12

votes

Private Insurance for Paleos

Answered on August 19, 2014
Created March 04, 2010 at 10:00 PM

This is a question in political economy.

Imagine if a million Paleos got together and said, "We eat better, live better, and will have fewer medical problems. There is only one true diet, and Taubes is its prophet. This we believe. So say we all."

Imagine if an insurance policy could be designed around that community. One would subscribe to it voluntarily, and one would have to prove, somehow, that one did live by its rules ??? just as one checks the "nonsmoker" box one could check the "vitamin D and Omega 3" box.

Under what conditions could a Policy-for-Paleos insurance scheme come to pass?

Please keep in mind that the readership of paleohacks.com is not exclusively American, so try not to let the current healthcare debate dominate your answer...

Edit: (by Patrik)

Please also see:

http://epistemocrat.blogspot.com/2009/10/ancestral-fitness-anti-health-insurance.html

http://epistemocrat.blogspot.com/2009/11/black-swan-health-policy-whats-in.html

http://epistemocrat.blogspot.com/2009/11/lifestyle-based-co-op-promising-model.html

7df8f3cc7f1475c3ecbbd4a4feb87d04

(514)

on June 30, 2010
at 05:09 AM

What about the cases where diabetes is what leads people to paleo? Especially type 1 diabetes - sometimes it can be controlled through diet if you do zero carb, I guess, but certainly not for all cases from what I understand.

95ab15c8ef50ff0daf87ccbdd52cd3b8

(2384)

on March 08, 2010
at 11:23 AM

Then you're out of luck in a bunch of states.

5ebeec76e20738d0a17cd724d64b1e0f

(1922)

on March 08, 2010
at 10:43 AM

Easy: don't cover pre-existing conditions.

93f44e8673d3ea2294cce085ebc96e13

(10502)

on March 06, 2010
at 07:19 PM

"The most effective: don't cover diabetes." Great point Meng

93f44e8673d3ea2294cce085ebc96e13

(10502)

on March 06, 2010
at 06:24 PM

"The most effective: don't cover diabetes."

Great point Meng.

93f44e8673d3ea2294cce085ebc96e13

(10502)

on March 05, 2010
at 04:58 PM

BTW I think Gary Taubes is great, but I don't think we want to cast anyone as a Paleo prophet. Even in semi-jest. Just my two cents.

A480640a53eb5dc8966f49141942f705

on March 05, 2010
at 12:44 AM

I agree with everything you say; but what if one were to put on an entrepreneurial hat and look at the problem from the point of view of a Christensen disruption? In that framework, the incumbent insurers are wholly committed to the high-end, "luxury disease" market of diabetes, cancer, etc. Paleos are an underserved low-end market who don't need much care, and should be allowed to pay less for it. There are many ways to fight cheating. The most effective: don't cover diabetes. That gets plan members wholly on side.

Frontpage book

Get FREE instant access to our Paleo For Beginners Guide & 15 FREE Recipes!

11 Answers

best answer

2
7bea72ef073e8f76b5828727f1460900

(2718)

on March 05, 2010
at 12:25 AM

It's tough, because you need a lot of initial capital to start an insurance company. All the people who control such money also have access to "the best doctors money can buy", which means the best CW doctors, i.e. they won't buy into the Paleo movement.

That said, I've also thought about this. To begin with, we need a recognition that people on Paleo indeed do cost less to insure. Currently the large medical insurers may have access to your lab results, but they don't have access to your dietary patterns. There's also no way to enforce that people who sign up for a Paleo plan are actually Paleo. From the insurer's perspective, the only way is still to correlate people's lab results with their claim amounts.

So, there are two steps:

  1. Getting the insurers to use the appropriate health markers to measure risk, e.g. recognizing fasting blood glucose, triglycerides/HDL ratio, and waist circumference as better indicators than total cholesterol, LDL, and BMI. This is partly the reason we created PaleoQ at Paleo for Life.

  2. Getting the public to understand that the Paleo diet and lifestyle is exactly what you need to improve the health markers identified above. This is the other reason that PaleoQ was created.

Help spread the word with Paleo for Life. If we can get the word out to enough people, eventually even the existing major insurance companies will catch on. The insurance companies analyze this type of data all the time, and once they confirm that, indeed, Paleo people are cheaper to insure, even they will start encouraging the Paleo diet and lifestyle on people. We may ultimately need the insurance companies' help to turn the tide against obesity and chronic diseases.

93f44e8673d3ea2294cce085ebc96e13

(10502)

on March 06, 2010
at 07:19 PM

"The most effective: don't cover diabetes." Great point Meng

93f44e8673d3ea2294cce085ebc96e13

(10502)

on March 06, 2010
at 06:24 PM

"The most effective: don't cover diabetes."

Great point Meng.

A480640a53eb5dc8966f49141942f705

on March 05, 2010
at 12:44 AM

I agree with everything you say; but what if one were to put on an entrepreneurial hat and look at the problem from the point of view of a Christensen disruption? In that framework, the incumbent insurers are wholly committed to the high-end, "luxury disease" market of diabetes, cancer, etc. Paleos are an underserved low-end market who don't need much care, and should be allowed to pay less for it. There are many ways to fight cheating. The most effective: don't cover diabetes. That gets plan members wholly on side.

7df8f3cc7f1475c3ecbbd4a4feb87d04

(514)

on June 30, 2010
at 05:09 AM

What about the cases where diabetes is what leads people to paleo? Especially type 1 diabetes - sometimes it can be controlled through diet if you do zero carb, I guess, but certainly not for all cases from what I understand.

3
Be4b60059db3511771303de1613ecb67

(1137)

on March 04, 2010
at 10:25 PM

Sounds sweet, but I'm a cynic because one corrupt system feeds another. This system you speak of would be so pure, they'd not let it fly.

So say we all. :-)

2
95ab15c8ef50ff0daf87ccbdd52cd3b8

(2384)

on March 05, 2010
at 11:12 AM

Interesting idea. Here's a wrinkle for you: Pre-existing conditions. There are plenty of people who have come to paleo after taking heavy damage from the SAD. I'm thinking of autoimmune stuff in particular -- Hashimoto's, Addison's, stuff like that, and t2 diabetes would certainly count as well if it had gone on too long to be reversed. Paleo is great medicine for these conditions but it won't (usually) cure 'em. Where would they fit in?

95ab15c8ef50ff0daf87ccbdd52cd3b8

(2384)

on March 08, 2010
at 11:23 AM

Then you're out of luck in a bunch of states.

5ebeec76e20738d0a17cd724d64b1e0f

(1922)

on March 08, 2010
at 10:43 AM

Easy: don't cover pre-existing conditions.

1
A47de6feae64a86049acf8e3c7b6c46c

(10)

on August 09, 2011
at 05:43 AM

Let me start by saying that I greatly appreciate everyone's interest and suggestions on this topic. I wanted to respond to some of the questions that were brought up and ask for additional input from the PH community.

  1. On the issue of the capital needed to start an insurance company: We were fortunate enough to have an employee from a major insurance company at our talk and he noted that we would be able to contract with an insurance company to act as a reinsurer. This insurance company could provide discounted premiums but would assume the risk of paying for claims and also accrue the savings from a healthier members. Ideally, there would be a sufficient amount of capital in the paleo community to create a stand alone insurance company which would allow the savings from improved health outcomes due to a paleo lifestyle to be recouped by the paleo community.

  2. Regarding the issue of non-paleo providers managing the care of paleo patients: To a degree, this will require patients to manage their own care. As members of the paleo community, they likely have already taken charge of their care to some extend. Non-paleo primary care providers would then only be used in acute situations, which is really is the strength of western medicine. Alternately, there could be discounts on co-pays for going to paleo providers. This is like how HMOs charge less for seeing providers that are in their network.

  3. How to assess compliance with the paleo lifestyle: This issue was raised by the insurance company employee and, I believe, is the stickiest issue in creating a paleo insurance company. As suggested, one way would be through lab tests and waist circumference. Another idea would be to have each member text a cellphone picture of each meal to a central database. Other ideas and suggestions on this topic would be greatly appreciated.

  4. On structure: As mentioned, a catastrophic paleo insurance plan coupled with a health savings account would be ideal. This would allow the insurance plan members to keep some of the savings caused by their healthier lifestyle while still protecting in the case of a traumatic event.

1
7bf306ada57db47547e9da39a415edf6

(11214)

on April 29, 2010
at 07:26 PM

I just ran across this post,monthly membership approach to healthcare, which introduced me to Qliance, a company with a different approach. Instead of health-care insurance, it's a membership to one of their clinics. They hope to make profits by reducing the overhead most of the medical industry suffers via dealing with insurance companies.

If they can use this model to serve the general public, then someone can use this model to serve a smaller paleo clientele. I assume a further reduction in costs because said clientele would be healthier. The major drawback, I assume, is the high cost of rolling out such a business, since a company would have roll out the clinics in various markets. Where's the highest paleo population? I know it's not my small town, so to maximize success it likely needs to start on one of the major urban centers on either coast.

1
7bf306ada57db47547e9da39a415edf6

(11214)

on March 09, 2010
at 06:05 PM

I have an as yet unfinished thought in my mind that the ideal version of such a policy would be some combination of a health savings account & a whole life insurance policy. Testing for various markers which indicate whether or not people are really eating paleo will only go so far- ideally we want a system that rewards the paleo-lifestyle, so being able to build up cash value by staying healthy would be one of the ways. It is unlikely one could gain as much cash value as a traditional whole life policy because the insurance would have to pay for unexpected medical issues, but there should be some benefit for those of us who manage to stay free of medical interference for several years. If I pay into the system every year but cost it zero, I ought to get some reward.

Since I've no idea whether or not any company selling something like this would be profitable, and I feel such a plan has, at it's root, socially beneficial aims, I'd look into forming an L3C, which basically allows some leeway for some profit while retaining a largely non-profit status.

1
5ebeec76e20738d0a17cd724d64b1e0f

on March 08, 2010
at 10:55 AM

I like this idea very much, and have thought about it before too.

I think the biggest initial challenges (in the US) would likely be on the regulatory side: there are some significant barriers to starting a new insurance company, and large associated costs to keep it running. Another challenge would be collecting enough capital to allow it to survive through the inevitable ups-and-downs. Major surgery alone can cost hundreds of thousands of dollars, and there are of course many conditions that a Paleo diet would not protect against.

To get things started, it might be possible to create an insurance cooperative of some kind, as some docs do with malpractice insurance. I suspect the number of people who would have to subscribe for it to be viable might be fairly high, though.

Other day-to-day issues, such as managing benefits, initial qualifications for entry into the plan, etc, are all relatively manageable.

1
6b73f0c4b971e2dde7147920e329fe7f

(2041)

on March 05, 2010
at 01:30 AM

Concierge Medicine sounds like a good business model for paleo physicians as an alternative to health insurance.

1
Eae21abfabb19c4617b2630386994fd9

on March 05, 2010
at 12:51 AM

The way to achieve this today is to not get health insurance. Unfortunately that leaves you open to a lot of risk. The next best may be to get a "catastrophic" plan or something close to that. All these types of plans do is put a cap on how much you can spend in a year- so if your medical bills reach $10,000, the insurance kicks in and pays for everything, but before then pays for nothing. Of course, a healthier individual would still be losing out quite a bit, but at least not on prescription drug co-pay.

0
03aeff8d87a3b53a449b5b8e9158da98

(3268)

on March 05, 2010
at 02:56 AM

Not sure I have a suggestion or opinion, but I vote this the most interesting question/idea posted so far!

Answer Question


Get FREE instant access to our
Paleo For Beginners Guide & 15 FREE Recipes!