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3.1 Analysis of Medical Insurance Discussion

April 06, 2013

http://online.wsj.com/article/SB10001424127887324600704578402784123334550.html
http://blogs.wsj.com/atwork/2013/04/05/if-workers-are-out-of-shape-should-companies-make-them-pay/tab/comments//

The Wall Street Journal had some articles on the issue of how companies, while trying to reduce health care costs, are penalizing folk who, through their own actions, require more spending.
This is a note to capture the pointers, ideas, and some viseral analysis.

Conceptual Items

Conceptually, there are a number of items all mixed together in this discussion.
The relevant concepts include:
    1. "health care" vs "catastrophic event medical insurance"
    2. "Personal choice/environment" vs "external event"
    3. "Self induced medical issues" through action or ignorance
    4. "moral hazard" - costly items with personal positives and no negatives/cost
    5. "pursuit of money..." - get others to pay

Then, for this article, there is the management dictum:
    "Behaviors you reward/ignore/pay for, you'll see more,
     Behaviors you punish/require they manage/discourage, you'll see less or handled.

Goals and Responsibilities

We have companies, who increment compensation by paying for "health care" and, of course, folk want to maximize their compensation while companies want to both reduce absolute cost and associate compensation with actual productivity.

Individual vs Group

The real issue is the "group" categorization vs the "individual".

The individual may or may not have the issues and problems of the general group with the same behaviors and characteristics and would prefer to be incrementally compensated in spite of their person proclivities.

Bottom Line

People are smart

"People" are clever, smart, and resourceful.

They will attempt to take advantage of and manage any specific environment to their personal advantage (as they see/understand it).

To optimize costs and enhance good actions,
it is critical to empower the individual and put the ability to be creative in their personal hands; along with sufficient penalty for inaction or problematic behaviors.

Needs and Requirements

It would seem:

  1. "insurance", for unexpected events, is needed by everyone
  2. "health care", and any collateral damage from negligence, should be paid and managed by the individual.
  3. There should be a simple way to "earn" health care, independent of lack of job
  4. There should be a negative, personal impact for not having health care
  5. Leeching off "the system" should have negative consequences.


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2.9   Tools: Spreading Knowledge That Can Hurt:
    April 14, 2008
2.10   Tools: Trying to Help While Still Selling Corn
    February 27, 2008
2.11   The Game is Rigged: Attacking with Speculative Analysis
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3   Analysis
  January 01, 1997
3.1   Analysis of Medical Insurance Discussion
    April 06, 2013
3.2   Degrees of Risk
    April 24, 2013
3.3   Qualifying Experts
    January 25, 2014
4   Finches: Urban Ones Smart??
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8   Ice Core TimeLine Munge
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9   Ice Age Survival
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