Older pilots and basic med

Lindberg said:
Sure, there are some folks who do it just because they hate the FAA, but even around here, the advice to go on Basic Med is often given to people from whom obtaining a 3rd Class would be difficult or impossible. That could be for reasons that we consider arbitrary or capricious, but how's an insurance company going to distinguish between the pilot who just hates the FAA from the pilot who hunts down a DOT clinic where the doc doesn't know or care what conditions the FAA considers disqualifying?
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I do basicmed because my PCP fills out the form at my yearly checkup, I can pass a class 3 but why bother?
Lindberg said:
Insurance is risk transfer in exchange for a premium. The insurer gets to set the terms on which it will accept the risk. The insured gets to decide if those terms are better than self insuring.
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It's legal gambling. You're betting you're going to crash, the insurance company bets you won't, and as always, the odds favor the house.
 
Lindberg said:
Maybe for the same reason my AME, who lives for aviation and pilots, stopped doing Basic Med exams. In his words, everyone coming to him for Basic Med had an issue with getting a 3rd Class.

Sure, there are some folks who do it just because they hate the FAA, but even around here, the advice to go on Basic Med is often given to people from whom obtaining a 3rd Class would be difficult or impossible. That could be for reasons that we consider arbitrary or capricious, but how's an insurance company going to distinguish between the pilot who just hates the FAA from the pilot who hunts down a DOT clinic where the doc doesn't know or care what conditions the FAA considers disqualifying?

We've even had discussions here about how conditions that disqualify you from a 3rd Class don't necessarily disqualify you from Basic Med. The insurance companies know that too. You're going to say it doesn't matter because those conditions don't make you any less safe to operate. But you (and the insurance company) don't know that for every such condition, nor do you know which condition(s) every Basic Med holder has.

Insurance is risk transfer in exchange for a premium. The insurer gets to set the terms on which it will accept the risk. The insured gets to decide if those terms are better than self insuring. Pilots who complain that a lack of insurance is keeping them on the ground are really saying they're unwilling or unable to meet the insurance company's terms AND are unwilling or unable to self insure on better terms.
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this ^^^^^^^^^^ And people dont want to accept that the Basic Med group is generally going to have issues that they either rightfully or wrongfully believe that getting a Class III will be difficult or impossible. And as mentioned above - its not the entire group, but it is a significant portion.

Bob Noel said:
your are comparing apples and colors.

Experiencing a hurricane in FL is not a risk, it's a certainty.

Experiencing fire and floord and earthquake in CA isn't a risk, it's a certainty.

ok, sure, a certainty is technically just a risk with a 100% probability of occuring.
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And this isnt true. If you want to take the entire pool in California or Florida - that isnt certain. There are MANY people in Florida who have had minimal impact with hurricane damage. There are many people in California that have not been impacted with flood. fire or earthquake in california as well. Just as there are many older pilots who dont and continue not to have issues. But saying its a statistical certainty for the others, is also saying that its a statistical certainty that /some/ part of that group of older pilots will experience an inflight health issue. That number is not zero - just like the others arent.
 
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Dana said:
I do basicmed because my PCP fills out the form at my yearly checkup, I can pass a class 3 but why bother?

It's legal gambling. You're betting you're going to crash, the insurance company bets you won't, and as always, the odds favor the house.
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and thats what BasicMed is intending to do. But guess what - just look at the medical board here and others - there are a ton of people who are moving to BasicMed because there is some requirement or threshold that they will have difficulty to meet. And they dont want to risk losing their flying privileges. And they are going to BasicMed because it is easier for them to obtain. Insurance companies know this (that a large portion of the group are ones that dont want to comply with SI's ) - because if that wasnt the case - then everyone can get BasicMed and forget about the FAA medical process completely.The insurance companies are treating BM as a "lower" standard for pilot privileges. And in reality - thats probably what it is - because there are very few people that can probably pass a class I,II, III and not be able to pass BM, whereas the reverse is true more than we want to probably acknowledge.
 
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Dana said:
I do basicmed because my PCP fills out the form at my yearly checkup, I can pass a class 3 but why bother?
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You missed my point. How is the insurance company to distinguish you and the pilots who are in BM because they can't pass a 3rd Class?
Dana said:
It's legal gambling. You're betting you're going to crash, the insurance company bets you won't, and as always, the odds favor the house.
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I do not consider having an insurance claim "winning." The "odds favor the house" in the same sense that the "odds favor the house" when you buy a Big Mac. It's a voluntary exchange where the insurance company, or McDonald's, sets the price for a product and you buy it or don't. Thinking of insurance premiums as a down payment on an insurance payout is less accurate than thinking of them as compensation to the insurer for assuming your risk.
 
Lindberg said:
You missed my point. How is the insurance company to distinguish you and the pilots who are in BM because they can't pass a 3rd Class?
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They can't, of course. Just like the insurance company can't predict when any one customer will die. But with a large enough group, they can predict with good accuracy how many of the group will die in a given year, and set their rates accordingly.

But my point was simply that not all of us on basicmed do it because we can't pass a medical or "hate the FAA".
Lindberg said:
I do not consider having an insurance claim "winning." The "odds favor the house" in the same sense that the "odds favor the house" when you buy a Big Mac. It's a voluntary exchange where the insurance company, or McDonald's, sets the price for a product and you buy it or don't.
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When you buy a Big Mac you know what you're going to get. When you buy insurance, the outcome is unknown... neither you nor the insurance company know if you'll have an accident, just like you don't know how the dice will fall. You pay your money and take the chance. That's gambling in my book.
 
Dana said:
When you buy a Big Mac you know what you're going to get. When you buy insurance, the outcome is unknown... neither you nor the insurance company know if you'll have an accident, just like you don't know how the dice will fall. You pay your money and take the chance. That's gambling in my book.
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I guess that's one way to look at it. But it's not really how the transaction is structured. When you buy insurance, you know what you're going to get: An agreement from the insurer to accept a transfer of certain risks. Whether those risks materialize is not a function of the transaction. Just like you don't know if that Big Mac is going to give you food poisoning....
 
I think a big part of the problem is that there may not yet be enough data available for the insurers to make a statistically-valid assessment of the risk. In that circumstance, I can see how they could conclude that it is best to err on the side of caution. I can see how that would apply to insurers of the physicians doing the exams as well.
 
Palmpilot said:
I think a big part of the problem is that there may not yet be enough data available for the insurers to make a statistically-valid assessment of the risk. In that circumstance, I can see how they could conclude that it is best to err on the side of caution. I can see how that would apply to insurers of the physicians doing the exams as well.
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If seven years and 80,000 is too small a sample, the event in question must be extremely rare.
 
Anthem said:
this ^^^^^^^^^^ And people dont want to accept that the Basic Med group is generally going to have issues that they either rightfully or wrongfully believe that getting a Class III will be difficult or impossible. And as mentioned above - its not the entire group, but it is a significant portion.
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Does anyone recall what percentage of deferrals and SI applications turn out to conclude in issuance of a medical certificate? Seems to me it was pretty high. For people in that group, the bottom line tipping the scales in favor of BasicMed is likely the extra expense, and the likelihood of being grounded for a year or so while waiting for the FAA to get around to making a decision.
 
One of the most common causes -- some sources say the most common cause -- is gastroenteritis. Is there a reason to believe that BasicMed pilots would be more likely than Class III pilots to suffer from that?
 
Stewartb said:
Because Federal law says it’s an acceptable means for certifying private pilot health? I’m surprised a lawyer hasn’t taken on an insurer over it.

My BasicMed exams are more health driven than any 3rd class exam I ever had.
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Sure. So go fly. No one is stopping you from flying. You are legal to fly as long as you adhere to the provisions set out in Bm.

Oh you want another company to mitigate or reduce your financial risk in case something happens ? - AND they can’t come up with their own risk assessments to determine what they want to do and how much ?
 
Palmpilot said:
Does anyone recall what percentage of deferrals and SI applications turn out to conclude in issuance of a medical certificate? Seems to me it was pretty high. For people in that group, the bottom line tipping the scales in favor of BasicMed is likely the extra expense, and the likelihood of being grounded for a year or so while waiting for the FAA to get around to making a decision.
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It's over 99%. The FAA brags about that from time to time.

And you're exactly correct. My SI 3rd class was for an autoimmune condition. I could pass a 3rd class today, and my condition has improved dramatically, but the FAA would require annual testing which my doctor deems unneccessary. Plus, every year I'd be risking some new bozo in OKC, who is not a specialist in this area and who has never examined me, deciding to bounce me. There's simply no compelling reason for me to risk my ability to fly.

Nope. Ain't gonna play that game. No sir.

And I'd bet many other Basic Med pilots have similar stories. Certainly the ones I know do.
 
Half Fast said:
My SI 3rd class was for an autoimmune condition. I could pass a 3rd class today, and my condition has improved dramatically, but the FAA would require annual testing which my doctor deems unneccessary. Plus, every year I'd be risking some new bozo in OKC, who is not a specialist in this area and who has never examined me, deciding to bounce me. There's simply no compelling reason for me to risk my ability to fly.
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And there is a cost. If your doctor does not feel it is medically necessary, you are going to have to pay for annual testing out of pocket.

Friend of mine went to Light Sport because he did not want to pay for an annual stress test his insurance would not cover.
 
Half Fast said:
…There's simply no compelling reason for me to risk my ability to fly.

Nope. Ain't gonna play that game. No sir.

And I'd bet many other Basic Med pilots have similar stories. Certainly the ones I know do.
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Yep. Recurring kidney stones. Getting the periodic treatment my urologist recommends, not an arbitrary annual obstacle course.

My only wish? That BasicMed could be used for Commercial operations not involving carrying passengers for hire. But grateful for my current options regardless.
 
Stewartb said:
Because Federal law says it’s an acceptable means for certifying private pilot health? I’m surprised a lawyer hasn’t taken on an insurer over it.
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I'm not since they (1) can't find the client willing to pay for it and (2) they know they'd probably lose. The courts are not likely to interfere with underwriting decisions whether it be annual flight reviews (the FAA says once every two years is acceptable) , minimum time in type (the FAA says ratings and endorsements are enough), or medical certificate requirements.
 
midlifeflyer said:
I'm not since they (1) can't find the client willing to pay for it and (2) they know they'd probably lose. The courts are not likely to interfere with underwriting decisions whether it be annual flight reviews (the FAA says once every two years is acceptable) , minimum time in type (the FAA says ratings and endorsements are enough), or medical certificate requirements.
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Well, I dunno, probably, but...if I recall the example of manufactured housing comes to mind. Manufactured housing meets all national codes and engineering requirements, just as stick-built structures, yet for a time insurors charged a premium for insurance over stick-built housing of similar if not identical specs because, well, it was manufactured housing. Additionally, "manufactured" was used as a pejorative in marketing, zoning or other situations as it implied lesser quality not in evidence. The manufactured housing industry filed suit and won relief on the basis of unfair discrimination.

I wonder if the same or similar theory might prevail in a Basic Med vs. Class 3 discrimination suit. Both are acceptable health certifications to the FAA administrator, and both use identical criteria for examinations. Of course, age is an acceptable basis of discrimination for insurance rating purposes, but is offering coverage to a class 3 vs denying a Basic Med when the exam criteria is precisely the same and all else is equal? Dunno, but might be a valid question for a finder of fact.
 
The answer is to eliminate the Class III medical and put BasicMed in its place.
 
Chip Sylverne said:
I wonder if the same or similar theory might prevail in a Basic Med vs. Class 3 discrimination suit. Both are acceptable health certifications to the FAA administrator, and both use identical criteria for examinations.
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(Italics mine)

That’s not actually true, is it? The checklist for BasicMed, while comprehensive, has different criteria for what is acceptable for safe flight. The checklist simply confirms that all particular areas were “examined”, with no clear criteria for what is safe for flight and what might not be. I mean, when might an examined anus be unsafe for flight? And, critically, fail to meet the “criteria“ for BasicMed and there’s nothing stopping you from seeking out a more liberally inclined doctor. Quite different from failing a Class 3.

Note: I’m not arguing against a successful BasicMed exam be treated as a Class 3, nor that BasicMed flyers are less safe, just that the criteria, such as they are, are not identical.
 
Capt. Geoffrey Thorpe said:
It makes a lot of sense that a 5 minute visit with a doctor would be so much better at predicting how well a geezer can handle an airplane than an hour or so with a flight instructor.
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Or the complete physical I get every year by the same doctor (who I see for any issues).

Let's see, what my doc does that a Class 3 does not do. EKG, Pulmonary Function Test, actual hearing test, complete blood workup (last time it was 7 tubes).
 
Ok, then let's say "qualitatively, quantitatively and materially similar criteria" for examination, derived from the same checklist of medical conditions to be examined.

BTW, I've been getting medicals for 35 years, and not once have I had an AME demand a rectal examination. So I guess the question really is when is an unexamined anus unsafe for flight?
 
Chip Sylverne said:
Ok, then let's say "qualitatively, quantitatively and materially similar criteria" for examination, derived from the same checklist of medical conditions to be examined.
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Maybe for examination, but not for "passing." The medical criteria to legally fly with Basic Med are different from those to legally hold or fly with a 3rd Class.
 
Lindberg said:
Maybe for examination, but not for "passing." The medical criteria to legally fly with Basic Med are different from those to legally hold or fly with a 3rd Class.
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Ok, but either is acceptable to the FAA, the regulatory agency, to legally operate a certain category and class of aircraft under certain limits. One is based on the opinion of a state licensed physician, the other is based on the opinion of CAMI.

As a practical matter, the examinations are similar enough that the FAA doesn't discriminate between them. Over age 80, an owner can fly a Comanche under basic med, or a class 3. Why shouldn't an owner be able to insure it under either one at a premium commensurate with the risk? As of now, there is no reason to believe Basic Med poses any higher risk than Class 3, per the FAA report to Congress posted previously in this thread.

Why should it be acceptable for an insuror to discriminate when the regulator doesn't?
 
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Bob Noel said:
your are comparing apples and colors.

Experiencing a hurricane in FL is not a risk, it's a certainty.

Experiencing fire and floord and earthquake in CA isn't a risk, it's a certainty.

ok, sure, a certainty is technically just a risk with a 100% probability of occuring.
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A pilot becoming incapable to fly at some point is a certainty.
 
Half Fast said:
Well, not exactly. Congress created Basic Med, not the FAA. The FAA had it forced upon them legislatively. They have no legal choice but to accept it.
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Distinction without a practical difference, no?
 
Chip Sylverne said:
BTW, I've been getting medicals for 35 years, and not once have I had an AME demand a rectal examination. So I guess the question really is when is an unexamined anus unsafe for flight?
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The medical requirements originated as a copy of the military medical requirements. The rectal examination probably originated as a way for flight surgeons to stick it to those arrogant fighter pilots.
Chip Sylverne said:
Distinction without a practical difference, no?
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Congress required the FAA to implement basicmed, but the FAA hacked it up as much as they could.
 
Chip Sylverne said:
Distinction without a practical difference, no?
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No, it's not. Don't expect the FAA, especially OKC, to do anything to defend or promote Basic Med beyond the bare minimum. It's not theirs, and they're not likely to tout it to the insurance industry.
 
How is an insurance company requiring a pilot over age x getting a Class III and not requiring a Class III for a pilot under age x not age discrimination?
 
EdFred said:
How is an insurance company requiring a pilot over age x getting a Class III and not requiring a Class III for a pilot under age x not age discrimination?
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Insurance companies have always factored age into their premiums as it directly affects risk.
 
Dana said:
Insurance companies have always factored age into their premiums as it directly affects risk.
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Yes, but that's a different question. Age is legitimate rating criteria based on risk profile. As it stands now, early data doesn't support that the type of medical clearance a pilot receives in order to legally fly an aircraft meeting the restrictions of basic med is a statistically significant risk factor.
 
Half Fast said:
No, it's not. Don't expect the FAA, especially OKC, to do anything to defend or promote Basic Med beyond the bare minimum. It's not theirs, and they're not likely to tout it to the insurance industry.
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I wouldn't expect the FAA to. Their ox got gored. But I sure would expect AOPA to, but that's fodder for a different discussion. Suffice it to say that the FAA is powerless to take away what Congress bestowed. So as much as the CAMI folk may dislike it, they have to live with it.
 
Dana said:
Insurance companies have always factored age into their premiums as it directly affects risk.
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Yeah, but this isn't a premium bump, (teen drivers also get one) this is a requirement not asked of those under a certain age.
 
EdFred said:
How is an insurance company requiring a pilot over age x getting a Class III and not requiring a Class III for a pilot under age x not age discrimination?
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Insurance has always allowed age discrimination. You are trying to apply something like employment law to something completely different. They are allowed to use it and I’m sure will always do so. There is no way they will be able to operate something like life insurance if they don’t factor age in to the equation. Or even vehicle insurance for new 16 year old drivers.
 
The difference isn't simply age. The difference is the discrimination against one of two equally valid measures of medical fitness and capacity to operate an aircraft within a certain category and class triggered by age of the pilot. At age 80, the opinion of your personal physician must be superseded by the opinion of a government agency if you are to obtain insurance, the opinion of which data to this point proves to be of no better predictive value.

Additionally, the government's opinion, though no more predictive, may require certain expensive and time consuming tests which place an increased burden on the the older pilot.

Insurance can only discriminate against you if there is in fact greater risk. It could be argued that a Basic Med pilot in fact presents no greater risk than a Cl3 after age 75 or 80 than before.
 
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Chip Sylverne said:
The difference isn't simply age. The difference is the discrimination against one of two equally valid measures of medical fitness and capacity to operate an aircraft within a certain category and class triggered by age of the pilot. At age 80, the opinion of your personal physician must be superseded by the opinion of a government agency if you are to obtain insurance, the opinion of which data to this point proves to be of no better predictive value.

Additionally, the government's opinion, though no more predictive, may require certain expensive and time consuming tests which place an increased burden on the the older pilot.

Insurance can only discriminate against you if there is in fact greater risk. It could be argued that a Basic Med pilot in fact presents no greater risk than a Cl3 after age 75 or 80 than before.
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But they do. They have a much higher prevvalance of CAD than do certified (1st-2nd-3rd) class pliots. We knew that back in 2016 (Published at the ASMA meeting) and that's just ONE "peril". It is indeed a lower standard. And the capital markets (secondary insurors) are free to do what they think is fit. And the primary insurors ARE free to add up their costs to their loss ratios.....
 
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