Charging the Unhealthy More For Insurance

Joe The Dragon sends us a BusinessWeek story, run on Yahoo, about Clarian Health and the new thing they are trying with health insurance coverage for their employees. They are charging unhealthy people more. The article goes into some depth about whether this is a good idea and whether the practice might spread. "In late June, the Indianapolis-based hospital system announced that starting in 2009, it will fine employees $10 per paycheck if their body mass index (BMI, a ratio of height to weight that measures body fat) is over 30. If their cholesterol, blood pressure, and glucose levels are too high, they'll be charged $5 for each standard they don't meet. Ditto if they smoke: Starting next year, they'll be charged another $5 in each check."

and if you have a slashdot account

thats another 20

Re:and if you have a slashdot account

Actually, I don't think it's at odds with the summary, it's just that the BMI is a pretty useless measure of someone's health.

Re:and if you have a slashdot account

it's just that the BMI is a pretty useless measure of someone's health.

Agreed. My BMI is 57, and I feel just fine thank you very much.

Now help a brotha out...I can't reach the remote and I can't get up off the couch. Could you change it to channel 114 and pass the Doritos?

Re:and if you have a slashdot account

The previous poster wasn't arguing that NO health metrics should be used, rather they were arguing that BMI probably isn't the best one. Which is entirely true. BMI makes assumptions [wikipedia.org] about the amount of muscle and bone in someone's body. Since the percentage of muscle can vary widely, that's obviously not the best assumption to make. There are better ways to measure [wikipedia.org] only the amount of fat in someone's body that resolves that problem, though they require more specialized equipment.

Re:and if you have a slashdot account

More people use Windows on their home computers. That doesn't mean it's the most reliable operating system. In this case, they use the BMI, because it is quick and cheap, and get's the job done, and be darned with the reliability of the system. Kind of like with Windows.

Re:you're making a joke but

I dunno, body builders with their crazy diets and protein concoctions don't impress me as having the healthiest lifestyle.

depends on definitions

I think if you're considering Ronnie Coleman and professional bodybuilders who are walking pharmacies, I agree.

If you're talking about regulars at T-Nation, or other natural body builders, I'd say you're wrong. There are people who manipulate their intakes, know everything (EVERYTHING!) about their diets, and keep meticulous workout and diet logs. They tend to be pretty damn healthy. If a bit obsessive compulsive. ;)

I'm not one of them but I play one on TV.

Re:you're making a joke but

I'm not a body builder, but I work out regularly. I started last year. My BMI has remained the same (over 30), because neither my height nor weight have changed, but my body fat has dropped from 33% to 16%. I am still classified as obese by the BMI, but am now extremely healthy and well below the average (22%) for my age. BMI tells nothing. Body fat percentage is a better measurement, but you can't get that number from the information on the insurance application form.

Re:you're making a joke but

But what you don't see is your lack of buoyancy increases your risk of drowning - why should a healthy tub-o like me have to pay for that? ;)

Re:and if you have a slashdot account

And since a physical every 18 months should probably be covered by their insurance anyway, it would be at no cost to the employer or employee.

Re:and if you have a slashdot account

That being fat also means you are more prone to certain health problems is a different issue altogether.

True, but the links between being overweight and many health problems are well established. I don't think any really reputable source is debating that being overweight -- particularly obese -- isn't unhealthy. Obese people tend to have an increased risk of heart disease, blood clots / strokes, diabetes, etc. The list is pretty long.

Every once in a while you'll hear someone talk about correlation vs causation and obesity -- i.e., whether being obese causes you to be unhealthy, or whether there's some sort of underlying cause which causes both obesity and the other health problems that it's correlated with, but to an insurance company that's irrelevant. They just want to find easily measurable risk factors and indicators; whether the relationship is causative doesn't matter a whit (to them).

Re:and if you have a slashdot account

Recent research published in JAMA says that the BMI is not necessarily a reliable predictor of health. Not nearly as reliable as waist circumference, according to the article.

Apparently there are healthy chubby people whose musculature surrounding their vital organs is sound, and skinny people who got that way through diet whose hearts, liver, etc are surrounded by flab.

That still doesn't excuse the idea, embarrassing in the richest nation on earth, that anyone should have to go without medical care from cradle to grave. As far as I'm concerned, if you believe that you, a healthy person, should not be responsible for paying into a system that gives care to a less wealthy unhealthy person, you have a fucked up, un-American world view. You don't have to be a bible believer to know that if you want to pull the heaviest loads, you hook up the strongest horses. That's why the rich pay a greater share of their wealth in taxes (or are supposed to). The dual economic crises of the "sub-prime" credit market and runaway health care are exposing the fundamental weakness in Milton Friedman's theory of the so-called "free market".

Why not have the Fire and Police Dept provide services based on the victim's ability to pay? Because that's not the way we do things in a great, rich nation. So why should health care be any different? We don't allow the Fire or Police Dept to base their service model on profits, so why medicine? We wouldn't suggest that Fire Departments should not save someone from a burning tenement slum because they couldn't afford to properly fire-proof their property, so why suggest that someone who is poor and has become overweight due to a substandard diet should be denied health care?

Re:and if you have a slashdot account

"I'm more worried about the Cholesterol"

You need to worry about triglycerides too. I'm predisposed to very high levels...as high as 1200+ in the past....down to 540 these days....started on meds again and working out to try to get them under 200.

The reason I state this? I can't GET freakin' insurance.....unless you are working for someone else in a group plan, you can't get anyone to insure you. I have no other problems, BP is good, etc. I can more than afford to pay for insurance, but, I cannot get anyone reputible to sell it to me.

I didn't realize it would be so tough to get it at any price.

Re:and if you have a slashdot account

I can't GET freakin' insurance...

You should check if your state has a state risk pool.

I am also self employed, and since I got sick once years ago I also
was not insurable through individual policies. A state risk pool gives people
like me coverage when nobody else will.

It's a little screwy because it is still a private insurer (at
least in the state of Texas) that is contracted by the state.
The premiums are set at double the average, so the private insurer
makes loads of cash (and the tax payers don't take a hit), but at least I have insurance.

The deductible is high, but I do get the negotiated rates
which are usually 1/3 to 1/2 of what the uninsured are charged.

Re:and if you have a slashdot account

What I find interesting is that average Canadians pay almost 50% income tax.

Simple question: What on earth does that number have to do with the percentage of one's income one spends on health care? The people who bring up the "Oooh! Taxes!" argument always list the total tax burden for a country (taking advantage of the fact that countries with socialized health care also tend to have higher overall tax burdens) rather than the percentage that's actually spent on socialized health care. Anybody who quotes you numbers like that is either clueless, doesn't give a damn, or is trying to sell you something. The interesting question is, What percentage of Canada's GDP is spent on health care vs what percentage of our GDP is spent on health care? Other cost comparisons are simply not useful.

Re:and if you have a slashdot account

You are absolutely right. It's interesting to compare what the French and Americans spend on their healthcare systems. In the US we are spending 16% of our GNP and have 46 million people without any form of insurance (and of those who do have insurance, a lot of it is worthless when it really counts).

In France, however, they are spending 10% of GNP [nyu.edu] on a system which covers everyone and routinely outperforms [businessweek.com] what we have in the US.

More FUD to watch out for is the crap about lines and impossible waiting times. I've spent a total of two years in France, including two months in the hospital with a pretty nasty pneumonia. The staff was always courteous and competent. This is at the same time my compatriots were all bashing surrender monkeys and feeling clever.

Where will this madness end?

Charging drivers with more accidents higher rates for auto insurance?

Re:Where will this madness end?

> Charging drivers with more accidents higher rates for auto insurance?

"Exempting highly-skilled workers from having to pay unemployment insurance premiums, and raising premiums on burger flippers."

That's where it'll stop.

Re:Where will this madness end?

Remember, a highly skilled worker is just one head injury away from being an unskilled worker.

Re:Where will this madness end?

That's not far from the truth in the US already. It's in our tax structure, insurance, oh and all the wonderful benefits you'll get screwed out of when you're in the military and unmarried. You're pretty much punished for being single, which really sucks for people who aren't ever going to get married.

Society maintains itself through having kids. It's been observed that family units tend to give kids better starts and are less prone to crime. Thus the society has a vested interest to promote this. If you've made a conscious choice to opt out, then they be wise to push you towards making a greater contribution through higher taxes. Your singledom generally doesn't forward the society. Occasional outlyers exists (Alan Turing etc..). beside the tax credit a family gets does not even make up half of what kids cost. I am single and I don't mind. A $2000 tax credit means a lot to a family but only a new HDTV for me. Society would make the right choice in pushing us toward shaving more kids. Opting out is umm... letting the terrorist win :D

Re:Where will this madness end?

The problem is that this is GROUP health insurance, not individual health insurance. The insurance company is taking a chance based on the group average. Some will cost more and some less than average. That is how they play the game. So they should not be able to charge more to some people in the group. This is just a way to make more money off of the consumer.

Now if these were individual health plans, then the market should decide. Don't like what company X charges, go to one that charges less. But employees don't have this choice in a group plan, so I'm against it.

Michael

Re:Charge vegetarians less?

or be hit by lighting

God, I HATE those damn low-hung fluorescent tubes they hang all over the jogging paths.

Form of Discrimination?

That sounds like it could be considered a form of discrimination. I doubt that obese people would take this move lightly.

Slope Slippery When Wet

Encouraging Americans to be healthy is great. I don't really have a problem with charging those who smoke more, for instance. But high blood pressure? Come on, that's hereditary. Once you start discriminating against people for their genetic makeup, you're on a slope that is not just slippery, but frictionless.

Bad idea

This is a horrible idea. The entire point of insurance is that everyone pays a more-or-less baseline amount and some people don't realize any of that value and some people realize more than they put in. Of course, now that Americans expect to realize 100% of any tax or insurance payments, and if even one penny goes to someone else, well, that's socialism! Insurance is inherently socialist. That's why it's called INSURANCE. If you're expected to pay an equal amount to what you receive, you don't really have insurance, you're paying as you go.

How not to do this

I would have expected this to be spun 180 degrees. i.e. Jack the rates up for all and then announce you get a $10 discount for meeting the BMI standard rather than a $10 penalty for failing to meet it. Same outcome, but less likely to piss people off.

Re:How not to do this

The truth often does piss people off. From the article:

After benchmarking other companies, Clarian, which had already been encouraging employees to join smoking cessation programs and take health risk tests, decided charging employees was more "transparent." Other companies "were providing what they called incentives through credits or discounts toward health premiums," says Wantz. "What we found was what those employers were doing, many times, was raising their premiums and discounting them back."

I can't fault a company for being transparent. Even if it is news I don't like.

Mostly OK

I would support a proposal like this with a couple of stipulations:

1. I would want it to lower my (a "healthy" person) premiums, deductibles, out-of-pocket expenses. I'm not trying to sound selfish, but the reason mine were so high to begin with is because of all the unhealthy people. If they're just going to use this to help their own bottom line without helping those that make the health insurance system work (the healthy people, again), then they can shove that plan where the sun don't shine.

2. Don't use BMI. It's a crappy measure. Anyone who lifts weights regularly can easily be considered obese by BMI (even if they're not a "body builder"). I've been over that line my whole life and I'm not fat.

One of the things that I really like about it is that it provides extra incentive for someone to be healthy. Want to save $50 / month? Get in shape, and that will help lower the expenses & burdens of the insurance system for everyone else. It's like taxing a congested road to help clear it up, or taxing emissions to clean up the environment. Sometimes money talks louder than anything.

Re:Mostly OK

Obesity can be seen as a form of addiction and Smoking certainly is one. When people have an addiction like that money isn't one of their primary concerns. They will literally Smoke until they day it kills them and overeat until that last heart attack puts them 6-feet under.

So true. If people think this will help, let's look at the taxes on smoking. Look at the unwealthy people that still continue to smoke cigarettes despite the cost.

then what's the point of insurance?

I always thought of medical insurance as a socialist concept. Everyone pays into a bucket, and the sick people take out of it when needed. So long as there are more healthy people than sick people, it should work. Even in capitalist implementations of medical insurance schemes.

So if sick people need to pay more than healthy people, what's the point of having insurance? Healthy people then shouldn't need to pay anything, as they aren't costing anyoen anything. And sick people should pay everything, as only they need it. Which completely voids any reason to send any money to the insurance guy. OK, that's going further than this article summary sounded, but if this idea gains any momentum that may be where we end up at.

How about this, as a related idea... Old people should pay more into social security because they use it more. young people should get discounts because they're a long way away from taking it. I bet todays elderly would get all riled up if we tried to make that change, eh?

If this is meant to be motivation to fix things, some things cannot be fixed. I've got high cholesterol. Very high. And very bad ratio of HDL to LDL. I'm relatively young, 31. I've gotten into running, have done a couple relay marathons (split the maraton distance between four runners) and am currently training for a 1/2 marathon. While still bad, my cholesterol measurements were better BEFORE I started running. Now after doing it for a few years, my cholesterol is 20 total points higher and it's time for the pills to fight it. Weird but true. Not sure what my genetics have in mind, but the doctor told me of other patients more athletic than I am trying to become are not able to lower their cholesterol without pills either. No amount of financial motivation can change that, and no amount of financial punishment for testing poorly will help either.

Re:then what's the point of insurance?

I always thought of medical insurance as a socialist concept. Everyone pays into a bucket, and the sick people take out of it when needed. So long as there are more healthy people than sick people, it should work. Even in capitalist implementations of medical insurance schemes.

So if sick people need to pay more than healthy people, what's the point of having insurance? Healthy people then shouldn't need to pay anything, as they aren't costing anyoen anything. And sick people should pay everything, as only they need it. Which completely voids any reason to send any money to the insurance guy. OK, that's going further than this article summary sounded, but if this idea gains any momentum that may be where we end up at.

The concept of medical insurance has been highly perverted. It actually works as insurance if it's only there to protect you from the costs of things like major surgery. But when it's used as a buffer to pay for EVERY medical expense it turns into something that is nothing like insurance, and is a lot like a socialist economy. The reforms, such as the ones being discussed, are attempting to make it more like insurance again. Part of that requires that higher risk people pay more because they're buying more. Just like if your house is located in a flood zone on a fault line you're probably going to pay a lot more for your home insurance than if your house is an underground bunker in Kansas. It doesn't matter if you inherited your house, and so it's not fair because it wasn't your choice. It still costs more if you want the insurance, and it IS fair.

How about this, as a related idea... Old people should pay more into social security because they use it more. young people should get discounts because they're a long way away from taking it. I bet todays elderly would get all riled up if we tried to make that change, eh?

The analogy doesn't fit. Social Security is an income annuity product which Americans must buy. The analogy would be giving working people discounts on their Social Security payments if they were in poor health or charging them extra if they were in good health -- or else increasing a retiree's benefits if they are in poor health or reducing their benefits if they are in good health. With commercially sold annuities you can do this -- get a higher benefit for your money by sending the insurance company your medical records to show a medical condition, like a heart attack or stroke, which implies a shorter life expectancy.

If this is meant to be motivation to fix things, some things cannot be fixed. I've got high cholesterol. Very high. And very bad ratio of HDL to LDL. I'm relatively young, 31. I've gotten into running, have done a couple relay marathons (split the maraton distance between four runners) and am currently training for a 1/2 marathon. While still bad, my cholesterol measurements were better BEFORE I started running. Now after doing it for a few years, my cholesterol is 20 total points higher and it's time for the pills to fight it. Weird but true. Not sure what my genetics have in mind, but the doctor told me of other patients more athletic than I am trying to become are not able to lower their cholesterol without pills either. No amount of financial motivation can change that, and no amount of financial punishment for testing poorly will help either.

It's not a punishment. Statistically, you are more likely to end up needing open heart surgery at some point compared to someone else just like you without the high cholesterol. The point of insurance is to pay a smaller amount (the premium) to cover the small possibility of requiring a larger amount (the cost of the surgery). If you were twice as likely as the other guy to need the surgery, then the fair price for that insurance would be twice as much as the fair price for the other guy.

Hey an even better Idea

We could just put all the unhealthy people in gas chambers and kill them.
Oh yea, that was tried in the 1940's and for some reason people didn't like that. (don't flame me, I am being sarcastic.)

For someone who is sick or with a family member who is sick, just keeping a job and earning money is difficult, then add to that charging more health insurance costs, even if they could afford insurance would just push more people over the edge.

Increasing insurance costs would just be a slower, less obvious and more politically correct way to kill them off.

But it would be just as immoral, maybe even more so!

Anyhow Sick-o the movie already points out how screwed the system is.

This is crap

They can go screw.

I have a BMI over 30. I used to play baseball. Heartrate? 63. BP? 122/63. Glucose, white cell count, red cell count? Normal. My doctors say I'm perfectly healthy, except for the rare form of cancer.

I truly fear the future where we treat insurance as a personal thing. We invented insurance as a way to spread risk. If we charge you directly for your risk, we are creating no economic benefit. It just means that in the future, I'll have to bear the entire cost of my cancer treatments.

And the healthy? You'll get the privilege to pay a private company to absorb zero risk.

Women of course...

Women have higher health costs, what with their frequent specialized doctors care, occasional pregnancies, and longer life span. They should be billed at a higher rate as well.

Can't see the forest for the trees

Okay, giving discounts, bonuses, etc. to say, folks that don't smoke, or something of value for regular exercise, great! But charging for many conditions that are hereditary, and/or difficult to control is stupid, as it just pisses off perfectly good employees, who then may quit because you are nickel and diming them.

This is one reason so many companies pound diversity and non-discrimination into their employee's heads over and over. Why? Because it results in the hiring and retention of quality employees. If a quality employee is fired, paid less, harassed, or whatever because of some trivial or irrelevant factor, such as gender, hereditary high blood pressure, race, religion etc., some other, more intelligent employer can pick them up, and they will be making money for somebody them instead of Morons, Inc. It is a colossally stupid business mistake to drive away (or not hire employees) for factors not relevant to your business.

Yes, unhealthy employees drive up health insurance costs for a business. But driving away otherwise perfectly good employees costs a business a heck of a lot more. It is an obvious fact that employees who voluntarily quit are generally those good enough to get paid the same or better elsewhere; otherwise, they would be far less likely to leave to begin with.

SirWired

This is not a good idea for anybody

The whole point of insurance is to spread the costs around. Not risks, costs. Let's take an example. Suppose there's a group of 1000 people, and in any given year one of them's going to get hit with a $100,000 bill. None of them can afford that large hit, but all of them can afford to pay $100 per year. So they start a pool, each paying in their $100 with the understanding that the pool will cover the entire bill for whichever of them gets unlucky that year. Sure, the other 999 have to pay even if they don't get hit that year, but they also avoid the even higher expense of preparing to handle that big bill and the worrying over what'll happen if they get unlucky before they've saved up enough to handle it.

Now, suppose the guy running the pool for everybody decides there's an awful lot of money floating around in the pool. He could, he thinks, work out which person'll be the unlucky one that year. If he can, then he can charge that person the full $100,000 that year. That'll cover the pay-out and leave the other $99,900 in the pool for him to play with. Yes, this is the extreme case, but it's what the insurance companies here want to do taken to it's logical conclusion.

But wait a minute. If I'm a member of the pool, the whole reason I'm paying my $100 every year is so I won't get hit with the high bill if my number happens to come up that year. If I'm going to get hit with that huge bill anyway, why am I paying in? I'm not getting any protection from it, I'd be better off with that extra $100 every year to spend myself. The more it moves towards that extreme case, the less reason I have to pay into the pool. And even at the near end, the more people decide to pull out of the pool the more the guy running it has to charge those who're left, which makes it less attractive for them to remain in the pool, which means more people will pull out. And when there's nobody left, who will the guy running the pool get his money from? Oops.

Re:What's the problem?

Except for the fact that the BMI is an outdated and inaccurate POS.

Re:What's the problem?

Agreed, & I have a solution.

We should gather every employee in a room & stand them on a table one-by-one, if the majority of the room thinks that person is a fat bastard, that person gets charged more.

Great idea!

We should gather every employee in a room & stand them on a table one-by-one...

Yeah! We could hire people the same way. Let different departments bid on them. Make them take their shirts off and show their teeth so you know they're nice and healthy. And, just for their safety and protection, we might want to chain them together, so they don't get scared and fall off the table. And maybe a small but tasteful whip, strictly to make sure things move along and people don't waste all day bidding on new employees. And make them sing worker songs, because people really like that. Swiiiing low, sweet cub-i-cle wor-ker...headed for the break room at niiiiiine. That's my favorite.

Dang, it seems so obvious. Why hasn't anyone thought of that before?

I knew that would come in handy....

You never thought that experience from Obfuscated C contests would be a good thing, did you?

It's NOT insurance

If employer-sponsored group plans were insurance, then people and their family members who have certain chronic illnesses would have no more hope of getting in the group plans than they would buying an individual plan. Since the plan providers don't bother to apply the most basic actuarial principles to the participants of the plan, it's not insurance at all.

Instead, employer sponsored group health plans are a form of socialized medicine, but implemented under a private feudal system. This system helps keep employees dependent on and loyal to their healthcare lords, the employers.

Since it's not insurance, there's really not much point in trying to charge differential rates within the group plans. If they go too far with it, they'll end up with the same premiums and individual filtering for preexisting conditions associated with individual health insurance. If that happens, the employers would no longer be able to use health plans as a tool to keep their employees pacified, employers no longer find it in their interest to offer group health plans, and the political pressure would quickly build to switch this country over to government-backed health plans like every other developed country on this planet.

It's NOT health care

All good points, but I do take issue with your conclusion:

and the political pressure would quickly build to switch this country over to government-backed health plans like every other developed country on this planet.

The problem with health care in the United States today is that costs are out of control. This is by design - see 100 Years of Medical Robbery [mises.org] or How The Cost-Plus System Evolved [ncpa.org] for more on how the AMA lobbied to exterminate the competitors to allopathic medicine.

Someone asked me about Michael Moore's Sicko today, and I said that while he had some good points, he missed the problem entirely. If the medical industry was like the auto industry, it'd be like ignoring your car until the brakes failed and you ran into a brick wall, or never changing the oil until the engine needed replacing. Auto bodywork == expensive, brakes == cheap; replacing the engine == expensive, regular oil changes == cheap.

Americans would be a whole lot healthier (and health care expenses a whole lot lower) if health care was about prevention. (Mammograms & prostate exams, et al, are NOT prevention - they're screening for conventional treatments). The basics of human health haven't changed in thousands of years. The body requires certain levels of essential nutrients (some bodies need more of a nutrient than others due to genetic variation - some sailors were resistant to scurvy, for example). These nutrients need to be effectively assimilated through the digestive system, and the waste products of the body's metabolic processes need to be efficiently disposed of. The body requires clear air, clean water, sunlight (to synthesize Vitamin D), essential fatty acids [nutru.com], etc. If any of these are missing, or are not available in the required amounts, illness will invariably result.

Dr. Harold Reilly's Handbook for Health Through Drugless Therapy [amazon.com] covers the basics pretty well.

(it's not 'health care' because the system waits until a person gets sick, then it performs highly profitable 'disease-care'.)

Re:Slow news day?

The problem here is that it only assesses one kind of risk. What about sexually promiscuous employees, or employees that like skydiving or downhill skiing? What about employees that pop too many aspirin, or employees with physically abusive spouses? What about those employees with genetic predispositions to any number of chronic (read: EXPENSIVE) diseases, who have thus far been lucky enough not to come down with them (so far)?

Re:Slow news day?

What about sexually promiscuous employees, or employees that like skydiving or downhill skiing? What about employees that pop too many aspirin, or employees with physically abusive spouses? What about those employees with genetic predispositions to any number of chronic (read: EXPENSIVE) diseases, who have thus far been lucky enough not to come down with them (so far)?

World wasn't invented in a day, boy. Simmer down. They'll get to it.

Re:Slow news day?

What about sexually promiscuous employees, or employees that like skydiving or downhill skiing?

Have you read an insurance application lately? Non-commercial pilot, skydiving, rock climbing and other "dangerous" activities are asked about.

As for the rest, I'm sure they'll get to them eventually.

Re:Slow news day?

No, it isn't. The point of insurance is that a certain percentage of a population will get hit. By spreading the financial risk over a large pool of people, each person pays an amount they can afford in case its them.

This is why private insurance is a bad thing- their job isn't to maximize protection, but to maximize profit. Ideally, they would want to insure only the people who don't get sick and none of those that do, to make 100% of that money in profit. In other words, they want to make it a giant scam, taking your money but providing no services. This doesn't stop the others from getting sick, it just forces them to pay through the nose for non-insured rates, or get no health services at all. And since we live in a humane society where we don't let them die on the street, society as a whole pays a higher rate as we pay for them to take up emergency services when things go completely wrong, rather than cheaper, more effective, and less risky preventitve care they'd recieve with insurance.

So no, this is *not* a good thing. This is a perversion that will inflate the pockets of wealthy insurance companies while bankrupting the lower and middle classes. This is why we need to get rid of insurance companies and get government healcare *now*.

As a licensed insurance agent

"By that logic, no insurers would ever pay out. Thus, they would eventually have no customers so they would go out of business."

I can most credibly say that insurance companies would LOVE to not pay out. They try to avoid paying out all the time. This is part of why people absolutely hate insurance and why state regulators are coming down so hard on them all the time.

All corporations would like to not make good on their obligations if they can get away with it. It's the inherent nature of capitalism.

Re:Good

Maybe we should do away with insurance (averaging) altogether, and just have everyone pay for whatever happens to them.
After all, if you don't have cancer, why should you pay extra for the people who do?

Re:Good

"Maybe we should do away with insurance (averaging) altogether, and just have everyone pay for whatever happens to them."

Anybody who prefers that system can do so right now by canceling their insurance. If you think your medical bills will be less than your insurance premiums, put your money where your mouth is.

Re:Is this bad?

I agree.

And I think anyone that gets a sun burn or sun tan should pay extra as well.
And anyone that doesn't eat range fed chicken.
And anyone that eats meat.

And anyone that doesn't do exactly what I want.

Because my real purpose is to control them.