It’s less about denying coverage and more about accurate risk pooling. If an insurer knows a specific marker leads to a 90% chance of a million-dollar claim, they have to price for that. If they don't, the 'healthy' people in the pool end up subsidizing the high-risk ones until the premium becomes too expensive for everyone and the pool collapses (adverse selection). The real challenge is that regulators often won't let insurers price high enough for those risks, which is why many companies just stop offering LTC (Long-Term Care) altogether.
It seems to me that risk pooling kind of negates of the intent of insurance, ie. to spread out risk.
that's the fundamental paradox of modern underwriting.
insurance relies on what philosophers call a veil of ignorance. it only works if we're spreading stochastic risk things that might happen to anyone.
once data gives us perfect foresight into a 90% chance of a million-dollar claim, it’s no longer insurance; it’s just a pre-funded bill. at that point, the pool isn't spreading risk, it's just facilitating a direct wealth transfer. the 'good' risks realize they're just subsidizing a known event for others and they flee the pool, which is exactly how the market for things like LTC collapses.
we're basically at a crossroads where better data is actually making 'insurance' as a concept mathematically impossible for certain risks.
This might sound crazy, but what if everyone in the country gave extra and as a result everyone in the country was covered?
why would I agree to that when I'm not at risk of that? (Assume for discussion I have had this tested - whatever it is). I have my own life and like everyone more things (including vacation...) I want to spend it money on than I have money.
Some of us think that a key aspect of society is that we take care of each other. If something terrible happens to you before you manage to amass a fortune, it’s nice to live in a society that won’t leave your family destitute.
Well of course, the actual intent of insurance today is to make profit.