My MIL actually has insurance, purchased privately, that does encourage preventive care in exactly the ways you describe. Her premiums go up if she neglects her annual physical; when she was smoking, her insurance didn't cover lung-related issues, and she had to quit, and sign a statement that she had quit, and then wait a year and sign another statement that she had remained not smoking, before they would cover lung-related issues. I guarantee you that both my husband and my brother would get their physicals done on time, or at least much closer to on time, if it affected their premiums, but of course, since they are insured through their employment, it doesn't; all employees are charged the same, regardless of health-related habits. Our current insurance makes "preventive care" "free" -- i.e., no co-pay -- but they still can't offset the fact that getting Chris to the doctor means time off work and work piled up when he returns; adding some financial cost into the system would offset that greatly. (Of course, the company could also give people a dedicated half-day specifically for physicals and require that they be done, and perhaps negotiate a lower rate with the insurance company in return; I'm not sure why this is not currently done, except maybe people would feel that it was too controlling, intrusive, or draconian on the part of the employer, and most employers likely don't want to be bothered with it.)
Newt
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