Perfect. Then maybe this will make sense.
In selling the older and less efficient gear, the customers will continue to have more issues and it will cost them more in the long run and their satisfaction levels will decrease.
However, the incentive program the insurance company has the opposite effect. It will increase the patients (customers) well-being (satisfaction levels) and cost the insurance company less in the long run.
Unfortunately, the same model doesn't map equally to live, human beings that are unpredictable, intelligent and their own moral agents.
Also, we actually don't know on a case by case, or overall basis, whether or not
it does actually help. A human biological generation is at least 40 years, so it is no surprise (to me) the culture of allergies, alleged autism spectrum, and aggressive diseases coming out now - almost exactly 40 years after the MMR vaccine became mandatory. We use mice and lab animals because we dont have to wait as long to see the changes in generations. The "satisfaction" levels are also subjective, as most of the "eligible" people getting these shots are pre-pubescent.
And, as said, it is very profitable for insurance companies to be the middle man - in healthcare, and other industries (auto insurance, for example.) The insurance companies lobby pharmaceuticals on their own, and they do a dance to establish a price
the insurance company is fine taking. The payers take most of the risk.
But, if someone is chronically ill, they are
dependent on healthcare and insurance - because part of the song and dance pharmaceutical and insurance companies do is make sure a customer wouldn't dare
stop paying for insurance, and try to get medications on their own. The prices are set so that "insurers" become the
only resort for chronically ill persons.
I wasn't explicit before, but I am talking about real commodities - "futures" of healthcare. A chronic, paying customer will stay a paying customer, but a healthy person can always change insurance carriers that offer minimal coverage, or not get insurance at all. (I am not the only one disillusioned with the entire medical and insurance industry.) Moreover, healthier people are more likely to
move than a chronically ill person that had grown comfortable with their healthcare, and doctor.
So, over the long term insurance companies profit hugely on chronically ill patients - especially those who depend on insurance for medication. Healthy people are traded as if you are short-selling, and chronically ill patients are traded as commodities. Both of those are ideal for their respective capitalistic trading vector. Acute illness patients, or patients that need surgeries do not fit in this category.