Cautious Prius owners probably wouldn’t be happy sharing equally in a risk pool with enthusiastic drivers of sports coupes. If insurance rates were standardized, there’d be a lot more sports cars out there, until the Prius constituency got them banned altogether. Charging different insurance rates gives all parties what they want at a cost that creates appropriate incentives.
You might be able to say something similar about health insurance and sedentary smokers vs. runners. If an extra hour of work is less economically valuable than a gym visit, the incentive structure should reflect that.
I agree that insurance rates should not be affected by luck. One of the reasons the preexisting condition part of the ACA is important.
If someone gets sick and thus becomes sedentary due to their illness now you’d be effectively discriminating against them due to their preexisting illness because they can’t go be a marathon runner.
So we better create a rule that somehow excludes ill people from being discrimated against like this. Oh and then we’ll force the sick person to go through a hellish process to prove it too. Etc.
Wrt health insurance we should just get off that train. It only leads to a worse and worse place.
2. Being healthy already has quality of life consequences. And the extra cost to insure those lifestyle choices are probably pretty low, and most of that cost is just shifting it from primary insurance to medicare. Because everyone dies of something, and a lot of times it's really expensive. Insurers care a lot about whether that happens at 64 or 66. But as a society it doesn't really matter, and the insured bears most of the impact.
I'm one of those people who gain weight easily due to always wanting to eat. I was morbidly obese at 19 despite coming from a household of healthy eating. I'm now 33 and have maintained a healthy weight for years but it isn't fun. For me to maintain a constant, healthy weight I need to be hungry. Despite 5+ years of maintenance, I am still hungry constantly.
Is insurance that large a cost factor? I would imagine the increased cost of the car and fuel costs would still be strong incentives against upgrading to sports cars.
You could say there's a spectrum, between stuff like healthcare and genetic diseases, and someone insuring their pinky finger not because they need it, but because they're vain and think it's an astonishingly pretty finger, and they're just that rich. But somewhere on that spectrum, there are also families that lose bread winners, and I don't see why solidarity wouldn't also apply there.
Call me naive, but I also always thought that's kind of the point of it: spreading the risk, or solidarity to use a less fashionable term. People can be very sick through no fault of their own, and those who are healthier should look out for them. If you calculate that "fair share" according to exactly how sick people are, then what's the point, wouldn't that just be a needless middleman that gets paid upfront?