My simple policy proposal is to repeal all laws and regulations requiring insurers to write coverage for routine healthcare procedures.
Automobile insurance does not cover oil changes, wiper blades, new tires, tuneups, water pumps, or other routine maintenance.
Homeowner’s insurance does not cover lawn mowing, interior or exterior painting, septic tank pump-outs, or air conditioning repair.
Insurance does not cover routine maintenance items. Insurance pools the risk of an unlikely event among many insured people. So auto insurance does insure in case of motor vehicle accidents. Home insurance does insure in case of tornado damage to your home.
In the same manner, health “insurance” should not pay for:
- Routine physicals
- Routine dental visits for teeth cleaning and checkup
- Routine ophthalmologist visits or eye glasses
These are routine services that should be paid out-of-pocket by the consumer.
Any insurer must charge the insured the full value of these items because the use of the routine service is or should be certain. There is no risk of a reasonable person not attending to his or her routine healthcare. There is no financial advantage to the consumer to insure routine healthcare services.
There might be financial advantage to others though. For example, if the insured neglects to go for routine care, then the insurance company can just pocket the amount paid for the routine service. For another example, medical providers might be slightly benefited since the consumer, having paid for the routine medical service, has some incentive to actually go to the doctor who will then be paid!