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Notes -
The more I think about it, the more the auto/medical insurance comparison is driving me up a wall.
I mean, imagine if auto insurance worked like health insurance. For starters, it would be the equivalent of accident insurance plus a maintenance contract. If they had to accept "pre-existing conditions" people would be driving their cars around until fumes were filling the cabin for unknown reasons, get insurance during an open enrollment period, and then dumping their clunker on the nearest garage with entitled demands to "just fix it". Further, imagine car mechanics had some sort of "duty of care" to these cars, and couldn't just turn them away. Imagine of mechanics had to fix cars, regardless of cost, of anyone who could tow them to the garage. And then a bunch of these people just took their cars and drove off into the sunset without paying a dime.
Suddenly car insurance companies would be desperate for anything they could possibly due to stay solvent. And garages would just be making prices up out of thin air to stay solvent. They'd both have virtually uncapped and unavoidable liabilities, and limited means of income. Absolutely every single interaction with a "customer" would be an arms race where they need to either fleece this person as thoroughly as possible, lest they risk getting taken by this person for as much as possible.
Conversely, if health insurance were just like car insurance, they'd pay for traumatic injuries and sudden illness and that would be it. Chronic issues are on you, lifestyle issues are on you. Furthermore, they'd probably calculate your estimated years of life left, versus cost of treatment, to render a decision about whether you are "totaled" or not. They'd probably be a lot more like life insurance too, where they go over you with a fine toothed comb in deciding what the cost to insure you should be. Hospitals and doctors would expect payment for services up front, but hopefully would drop the arms race and just have generally consistent pricing for x-rays, casts, stitches, etc.
Now, things get thorny, in both directions, when you consider the state requiring you to have car or health insurance. Many states do currently require car insurance, and many states are also experiencing the effects of society shifting towards low trust defect-bots where illegal immigrants without insurance are crashing left, right and center ruining things for everyone, and despite breaking all the laws, nobody does jack or shit about it. Likewise when the ACA attempted to make having health insurance mandatory, the cost of plans was so ruinous many people just ate the penalty, and the whole scheme was so unpopular Trump got the mandate revoked.
But maybe we could pretend we still lived in a functional high trust society where everyone bought health insurance and the prices were reasonable, with all of the above. I still don't think people would accept the tradeoffs of health insurance being "just like" car insurance.
Yeah… ultimately, a lot of Americans view health insurance as a general paypig for health-related expenditures, in a way they don’t when it comes to car or home insurance (not yet, at least, as they’re getting there with regard to uninsured motorists [a Noticer might ask: and who are these "uninsured motorists"?]). From their point of view, health insurance companies exist just to approve claims and send money.
They’re not entirely blameworthy in that view, descriptively-speaking. Where the US government does its usual subsidization of demand and restriction of supply, and turning intrapersonal reallocation of risk into stealth interpersonal redistribution of wealth (another example would be Social Security).
However, prescriptively, it’s also an ought for many Americans—not just an is—that Someone Else should pay for their healthcare (especially if they’re frequent flyers due to some meme “diseases”/”disabilities”), that Someone Else should pay for their parents’ end-of-life care to eke out a few more months (lest they have to do a cost-benefit analysis using their parents’ estate—or heaven forbid—their own net-worth), that Someone Else should pay for the healthcare of Vulnerable Communities such as women, non-Asian minorities, and Persons of Under-documented Citizenship.
The notion that health insurance companies might perform actuarial risk/reward assessments is out of their personal Overton Windows. On DataSecretsLox (where I’m but a humble, occasional lurker), there were two back-to-back comments that I thought summarized the situation nicely:
Lumifer:
EchoChaos:
Illegals, who everyone just bluntly refers to as illegals or ‘Venezuelans’ when they’re around them. It’s not some big secret; when I went to driving school they straight up told us it was a good idea to have uninsured motorist protection in case you got into an accident with an illegal.
This isn’t some kind of politically incorrect knowledge that everyone pretends not to have like 13/52 or drunk driving rates by ethnicity.
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