Tuesday, October 6, 2009

Incentive alignment, anyone?

Colleague Larry Van Horn wants President Obama to stop subsidizing his slovenly lifestyle:
I start each day with my morning “cocktail” of an ACE inhibitor, Beta blocker, and Statin - all grossly subsidized by my health plan. I pay the same monthly premium as every other employee at my workplace with a family health plan. My wages have been reduced to fund the insurance premium behind the scenes, so I never know how much was taken from me. I know the only way to get my money back is to consume the services and drugs.

It’s ironic that I rarely speed on my way to my favorite fast food restaurant.  The consequence of speeding is real and immediate.  I would like to speed and given the opportunity – free of consequences – I’d light up my big-block V8 all the way to the drive-through.  Let’s take it a step further. What if I purchased auto insurance the way I receive health insurance— priced independently of conduct, with a true premium cost hidden from view, which covered all preventive maintenance?  I would drive like a bat out of hell.  The insurance would also be so costly that I wouldn’t be able to afford it.

... unlike my auto insurance, my health insurance rates are not based on my underlying lifestyle choices, which are the primary determiner of how much health care I’m going to consume. We need to get to a world where I’m held individually accountable for the decisions that I make.

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