This will only hurt the poor.
Thanks for the contribution. I’m only expressing my intuition here, it’s very possible that I’m wrong. The point about regular checkups is very good, that’s why in Singapore, where medical costs are very low, annual health checks are mandatory. If the insurance company had a long-term incentive of keeping you healthy, I’m sure they would insist on you checking your health as well. But since you can switch every year, then this incentive is not explicit.
And yes, you may be right that since there are multiple deductibles offered, the cost of e.g. Cortana going to doctor often may be fully priced into the premium of his low deductible insurance. If people abuse it, then the price difference between lowest and highest deductible should rise.
Low-taxable-income residents receive health insurance premium subsidies. In many cantons, the subsidies are higher than the cost of the cheapest available 2500-deductible health insurance. In some cantons, you actually get the difference paid back to you by the health insurance company. So in actual practice, the 2500 deductible is often the better choice for low-taxable-income residents. The only exception to this rule may be individuals who are in poor health and need a lot of medical care. The reason I use the term low-taxable-income is that you can earn a fair income and still have a low taxable income. I received health insurance subsidies for a long time because I have a large family and maxed out tax deductions. I used the highest-deductible, lowest-premium insurance available for all of us, and actually got paid the 30-franc monthly difference by our health insurance company instead of paying premiums.
For those unfamiliar with premium subsidies, check out this post on my blog:
Well, you can also say that low deductible discourage you from taking care of your health, because if going to doctor and medicine is (almost) free, then what’s the point of doing sports, eating healthy, managing stress as a means to prevent diseases? As treatment becomes cheaper, prevention is less attractive due to its high effort cost. In other words, cheap health-care (or comfort in general) can make us lazy.
In my case I’m speaking from experience, and how about your theory? I don’t think people are more willing to put their health at risk when their healthcare is covered. Smoking and drinking rates are highest in countries where healthcare is poor.
However, I’m pretty sure if the price of the premium depended on your “health score” (which would factor in obesity, drug consumption, exercise rate etc), then people would really take care of their health. The premium is a real monthly price, that you can compare with other people. Of course you don’t want to pay more, I think it could work well on psychological level.
In a funny sort of way, health insurance deductibles are a type of health score. If you have good health and expect things to stay that way, you will pick a 2500k deductible. The lower premiums are your reward for staying healthy. If you pick the 300-franc deductible, it’s safe to assume that you either have poor health or expect to. The higher premiums are your penalty for not staying healthy. In this way, health is scored in a largely anonymous way which does not discriminate or exclude, and doesn’t invade privacy.