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.
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.
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.
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.
"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.
It would seem: