Wednesday, June 02, 2010

An Insurance Story

I busted one of the panes in the rear window of my Toyota Tacoma yesterday. I was putting a piece of cedar decking into it, and just nicked the edge of the window -- shattered it.

Called a window replacement service and almost had a heart attack: $1200 for the Toyota OEM replacement window. $1200 for one stupid Finlander moment?

But...I could get a third-party replacement, installed, for $295. A call to a second service confirmed the OEM price but got the third party window down to $220.

Now isn't that amazing. The OEM window costs 5.5 times as much, and we are not talking small change here. There might be some, hopefully minor, quality difference -- on the fit, most likely. I will find out tomorrow when I see the window.

Why the huge price difference? Two things. One, a monopoly position in the OEM window, due to the brand of Toyota. Second, insurance. Most people with comprehensive insurance will just pay the deductible and will therefore go for the more expensive but brand name window. Me, I cannot justify sending that kind of money to Toyota no matter who is paying, so even though I have comprehensive, if that third party window is OK it is going in.

What a lesson in what insurance can do to demand and prices! Do we wonder why medical services cost so much?

One of my colleagues had a very interesting proposal for health insurance that I have not come across. There are proposals to pay health care providers a lump sum -- bundled payment -- for a patient with some diagnosis. Say you need a hip replacement; then your insurer would pay the provider a lump sum of like $12,000. My colleague takes this one step further: he would have the insurer pay the patient the $12,000 and let them get their hip replaced wherever they wish.

That would create some very neat incentives! The problems, and they are important, are several. Foremost is the risk that the lump sum won't be enough to cover some complications. That puts additional risk onto the patient. Second might be the issue that some folks would rather take the money than the new hip. So we would have a nation of limping, but wealthier, elderly.

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