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Comparing insurance with expected value

Sal uses expected value to compare a couple of different insurance policies. Created by Sal Khan.

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  • blobby green style avatar for user Laura Coogan
    Can you update this example and use better numbers for the medical costs? I am getting an expected value of $3200 for medical expenses ... and it looks like Paul would be much better off self-insuring. Maybe make the last event have a cost of $150,000 instead of $15,000??
    (20 votes)
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  • starky ultimate style avatar for user Angie
    I still don't understand why we aren't adding 8000 into all of the costs. E.g. 8000 * 0.3 + 9000 * 0.25 ..... . I understand that the 8000 is a cost no matter what, but when we are doing similar problems regard an arcade game that costs $2 to play and but gives a $40 reward for winning, we subtract 2 from both the winning and losing possibilities. In that case, you're spending the 2 dollars no matter if you win or lose. So why do we account for the "fee" in both outcomes for the arcade game, but not account for the "fee" in all outcomes with the insurance?
    (4 votes)
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    • leafers ultimate style avatar for user Phil P
      It doesn't make any difference to the result whichever of those ways you calculate it. Sal is taking advantage of the fact that E(X + k) = E(X) + k, where X is the random variable (the medical costs) and k is a constant (the price of the insurance).
      (9 votes)
  • ohnoes default style avatar for user Cyan Wind
    At , why do we add $8000 to calculate the expected medical costs with the low deductible plan, instead of $9000? Can anyone explain it to me more clearly?
    (4 votes)
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  • male robot johnny style avatar for user Mohamed Ibrahim
    Not going with any insurance plane seems to be the best, it has expected cost of 3,200 dollars
    (4 votes)
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  • leafers seed style avatar for user mayuragrawal07
    This is not a correct cost benefit analysis in my opinion. Payoff should be calculated in terms of net cost which includes what net benefit he derives from insurance.
    expected value from first plan should be calculated in terms of net benefit--
    Plan 1--

    0.3*(-8000)+(-8000-1000)*0.25+(-8000+4000-1000)*0.2+(-8000+7000-1000)*0.2+ (-8000+15000-1000)*0.05
    that turns out to be -5500. so, from first plan he actually will lose out -5750 per year on an average.
    Plan 2:

    E(benefit) = (-7500)*0.3 + (-7500-1000)*0.25 +(-7500+4000-2500)*0.2+(-7500+7000-2500)*0.2+(-7500+15000-2500)*0.05 = -5925

    so, if someone forces him to buy one of the plan, he is better off buying first plan. what do you think?
    (3 votes)
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    • blobby green style avatar for user daniella
      Your analysis is correct. When comparing insurance plans, it's crucial to consider the net cost, which includes both the cost of the insurance premium and the expected out-of-pocket expenses for medical costs.

      Let's go over your calculations:

      Plan 1 (Low-deductible plan):
      The net benefit can be calculated as follows:
      E(benefit) = 0.3 × (−8000) + 0.25 × (−8000 − 1000) + 0.2 × (−8000 + 4000 − 1000) + 0.2 × (−8000 + 7000 − 1000) + 0.05 × (−8000 + 15000 − 1000)
      E(benefit) = −5500

      So, on average, Paul would lose $5500 per year with Plan 1.

      Plan 2 (High-deductible plan):
      Similarly, for Plan 2: E(benefit) = 0.3 × (−7500) + 0.25 × (−7500 − 1000) + 0.2 × (−7500 + 4000 − 2500) + 0.2 × (−7500 + 7000 − 2500) + 0.05 × (−7500 + 15000 − 2500)
      E(benefit) = −5925

      With Plan 2, on average, Paul would lose $5925 per year.

      Given these calculations, if Paul had to choose between the two plans, he would be better off purchasing Plan 1 (the low-deductible plan), as it results in a lower expected net cost compared to Plan 2.
      (1 vote)
  • male robot johnny style avatar for user Dhawal Kapil
    How come concept is explained later but a question on this concept was given in the previous exercise which ofcourse I was not able to score. :(
    (1 vote)
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  • leafers ultimate style avatar for user Riku Lintula
    What's the difference of calculating the expected value like Sal does it versus calculating the expected value of the medical cost distribution (3.2k USD) and then using that as the average cost per year and stating that on average he'll pay 9k for the low plan and 10k for the high plan? (Average cost per year exceeds both 1k and 2.5k so he has to pay max in either plan's case, so then you'd just add the two)

    What am I calculating here and why is it wrong? I still get the same result in the sense that the low plan is better but it's also immediately evident that you should just opt to pay your bills without insurance since you're average annual cost will be 3.2k anyway -- unless my math is fundamentally broken.
    (1 vote)
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  • blobby green style avatar for user b a
    The video is great as always, but this example of a "health insurance" is the epitome of America... as someone from a country with an actual and affordable health unsurance, these numbers seem insane. Why would anyone even get a "health insurance" like this if you pay them but basically you get almost nothing back at all like Sal showed in the alculations.
    (1 vote)
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  • male robot donald style avatar for user Harold Villacorte
    Hey there's a quiz question in there that's insisting that a low deductible insurance plan with a cost of E(x) = $6,500 is a better choice than high deductible plan with a cost of E(x) = $5,540? Wut?
    (1 vote)
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    • blobby green style avatar for user daniella
      If the quiz question states that the low-deductible plan with a higher expected cost is a better choice than the high-deductible plan with a lower expected cost, it would be inconsistent with the principles of cost-benefit analysis. It's essential to choose the plan with the lower expected net cost, which may not always align with the plan with the lower premium cost.
      (1 vote)
  • spunky sam blue style avatar for user Dhoomketu
    I can't understand why are we multiplying percentage and costs. It somehow doesn't make sense, what product of probability and medical costs represents?
    (0 votes)
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Video transcript

Voiceover:Paul has the option between a high-deductible or a low-deductible health insurance plan. When we talk about the deductible in health insurance, if someone says that they have a plan with $1,000 deductible, that means that the insurance company only pays the medical cost after the first $1,000. So if you have a $1,000 deductible and you, say, incur medical cost of $800, you're going to pay that $800. The insurance company won't pay anything. If you have a deductible of $1,000 and your total medical costs are $1,200, you're going to pay the first $1,000, and then the insurance company will kick in after that. So with that out of the way, let's think about his 2 plans. If Paul chooses the low-deductible plan, he will have to pay the first $1,000 of any ... let me do that in purple, the first $1,000 of any medical cost. The low-deductible plan costs $8,000 for a year. So in this situation, he's going to pay $8,000 to get the insurance. If he has $900 of medical expenses, the insurance company still pays nothing. If he has $2,000 of medical expenses, then he pays the first $1,000, and then the insurance company would pay the next $1,000. If he has $10,000 in medical expenses, he would pay the first $1,000, and then the insurance company would pay the next $9,000. If Paul chooses the high-deductible plan, he will have to pay the first $2,500 of any medical cost. The high-deductible plan costs $7,500 a year. It makes sense that the high-deductible plan costs less than the low-deductible plan because here, the insurance doesn't kick in until he has over $2,500 of medical expenses, while here, it was only $1,000. To help himself choose a plan, Paul found some statistics about common health problems for people similar to him. Assume that the table below, and I put it up here on the right, correctly shows the probabilities in cost of total medical incidents within the next year. So this right over here, it's saying what's the probability he has $0 in medical costs? What's the probability of ... he has a 25% probability of $1,000, 20% probability, $4,000. And this is a simplification, a pretty dramatic simplification from the real world. In the real world, the way this makes it sound is there's only 5 possible medical costs that someone might have, $0, $1,000, $4,000, $7,000, and $15,000. In the real world, you could have $20 of medical cost. You could have $20,000. You could have $999. So in the real world, there is many, many more situations here that you would have to redistribute the probabilities accordingly. But with that said, this isn't a bad approximation. It's just saying, OK, roughly, if you wanted to construct this so it's easier to do the math, which the problem writers have done, say, look, OK, 30% $0, 25% $1,000. This is pretty indicative if you had to group all of the possible costs into some major bucket. So it's probably at least a pretty good method for figuring out which insurance policy someone should use. So they say, including the cost of insurance, what are Paul's expected total medical costs with the low-deductible plan? Round your answer to the nearest cent. Actually, I'll get the calculator out for this. With the low-deductible plan here, low-deductible plan, he's going to have to spend his total cost, he's going to spend $8,000 no matter what. Whoops, what happened to my calculator? He's going to spend $8,000 ... My God, I'm having issues. He's going to spend $8,000 no matter what, so that is $8,000. Then let's see. There is a 30% probability he spends nothing. I could just write that as plus 0.3 times $0, and I will write it just so that you see I'm taking that into account. There's a 25% chance that he has $1,000 in medical costs. In the low-deductible plan, he still has to pay that $1,000, so plus 0.25% chance that he pays $1,000, $1,000. And then you might say, OK, plus 0.2 times $4,000, but remember, if his medical costs are $4,000, he is not going to pay that $4,000. He is only going to pay the first $1,000. So it's really plus 0.2. In this situation, his out-of-pocket costs are only $1,000. The insurance company will pay the next $3,000. So 0.2 times $1,000. And then plus 0.2, 20% chance, even if he has $7,000 in medical costs, he's only going to have to pay the first $1,000, so 0.2 times $1,000 again. And then plus 0.05 times, once again, $1,000. If he has $15,000 in expenses, he is only going to have to pay the first $1,000, times $1,000. And we get $8,700. One way you could have thought about it is OK, he is going to have to pay $8,000 no matter what, and all of the situations where he ends up paying, that's anything, that's these 4 situations right over here, there is a 70% probability of falling into one of these 4 situations. At any one of these, he only has to pay $1,000. The insurance company pays everything after that. So you could say $8,000 plus there is a 70% chance that he is going to pay $1,000. And once again, this table is a pretty big simplification from the real world. There's probably a lot of scenarios where you would have to pay $500 or $600 or whatever it might be. But let's just go with this. That's essentially a simplification. There's a 70% chance that he's going to have to pay $1,000, and so that's $700 expected cost from that, plus the $8,000 from the insurance gets us to $8,700. So let's write that down. So $8,700 ... My pen is really acting up. I don't know what's going on here. I think I have to get a new tablet. You can't even read that. Let me write this. $8,700. Including the cost of insurance, what are Paul's expected total medical costs with the high-deductible plan? Round your answer to the nearest cent. Let's look at the high-deductible plan. He's going to pay $7,500 no matter what, $7,500 no matter what, and then there's a $0 ... We could write $0 times 30% or 30% times $0, but that's just going to be $0. There is a 25% chance he spends $1,000, so plus 0.25 times $1,000. There is a 20% chance, plus 0.2, he's not going to spend $4,000 here. He's going to have to spend the first $2,500. So it's a 20% chance he spends $2,500, so times $2,500. Insurance company will pay the next $1,500. Plus another 20% chance. Even in this situation, he only has to pay $2,500, so times $2,500, $2,500. And then finally, plus there's a 5% chance. Even in this situation, he only has to pay the first $2,500, times $2,500 gets us to $8,875. So $8,875. Once again, you could think about it as, OK, there is a 25% chance that he pays $1,000, and then there is a 45% chance that he pays $2,500. All of these situations, he is paying $2,500. But either way, you would get $8,875. If Paul wants the best payoff in the long run and must buy 1 of the 2 insurance plans, he should purchase the? Well, his expected total cost of insurance, including medical costs, is lower with the low-deductible plan. So this one, he should go with the low, low-deductible. Which, once again, you shouldn't use these videos as insurance advice. This is actually ... But also, it's an interesting way to think about it. It's typically ... Well, it's not always typically the case that the low-deductible plan is going to have a higher long-term ... or the low-deductible plan is going to be a better deal. It's usually the ... Well, I won't make any actuarial statements. But at least in this situation, the low-deductible plan seems like the better deal. He has lower expected total costs given these probabilities.