Longevity Insurance

It sounds like you're trying to get them to maximize the probability of you living to a certain age. It would be better if you could make the incentive more along the lines of maximizing your lifespan. For example, you insure 100 years for $10,000 per year. If you die when you're 50, then your closest relative gets reimbursed for the remaining 50 years, so they get $500,000 back. Also, you don't have to set it as constant. For example, you could say that you will pay $10,000 per year until you're 50, and then $5,000 per year after that. That way, you get more money if you're not retired. You could also set it so you pay $5,000 per year, but have an additional $5,000 per year before 50 if you're capable of doing your job. And maybe specify it more so that if you're disabled your life isn't worth as much.

I notice that in your example, if the money will pay off tomorrow, they will pay up to the remaining amount to keep you alive one more day.

Suppose early on in my life I incurr $1,999,999 in expenses. Then, later on I have an unexpected accident that costs $2. Prima facie the system should still fund this. However, your system, by not focusing on the margins, does not satisfy this.

Also, you probably want a smoother tail. Your system would spend $2m to extend the life of a 74 year old by a year, but nothing to extend the life of a 75 year old by 20 years.

Also, I don't think that, in equilibrium, health insurance companies are actually incentivised to fund research into longevity. This would only make policies cheaper if consumers hadn't already taken into account the increases to lifespan.

Finally, I think this post would be improved if you hadn't mentioned its making public healthcare easier - Politics is the Mind-Killer.

Interesting idea, but I see two problems :

1. "Most individuals would want to avoid trivial medical expenses" that's actually a huge problem. In our societies, people tend to postpone going to see doctors (because it costs money, even if most is paid back by social security (like it is here) or private insurances, and because it takes precious time). But for many disease, the earlier they get treated, the easier is the treatment. You have a small weird thing on your skin, you don't go see a doctor for that, and it happens to be a skin cancer and you die, or it happens to be a wart, and when you finally go see a doctor, it has multiplied and you may even have contaged someone else. The key for efficient healthcare is frequently going to the doctor to check you don't have anything. Maybe there could be a number of checks/examens that are not taken from your $2 millions ? A visit to the dentist and general practitioner for a checkup a year and a few things like that ?

2. You only consider "life", but not in which condition. So how does your mechanism handle issues like eyesight ? How does it handle artificial limbs for people who require them ? The interests of the person and of the insurance will be opposite in those issues - the insurance doesn't care if you're blind and limbless, as long as you're alive, but the person may prefer to be able to see and move around, even if it means a risk of dying earlier (surgery always has a risk).

Robin Hanson's proposal is pretty similar.

You should really call this something else, since longevity insurance is already a thing.

(Don't feel bad; I actually invented them independently before finally learning that it was already a mature industry. Oops.)

An appealing idea. I would also consider such an insurance.

I also see a problem, similar to kilobug's second point: How would such an insurance handle a person refusing some recommended treatment? Especially if the treatment is effective (say in terms of life expectancy), but also has nasty side effects (for a while/for the rest of your life/etc). The parallell obvious to me is life insurance and suicide, but life insurance does not pay out for death due to suicide. The policy becoming void if treatment is refused (without caveats) would, however, be a dealbreaker for many people (me included). As far as I can tell, Robin Hanson's proposal also does not address this.

I can imagine wanting to say something about what risk/quality of life/life expectancy tradeoffs I would want to make (and thus what treatment I would refuse), but it's not clear to me how something like this could be specified.

In your example there is very strong inclination to kill yourself the day before 75th birthday, and very strong inclination to 'spend' all the money trying to save you after that suicide attempt even if it is 100% hopeless (better to put money through the hospital than to give them away to next of kin). Note: you can't reliably recognize suicide. The worst forms of suicide (closing eyes and steering onto opposite lane on the road for example) are indistinguishable from accidents, and so you will treat accidents as suicides or suicides as accidents.

A sensible policy really needs to avoid discontinuities and special cases.

Financially, this sounds very similar to whole life insurance. Conceptually, you pay premiums over time, and the policy builds in value (as opposed to term life insurance, which does not build equity). At any time, you can borrow against the value of the policy (i.e. to pay medical expenses). Eventually, the policy matures and can simply be cashed in.

If that financial instrument would fulfill the described purpose, then great. But when I went shopping for that product, it was incredibly expensive. I pay ~$1500 for term life insurance, and I think that life insurance that built value was about an order of magnitude more expensive.

Interesting idea. I would consider this option in a free market. I wonder though, about what the natural price would be. It may be that there are so many very high cost ways to try to keep somebody alive that this plan would be very expensive. That is, it may be that so many people end up getting million dollar cancer treatments that the company has to pass this onto consumers in the form of a high monthly premium.

Sounds interesting, but I'm not clear on how it would work with treatment that has a much larger effect on quality of life than life expectancy.

To put it into perspective, it makes little sense that we spend $1M (as a society) trying to save a 92-year-old when that same amount could have saved 10 teenagers.

I don't think we actually do that, once you take into account how much we care about the individuals in question. That is, while I'm willing to believe that we'll spend $1M on Grandpa rather than 10 teenage strangers, I'm not at all convinced we would make the same choice when it's Grandpa versus 10 teenage family members in criticial condition. (And there's no way we would if it were 10 teenage family members versus a 92-year-old stranger.)

What this complaint is really about, it seems to me, is that people spend their resources on people close to them rather than on others who "need" them more.

And then if you die, the insurance company could have you frozen to avoid paying out however much is left in your coverage. Of course, they would first have to lobby for cryopatients to be legally recognized as non-dead.

But then again they would have little incentive to reanimate you later.