolation, no, but "unusually extreme case of the flu" is something that can be insured because it is a rare stochastic problem. So out of enlightened self-interest, the regular boring preventative measure gets insured as a way to reduce the odds of the exceptional case occurring and needing a payout.
fn-mote 2y ago
> Health insurance is such a weird thing. It shouldn't exist. You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. Yes. The problem here is that (in the US) the "insurance" part is combined with the "price negotiating power of an association with lots of members" part. I think it is well known that the non-insurance "list price" for a procedure is many times higher than the actual price that should be paid. Witness the comment here about the $150k bill for a procedure that was settled for $30k once insurance admitted they had to pay. This is one of the reasons that you really can't be paying for medical expenses without the weight of the insurance company behind you - your bills will not be (what I consider to be) fair at all.

josefresco 2y ago

I get your point but Michelin is a global company, that manufacturers in over 60 countries. Maybe leave the "Chinese" part out and go with just "cheap tires".

efesfseegseg 2y ago
[dead]
schmookeeg 2y ago
I think those two are colloquially synonymous to most people. Particularly those with Amazon Prime accounts :)
dotancohen 2y ago
I used to work at the Vehicle Engineering Lab at the Technion in Israel. China is the only place where large volume of tires are manufactured and distributed to worldwide retailers, which documents their tires using the DOT standard yet consistently fails all DOT tests when tested. As the DOT requires tires to be tested only after a certain number of failures, the DOT standard is meaningless when the factory can change owners and name on a whim. That consistently happens only in China.

hervature 2y ago

> You insure yourself against exceptional things. This isn't strictly true. We insure against the unexceptional as well. With regards to your specific example, I think refunding the flu shot is perfectly reasonable and an elegant solution to solving the social problem of getting people to be healthy. We all pay higher premiums but only those that actually do the preventative stuff get any benefit. Put another way, if health care plans were $1/month cheaper and the cost of the flu vaccine was $12, I'm pretty sure we'd see our already lackluster yearly vaccination rate plummet.

GolDDranks 2y ago
You are correct but not taking it far enough. Vaccines are (often) cheap and preventative for diseases that are not cheap to treat. I bet there are many cases where taking the vaccine should not just be refundable, but actually discount your rate.
MajimasEyepatch 2y ago
On the other hand, imagine if you had to go through your car insurance every time you had your oil changed or your tires rotated (going for an annual wellness check). Or worse, every time you had to fill up your gas tank (picking up a regular prescription). Ideally this sort of routine "maintenance" work would be affordable and accessible to anyone, but we have layers of middlemen in the way because the entire healthcare industry in this country is designed to run everything through insurance.
- HarryHirsch 2y ago
  And then you have phenomena like a restaurant being closed for deep cleaning because an outbreak of Hepatitis A was traced back to it - a sick employee dragged himself to work instead of being at home curing their disease. So you go and take personal responsibility for your liver and take the Hep A shot yourself. One wishes the government supported life, liberty and happiness of its people and offered labour protection, sick leave and healthcare to its weakest citizens. Vaccinations are a few hundred per shot, and the part-time worker hasn't got insurance or the spare cash.

Buttons840 2y ago

> Health insurance is such a weird thing. It shouldn't exist. You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. I knew this in theory, but never really thought much about it. I need a flu shot, so the company that makes the flu shot needs to be compensated (paid), and the nurse that knows how to inject it into my arm needs to be compensated, and that's it. The manufacturer and nurses provided a sufficient infrastructure to administer flu shots. But in America, I also have to pay a bunch of insurance companies. I used to make 6 figures as a programmer in the insurance industry. I knew my salary ultimately came from the high medical bills everyone pays, and while I didn't blame myself personally for a nation wide problem, I would have been happy to see my job and my company rendered obsolete and all of us move onto more useful jobs. I want to see a political cartoon where someone gets a flu shot and then does their patriotic duty, opens their wallet, and starts handing out money to half the nation. In the end, there's even a few bucks left for the nurse. I exaggerate a bit. In truth I think about 20% of US workers are involved with the healthcare industry and the surrounding insurance and other supporting industries (if I remember correctly). I really do have to pay all those people every time I have a medical bill. Fixing healthcare costs will require a lot of people losing their job, and that wont be popular.

mgkimsal 2y ago
> Fixing healthcare costs will require a lot of people losing their job, and that wont be popular. And going to a 'single payer' model would also reduce jobs. And the whole "they want to get rid of your insurance and raise your taxes!". Well, the taxes would be raised, but almost certainly to a smaller extent than the price of the insurance policy you pay for. A middle of the road health insurance policy for me right now is around $1k/month. Whether I pay for it, or an employer offsets some of it - it's beside the point. That's $12k/year that is effectively a 'health tax', it's just not called a 'tax'. Somehow, weirdly, we use the term 'benefit', without with I may more easily and quickly die or languish in pain. Some benefit ;) But yes... if my taxes go up by $10k year, but I don't have to pay for a health insurance policy... I'm still ahead. If I pay for it all, and the employer is out of the loop, it'll feel 'wrong' to many employed folks, but the employer will have more money - they should either pay people more, or hire more people (who used to work in private insurance companies).

jrockway 2y ago

I really think that health insurance is this. Your premiums cover the yearly risk of getting cancer plus a constant amount for preventative care; a couple vaccines (get your HPV vaccine if you haven't!) and a physical exam. I'm looking at my EOBs for this year, and all insurance has done by their own documentation is negotiate discounts for care I've received. I think they have paid $0 of their own money. Meanwhile, I'm still paying premiums, but I don't know for what!

PaulDavisThe1st 2y ago

The problem with this analysis is (at least) two fold: 1. health care is a mixture of the predictable and the utterly unpredictable. It is vaccines, regular exams, and minor trauma care. But it is also cancer, severe trauma, rare diseases. 2. insurance in its purest form is not a business but a way of pooling resources and distributing risk. Even in some countries with socialized health insurance, it is still called "insurance" for that very reason. We could get rid of every for-profit health insurance company in the USA tomorrow, and we'd still want something that is in every way just like "insurance" and would likely still be called that.

Terr_ 2y ago
> Even in some countries with socialized health insurance, it is still called "insurance" To add another data-point: In the US, the real name for the law behind "Social Security" is "Old-Age, Survivors, and Disability Insurance". That said, it is frequently mis-characterized in our political discourse, with people making apples-to-oranges comparisons to investment accounts. I blame that on bank lobbyists' attempts to take the money for themselves. Anyway, if one views it as "old and unable to support yourself" insurance, many of its "weird quirks" make perfect sense.

throwaway-blaze 2y ago

The weirdest thing about health insurance in the US is how tied it is to employment, Obamacare helped a little with this. The second weirdest thing is that insurance companies can't offer more tightly defined plans for, say, young people who never go to the doctor except for critical/emergency care vs me who goes a couple times a year for various things. Obamacare did not help with this, at all.

Retric 2y ago
Age impacts health insurance costs, but health insurance is specifically excluded for considering existing conditions because people can’t get long term coverage. If someone gets a chronic condition while covered the company isn’t paying out a lifetime benefit, so they soon need to renegotiate rates while sick even though they had insurance while they got sick.
ceejayoz 2y ago
> The second weirdest thing is that insurance companies can't offer more tightly defined plans for, say, young people who never go to the doctor except for critical/emergency care vs me who goes a couple times a year for various things. That's not weird; it's essential for the system to work, because you can rapidly move from "never go to the doctor" into "seven figures of healthcare spend" without much warning. We used to have "high risk pools"; it was horrific. https://www.kff.org/affordable-care-act/issue-brief/high-risk-pools-for-uninsurable-individuals/ https://www.kff.org/affordable-care-act/issue-brief/high-ris...
SkyPuncher 2y ago
One the second point, they essentially offer this with high deductible plans. Essentially, these plans really only make sense if you only expect to have emergency care (like young people).
- HarryHirsch 2y ago
  These things don't make sense even for young people because at a young age people tend not to have savings, and a medical emergency can totally wipe out your finances. Remember what they told you about burial insurance: it's a scam, except for young people who don't have savings

golergka 2y ago

> Health insurance is such a weird thing. It shouldn't exist. You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. I treat it more like a subscription. I pay a little over $100 a month for health insurance. A doctor visit would cost around $10-20 out of pocket, so it wouldn't be worth it. However, the insurance also costs with 50% discount on medicine, which ends up right about $80 a month (in discount), so it pays itself back more or less.

kaibee 2y ago
> I pay a little over $100 a month for health insurance. Sorry friend, your total comp likely something like $800~$1400 lighter per month due to health insurance. The fact is that your company is paying the vast majority of your actual premium and you just never see that money as coming out of your paycheck. https://www.completepayrollsolutions.com/blog/how-much-does-health-insurance-cost-an-employer https://www.completepayrollsolutions.com/blog/how-much-does-...
- golergka 2y ago
  I work as a contractor. My company is one country, my legal entity that receives SWIFT transfers, invoiced every week, is in a second country, and I live and pay medical insurance in a third country.

amarshall 2y ago

Health Insurance pays for vaccines and other preventative care in part because they believe that doing so will cost them less money in the long run. Somewhat similarly, car insurance will often give discounts for completing defensive driving classes, and home insurance for having an alarm system.

alphazard 2y ago

Insurance isn't weird. We have been trading risk for thousands of years, and modern insurance companies have existed for hundreds of years. What's weird about health insurance in the US is that it's often tied to an employer, and you can't freely switch between insurance providers on a whim. It's a way worse experience than insuring a car, which can be done on a phone in a few minutes.

jacobsenscott 2y ago
It's weird you use your insurance to get a routine shot or exam. I don't use my car insurance to put gas in my car, or get the brake pads changed. I use it when someone does thousands of dollars of damage to my car.
- throwway120385 2y ago
  If the type of fuel or the type of brake pads you put on had a direct impact on your likelihood of getting in a giant accident in the future they would regulate that and require you to buy from insurance-approved brake companies. In effect this is how home appliances are regulated. You have companies like ETL Intertek and Underwriters Laboratories performing fire and electrical safety testing of home appliances, originally on behalf of homeowner's insurance companies(See the definition of "Underwriter"). It's effectively self-regulating because the Intertek or UL stamp implies a certain degree of care. And based on some lease provisions I've seen the insurance companies for buildings do require use of certified equipment as a condition of coverage in many cases.
- DennisP 2y ago
  It's not weird if you consider that paying for preventive care tends to be profitable for the insurance companies, because it's cheaper than paying for the problems that arise if you skip preventive care. Auto insurance doesn't pay for your gas because they don't have to pay a claim if you run out of gas.
  - chimeracoder 2y ago
    > It's not weird if you consider that paying for preventive care tends to be profitable for the insurance companies, because it's cheaper than paying for the problems that arise if you skip preventive care. This is often repeated, but it's simply not true. Preventive care is better for patients in the long run, but at a population scale it is more expensive than foregoing it. And that is before you account for the fact that patient churn is quite high (especially since most plans are linked to employment). An intervention that cost money today and may increase costs within the next few years (due to followup care) is much more expensive for insurers if the savings will only be realized in 10+ years, when the patient has moved on to another job and so is no longer on their plan. Very few medical interventions save money in the short- and medium-term at a population level. That's reflected in the fact that health insurers didn't cover most preventive care until required to by law (the ACA), and even then they routinely simply ignore this provision of the law. If it were profitable for them to follow the law, why would they go out of their way to break it?

gnopgnip 2y ago

>You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. Insurance makes it free to get a flu shot because it makes everyone healthier and lowers their expenses. Similar to how you get a discount on car for installing a theft prevention device. Insurance isn't just about insuring for exceptional events either. It results in a better allocation of resources. By incentivizing reducing risk to reduce premiums. Insurance is also a huge boon to providers who would otherwise need to spend much more time pursuing non payment, or entirely deny services to financially risky patients. And then this goes back to the outcomes for society at large.

deleted 2y ago

[deleted]

Terr_ 2y ago

> Health insurance is such a weird thing. It shouldn't exist. Half-disagree: "Health insurance" is a big group that includes a whole ton of things, and only a subset of those don't make much sense. There are plenty of other maladies/treatments which should be insurable because not everyone will get/need them but everyone has a risk that can be understood mathematically. > Yet we use insurance for our yearly flu-shot, hardly exceptional. In isolation, no, but "unusually extreme case of the flu" is something that can be insured because it is a rare stochastic problem. So out of enlightened self-interest, the regular boring preventative measure gets insured as a way to reduce the odds of the exceptional case occurring and needing a payout.

fn-mote 2y ago

> Health insurance is such a weird thing. It shouldn't exist. You insure yourself against exceptional things. Yet we use insurance for our yearly flu-shot, hardly exceptional. Yes. The problem here is that (in the US) the "insurance" part is combined with the "price negotiating power of an association with lots of members" part. I think it is well known that the non-insurance "list price" for a procedure is many times higher than the actual price that should be paid. Witness the comment here about the $150k bill for a procedure that was settled for $30k once insurance admitted they had to pay. This is one of the reasons that you really can't be paying for medical expenses without the weight of the insurance company behind you - your bills will not be (what I consider to be) fair at all.