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  #61  
Old 12-28-2016, 03:26 PM
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Originally Posted by Dr T Non-Fan View Post
Hard to know where to start.
1. Assume that insurance is a fraudulent business.
2. Eliminate them, 'cause fraudulent.
3. Replace "app" with "government health plan" in your "idea" and voila, we're Cuba!
Not really what he was saying.
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  #62  
Old 12-28-2016, 04:03 PM
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Not really what he was saying.
Pretty close if you read between the line on "bureaucracy" and "conflict of interests"

FWIW I think some companies have pioneered the idea with family-like insurance , and here's an example of how things went

Tech-startups have been experimenting with the app idea as well, here's how one of the bigger one went down
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  #63  
Old 12-28-2016, 05:04 PM
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Pretty close if you read between the line on "bureaucracy" and "conflict of interests"

FWIW I think some companies have pioneered the idea with family-like insurance , and here's an example of how things went

Tech-startups have been experimenting with the app idea as well, here's how one of the bigger one went down
I'm talking about the cuba comment. The government could replace insurance companies and charge premiums. They don't necessarily have to run healthcare and manage hospitals like they do in cuba.
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  #64  
Old 12-28-2016, 09:00 PM
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Not really what he was saying.
He wanted ideas. This was one.
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  #65  
Old 12-28-2016, 09:03 PM
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I'm talking about the cuba comment. The government could replace insurance companies and charge premiums. They don't necessarily have to run healthcare and manage hospitals like they do in cuba.
Gov't would have to pay claims, though.
So, would there be a standard fee for every possible procedure, examination, lab test, hospital stay, etc.?

Would there be utilization review? Would there be claims review?
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  #66  
Old 12-28-2016, 09:04 PM
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Or, OP could consider his insurer his friends/family, who pays some portion of claims for a reasonable fee, instead of doing it out of actual or perceived love.
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  #67  
Old 12-28-2016, 11:31 PM
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I had Lemonade in mind when I posted. I was wondering if the ACA is repealed if there couldn't be a health-insurance version of Lemonade. Thanks for pointing to the post. I know the idea can sound nice in theory but I was interested to get the opinion of skeptical actuaries.
Where some people say "skeptical", others might say 'informed' and 'realistic'.

For those with political inclinations, you inclinations, you can usually figure out ahead of time which words they will choose.
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  #68  
Old 01-19-2017, 02:05 PM
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Insurance is an antiquated and bureaucratic industry with an inherent conflict of interest at its core where companies make more money if they deny more claims.

With the current technology available, couldn't there be a simpler alternative to health insurance where families, friends, or other associations connect via some kind of mobile app to insure one another without all of the bureaucracy? Wouldn't this ultimately be much simpler and less costly then the current insurance business model?

I am very interested to hear your thoughts as to why or why not this is/isn't a good idea, or why it may/may not be possible under the current regulatory regime and if the ACA is repealed.

Thanks

The bolded assumption is wrong. Needed treatment should make a patient less sick and thus make them less costly to insure.
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  #69  
Old 01-19-2017, 02:07 PM
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I don't know that much about health insurance. Why would they have to decrease their premiums if they receive less claims? Is this part of the annual premium rate filing process?

Would an accurate summary be that insurers are agnostic to the amount of claims they are paying? Do they have any incentives to pay more/less claims?
Yes, we are monitored at a state and federal level for profit margins. Also we need to be competitive to grow so any savings go into maintaining or lowering premiums.
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  #70  
Old 01-19-2017, 02:43 PM
New York Actuary New York Actuary is online now
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Yes, we are monitored at a state and federal level for profit margins. Also we need to be competitive to grow so any savings go into maintaining or lowering premiums.
Yes, we are monitored at a state and federal level for profit margins. The same can't be said for providers, drug manufacturers, or anyone else in the chain that has their hand out.
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