A Quick Thought on Health Insurance

One thing about the current health insurance debate that has been running through my mind lately is the argument that the health insurance market has morphed into something much larger and more complex than insurance; namely a third party payer for all things related to professional medical care.

I’ve read in many places how stupid it is (and how harmful to economic incentives) to have an insurance company paying for everything a doctor or a hospital does for us, comparing the situation to our car insurance companies paying for our gasoline or new tires (or even homeowner policies paying for our groceries).  For the large part I agree, but there seems to be a much bigger problem drawing a line somewhere in the field of medical care than there is in the auto insurance industry.  The type of auto insurance that is required for all drivers is liability insurance: basically that your insurance provider will compensate the other party should you cause an accident.  Collision coverage (which is not required) will also pay to repair your own vehicle if you cause an accident.  Note here that auto insurance only deals with accidents: unforeseen events.

But what would constitute an unforeseen medical accident?  Surely an industrial accident or car crash would qualify, but those are generally covered by other forms of insurance than our own personal health insurance.  Cancer would be a good example, although certain types of it can be tied to specific actions, such as lung cancer can result from smoking.  At what point does medical care stop being routine maintenance and start being something that insurance would cover in any realm besides healthcare?

Another thing to consider is that health insurance companies may have incentives to pay for preventative care because it would lead to fewer (and less expensive) claims in the future.  Just like we perform (or pay for) regular maintencance on our cars to prevent a more costly breakdown in the future, how do (and should?) insurance companies deal with preventative maintence on our bodies to avoid more costly future bills.  (This also raises more questions about the degree of discretion insurance companies should have when paying claims or issuing policies for people who make unhealthy lifestyle choices.)

P.S. Do mountaineering and rock climbing constitute unhealthy lifestyle choices?