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Here’s the problem. Let’s say you have a doctor club, where everyone pays the same amount regardless of how often they use the doctor. For people who need the doctor a lot, that’s great. They pay a lot less than they would if they had to pay per visit. For people who just need one checkup a year, they end up paying a lot more than if they just paid for their annual checkup. And they would quickly figure that out, and drop out of the program.
So now the people who are all basically healthy aren’t in your pool anymore. They’re paying for their annual checkup at another doctor. So only the people who need the doctor a lot are paying in. So you have to hire more doctors and increase the cost of the program, because everyone who is in it needs a lot of doctor time.
But then the same thing happens again. People who need more visits a year are getting more out of the program than they are paying in, and people who need fewer visits a year are getting less than they are paying. So the people who need the fewest doctor visits drop out. And so on as the cycle repeats.
You get the idea. There’s a game theory term for this that I am forgetting, but the result is spiraling costs and more dropouts. This is why the ACA (for you non-Americans, that’s the Affordable Care Act, which was attempting to reduce US healthcare costs) had a health insurance mandate. Requiring everyone to be part of the program is the only way to make something like this work.
You're right. Health care needs are more uneven than the other services I mentioned. What about piecemealing the services? So not universal healthcare for Smalltownsville, not MRIs or designer drugs initially, but everyone at least gets a general physician visit. Potentially still a better experience for doctor and patients. But not thinking just about healthcare, what about a neighborhood cafeteria or tax service, or any commonly used service?
I feel like the cafeteria is the best scenario, because there isn’t an imbalance of needs like this. Pay a flat fee per year and get a lunch every day, or every work day, or whatever. Economy of scale would mean that it would save the subscribers money.
…huh, this could actually work. The one downside is that people nowadays expect variety in their food and cafeteria food tends to be samey. But if you could solve that, this is a good idea.