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Your insurer wants to know everything about you
- Canada 11y agoThe more such data becomes required, the more demand there will be for means to falsify it.
- lumberjack 11y agoIs this good or bad from a societal point of view? It seems like a way to try to calculate and thereby eliminate risk, would be an overall beneficial thing. But then it also seems to make insurance less effective overall. Let's not think about big "evil" insurance companies for a moment. Say there are 10 Amish guys who want to form a risk pool to provide emergency health care for their families. They were just about to finalize the contract when one of them proposes that they take a medical exam beforehand. It transpires that one of them has lung cancer. Why would the other nine allow the poor guy to partake in their risk pooling? If you eliminate risk you also eliminate the need for insurance. This seems like a good thing. But then you also leave a bunch of people helpless. It's an interesting ethical question.
- wfo 11y agoBefore the medical exam the reasoning would have been "any of us could have lung cancer. So we'll all pay so that the one person unlucky enough to have it doesn't have their finances ruined". After the medical exam the reasoning is "we already know who rolled the dice and lost. Fuck 'em, they can suffer on their own, us lucky ones will help each other out and throw the others to the wolves". I know which society I'd prefer to live in. The more we know about who is and is not going to need care the better we are able to see past the veil of ignorance and let our selfishness and greed make our decisions rather than our sense of fairness and community. Having the information certainly helps providers become more efficient, but that efficiency comes at the human cost of throwing anyone who gets sick under the bus. I'm not so sure health insurance should be allowed to be privatized in the first place; it almost inevitably leads to disgusting moral hazard and disaster. But it currently is privatized so I'd say any information private insurers get is a net loss for society.
- x5n1 11y agoThe whole point or insurance is exactly to do what you have described. To pool risk. Insurers are hoping to reduce risk to increase profit while basically destroying the concept of insurance itself. This is exactly why insurance should by law be a non-for-profit enterprise. Making it a capitalist enterprise will always lead to these sorts of games.
- dTal 11y agoIt is an interesting question. But why Amish?
- kspaans 11y agoThat's my favourite argument for nationalized health care (insurance)! _Everyone_ pays the insurance and so the risks can be accounted for actuarially without leaving anyone behind.
- yummyfajitas 11y agoThe problem with this is that it creates moral hazard. There are lots of individual acts which are fun that I might engage in (e.g., gluttony, gay sex, inactivity, smoking, drugs) but which impose potential costs on others. Why is it reasonable for me to enjoy these benefits while others pay the costs? One way to mitigate this would be with Singapore-style high deductible insurance - subsidies only kick in after you've spent 10-20% of your income on medicine. See also "too big to fail", federally subsidized flood insurance, student loan guarantees, etc, all of which have the same problem.
- elipsey 11y ago>> gay sex I heard promiscuous straight people can catch AIDS too! No way that's really true though, right?
- yummyfajitas 11y agoThey can. It's just far less likely. http://www.cdc.gov/hiv/basics/statistics.html http://www.cdc.gov/hiv/basics/statistics.html Simple division (63% of HIV infections / 2% of population) / (25% of HIV infections / 98% of population) suggests gay sex is about 120x as risky as straight sex.
- kspaans 11y agoI think you mean unprotected anal sex, not "gay" sex.
- gambiting 11y ago>>The problem with this is that it creates moral hazard. There are lots of individual acts which are fun that I might engage in (e.g., gluttony, gay sex, inactivity, smoking, drugs) but which impose potential costs on others. Why is it reasonable for me to enjoy these benefits while others pay the costs? Does it not work the exact same way with private insurance? If you require treatment, you increase premiums for everyone, not just yourself. Anyway, I'm personally super happy with national insurance because I simply don't have to think about it. I know that if I need an operation, I will get one. I know that if I have an accident, and they need to send a helicopter to get me, I won't even see the bill for that. If I need to stay in hospital for the next year of my life, I won't see the bill. If I lose my job and become homeless I'm still going to be covered. I don't need to worry which hospital to go to, or which doctor/dentist can see me - they all can, there's no receipt produced, it's simply not a worry I have. Right now I pay about ~$100USD a month for the national health insurance, and it's an amount I am extremely happy to pay. Why would I care that other people are having accidents or smoking?
- forgotpwtomain 11y ago> Let's not think about big "evil" insurance companies for a moment. Say there are 10 Amish guys who want to form a risk pool to provide emergency health care for their families. They were just about to finalize the contract when one of them proposes that they take a medical exam beforehand. It transpires that one of them has lung cancer. Why would the other nine allow the poor guy to partake in their risk pooling? We aren't talking about big "evil" insurance companies, we are talking only about the measure of success in a capitalist economy - and from that point of view insuring the 10th guy will constitute a loss. On the other hand as a society we actually can afford to treat the 10th guy with cancer and if that we aren't doing so is an ethical failure not an economic one.
- npsimons 11y ago> On the other hand as a society we actually can afford to treat the 10th guy with cancer and if that we aren't doing so is an ethical failure not an economic one. Whatever else may be said about health care and insurance, I feel it boils down to two questions: can we afford to cover everyone, and should we?
- pavel_lishin 11y agoIf the answer to the first question is "yes", how could it be ethical to answer "no" to the second question?
- jrs235 11y agoFair answer. The question is, what amount or level of coverage is used to determine affordability. Should we, ethically, user resources to transplant a kidney in an 80 year old which might extend their life by 5 years or should we use those resources to treat more individuals with less severe issues that will likely extend their life for a longer period of time? Time and qualified doctors are limited resources. How do we determine how to allocate then? Where are we starting the line on what and when to treat certain conditions (and to determine affordability)?
- cousin_it 11y agoFrom a societal point of view, I feel that healthcare should be available to everyone regardless of ability to pay. That makes it more like redistribution than insurance. Describing it as "insurance" is just a way of selling the idea to people who believe in markets, and it backfires in exactly the way you describe when insurers begin to discriminate.
- ams6110 11y agoExactly. We need to stop calling it "insurance" if that's not what it is.
- lisivka 11y agoI will damage my health a little just to stay in hospital forever for free.
- efes 11y agoI would rather allow you to do that than require you to harm other people if you want to be provided for in an institutional setting.
- mkj 11y agoEven if it is beneficial, their calculations of risk will be imprecise causing unjust penalties.
- aburan28 11y agoWhat happens when they get a copy of your genome?
- littletimmy 11y agoJust put insurance in the public sphere, and we don't need to contend with these parasitic corporations who profit of people's health.
- grecy 11y agoEliminate insurance altogether. Even if everyone paid the same amount of money they do today into a huge pile, and accidents were paid out of that pile, there would be an enormous amount left over because nobody is making a profit. Insurance is just a middle man taking their cut
- ams6110 11y agoThe profit of insurance companies is hardly significant in the general problem of health care costs. It's nothing close to an "enormous amount" relative to total health care spending.
- lordnacho 11y agoBefore we venture into whether it's good or bad, here's a couple of observations. 1) The point of insuring is to reduce tail risk. If you have a 1/1000 years chance of your house getting flattened in an earthquake, you want to spread that bill over 1000 years. If you don't you might get away with it most years, but you'll have a new house to buy if you're unlucky. To contrast, if your house is flooded every other year, someone insuring you will ask you for roughly half the likely damages each year. That's not smoothing it out by much, and you might as well save up for the inevitable. 2) If you're going to smooth out risk, you need to know what the risk is. For that, you'll need information. For instance if women are less likely than men to get themselves hurt while driving sports cars, you will want to know whether someone is a man or a woman. If old people are more likely to get cancer, you want to know how old someone is. 3) If you do not heed the above observation, there's something called adverse selection that will get you. Suppose you have a bunch of high risk people mixed with low risk people. You'll calculate a premium that's somewhere in between the two pools. The problem is the low risk people will look at it and conclude it's expensive for them, and they'll be less likely than you'd realised to sign up. So you then get a bunch of high risk people who think it's a great deal signing up, getting killed in accidents, and costing you more than you thought likely. It also means if you as a low risk person got into an accident anyway, you'd be without insurance. So is it good that insurance companies want more and more info? For the most part, yes. It lets them price the premium more precisely, which helps everyone get insured. We'll be able to pay for unlikely events at a cost that reflects the likely average. And you wouldn't be paying for people who are more risky, and you wouldn't be receiving anything from people in lower risk groups. One thing to look out for is how we treat expensive-to-insure people. Even if there's going to be a more accurate price for them, they may be very small groups whom the insurance companies decide aren't worth the effort. For instance if we know that 80% of people with the BRCA2 gene will get cancer by age 50, you're going to calculate a huge cost for them. You'd be collecting money from 5 people to hand it out to 4 of them, plus the expense of handling a claim. One interesting thing about this new information fountain is you can lose money by having tests done. Say you have a parent with BRCA2, and people who aren't tested have a 40% chance. WTF do you do then? You will either pay a huge premium or barely anything.
- eternalban 11y agoHere you go Google ..
- aburan28 11y agoRecently I started noticing ads from my insurer when I was up late stating the "benefits of going to sleep early" and "why sleep is essential". This business is going to get real sketchy in my opinion
- jrcii 11y agoIf I'm not putting words in your mouth, and maybe I'm just projecting here, but I think the disturbance you're expressing stems from the imbalance inherent in the idea of a faceless corporation and their semi-autonomous mechanical agents (code) having access to intimate, personal knowledge of you while you have no access to knowledge about them. This is compounded by the motivation being to extract money from you. If a friend knew and felt your sleep pattern was problematic I'm sure you wouldn't mind - in that case personal knowledge is reciprocal, voluntary, and not motivated by money.
- vollmond 11y agoCouldn't that be innocent, though? Can't an advertiser run different ads based on time of day? You were up at night, so you saw the nighttime ads (for your geolocation).
- aburan28 11y agoIf it was innocent then I guess the question is why did they target me for ads and who determines a normal sleep schedule? That means that are using tracking cookies at some level. I should also note it happened multiple times and I have never once seen my insurance advertising
- pavel_lishin 11y ago> why did they target me for ads Because you were a human being who was up late. > who determines a normal sleep schedule Researchers and statisticians.
- gotchange 11y ago
- jeffdavis 11y agoThe more someone has a vested interest in your behavior, the less freedom and privacy you will have. That goes for health insurance companies, which want to accurately price in things like your diet and sleep. But the same principle applies to government social programs. All money comes with strings attached.