If I am young and healthy, I won't buy health insurance.

[johnmarc]

If I'm healthy and don't foresee any need for medical care in the future, I'm probably not going waste my money on an insurance policy.

Winepusher ended our conversation before I could really get to the heart of the matter (from my perspective anyway) and that is, "What does the end game look like?

Let's assume a 'Winepusher world' whereby public subsidies and government control were set aside in favor of a capitalistic (marketplace) insurance industry which (one would assume) would not require insurance coverage but certainly there to offer policies to those who might choose that direction.

Let's assume also that a large part of the population simply opted out of coverage during the young and healthy part of their lives---and it makes sense---why contribute from a limited income, funds that are clearly needed to pay the everyday bills and for which no benefit directly is derived anyway? Let's put that bill off until we need it.

What is the end game in this scenario? What does it look like a few years down the road?

Individual 'A' dies in his/her sleep at 82 years old having never contracted any illness nor suffered any accident except for that which 'over the counter' could provide. (unlikely)

Individual 'B' develops a host of ailments most of which need expensive treatments and simply pays the bill as he/she goes from his/her own pocket. (unlikely)

Individual 'C' decides that at about fifty years old, he/she should be thinking about an insurance policy and discovers that he/she is in a different 'risk' bracket than he/she would have been at twenty-five and the premiums are simply out of reach for his/her moderate income. (likely)

Individual 'D' develops a 'condition' at about thirty-five years old that qualifies as a 'pre-condition' and the private marketplace will not issue a policy to him/her. (likely)

Individual 'E' dies at age 35 in an automobile accident and has incurred little medical expense up to that point. (not a majority position certainly)

Individual 'F' is a member of a local church which is holding a bake sale for his/her expensive treatments. (bake sales won't fully cover expensive treatments)

Is there anyone out there who could work this thing backwards and give me a workable scenario for millions of individuals who for need or want would delay insurance costs until (it's too late) or what exactly? Is there a magical time in which these individuals would begin to contribute?

Question for debate:

If I'm healthy and don't foresee any need for medical care in the future, I'm probably not going waste my money on an insurance policy.

What is the end game? I am claiming that there is no suitable end game. Your claim????

By, "not wast[ing] my money on an insurance policy" one sets up eventual outcomes that (collectively speaking) either devastate the individual in the form of bankrupting costs or some other outside group or groups bear the cost of treatments. If we all chose to participate in medical insurance at age fifty (and not before) Some of us would be bankrupt and the others couldn't afford the premiums. The whole thing fails because the cost of medical care has to be spread out over our lifetimes to be cost effective when we need it.

[DanieltheDragon]

[Replying to post 30 by bluethread]

well you don't need innovation from an insurance company I wouldn't say that is a high priority in fact most decision making is done using computers. As far as flexibility to react to changing environmental pressures. It's simple say for example wound vacs. That are used to clear and keep clean wounds post-op need bandages changed 6 days a week for the elderly, but the insurance currently only pays for 3 changes a week. At the end of the year the budget goes under review if it was shown to be effective at treating the patient, and could fit within the budget they should have the power to make that change.

Now lets say a company was pushing bandages when they were not needed to make a profit off of the system. With digital record they could quickly and easily be able to drill down to individual use cases to see how effective the treatment was or if it was abused. If to many of these occurances took place it would revoke the change automatically.

of course this is just me brainstorming in the wind I am no expert but to say, we cant because its to hard or complicated is not the course of action I look to take in life.