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Politics : View from the Center and Left
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To: epicure who wrote (237306)11/9/2013 2:28:58 PM
From: neolib  Read Replies (1) of 541906
 
That is an excellent question to ask and a very difficult one to answer. But Obamacare hasn't tried to answer it either.

There are very real issues with behavior and links back to depression which make it VERY difficult to use penalties to alter behavior.

To follow the auto insurance case (and I think its an excellent analogy, because its meant to separate payment dynamics from how crucial the service is, something some of those reading my post completely fail to understand) we see the following feedback loops:

1) Risk profiling: Young men are statistically worse risks, so they pay more (Some see this as discrimination)
2) Behavioral Benefits: Many auto insurance cos do offer breaks for young men if they have certain behaviors. Having drivers ed training, and high HS GPA were two in play that IIRC.
3) Personal Driving Record: Accidents and tickets impact your rate. More of either and your rate goes up.
4) Law Enforcement: If you are too bad, you lose your license and can't drive, i.e. you get kicked out of the system.

What are the analogies of the above to healthcare? Most people are wanting to reject anything like 1) in healthcare, although age is still a factor in Obamacare. For 2) Obamacare only has smoking as a factor. 3) Obamacare eliminates completely this feedback. 4) Obamacare completely eliminates this as well.

2-4 are exceedingly valuable in controlling auto insurance costs. If you construct a system which eliminates them (or their analogs) expect trouble.
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