How health insurance came to be

(as I understand it)

Let’s go back in time to before medical insurance existed.

You would go to a doctor, who would diagnose and treat you. Then you’d pay. Either up front or not, I don’t know.

Eventually the services that doctor provides get really expensive. Like surgery.

A business owner with say 30 employees thinks hmmm, I want my employees to be healthy. Maybe if one of them needs an expensive surgery, I can front the costs. It shouldn’t happen often. So I can provide that as a benefit to differentiate myself

As this evolves, employers start to “process claims.” In other words, employees go to the boss and ask for $ to pay for doctor visits. The boss does his due diligence. “What was the doctor visit for?” “What did you get done?” Perhaps the boss says “No, I’m not paying for that.” Or, knowing another employee got the same services done, he’ll say “[other employee] got charged $n. So I’ll give you $n and you tell the doctor that”

Eventually, this sucks up too much of the boss’s time. He says fuck that, and outsources the work.That’s what insurance companies do. They handle the overhead of processing claims, negotiating with the doctors. And they help determine what the premium would be for the employees. Because some employees just tend to cost more, so take higher premiums from them.

As companies grow, and nobody holds the insurance company accountable for not negotiating well, costs grow and middle men are spawned left and right. Let that go on for a few decades, and perhaps that’s how you we end up in the mess we’re in today

The insurance company needed data to grow. Because the more data it had, the better it could negotiate all around.