4 ms·

> 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 f

> 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 ago
  If the answer to the first question is "yes", how could it be ethical to answer "no" to the second question?
  - jrs235 11y ago
    Fair 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)?
    - npsimons 11y ago
      I would love to live in a society with those problems. Right now, we're still squabbling over issues like those mentioned in the article. My only comeback to your initial question is: why does the 80yo need a kidney? Is it because he burned the old one out with drugs? I'm all for holding people accountable for health problems they can prevent (like obesity - many health insurance plans give you a discount (rightfully so) for being in the healthy BMI range), but the problem comes up when insurance is run as a business, and of course the first way to cut costs (and increase profits) is to stop insuring those who you know will cost more (whether it's their fault or not).
      - pavel_lishin 11y ago
        Who gets to decide what's a morally acceptable way to become injured and what isn't? If the 80 year old has turned their life around at 65, and has been mentoring at-youth kids, do we still reject them for their earlier mistakes? Should we give it to a 25 year old who injured himself playing hockey, despite that being a high-risk activity as well? If there is a scarcity and we can't heal everyone, those choices have to be made, but my original context was that the answer is that we can afford to help everyone. In that situation, I don't think there's an ethical reason to not help everyone.
- deleted 11y ago
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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 ago
If the answer to the first question is "yes", how could it be ethical to answer "no" to the second question?
- jrs235 11y ago
  Fair 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)?
  - npsimons 11y ago
    I would love to live in a society with those problems. Right now, we're still squabbling over issues like those mentioned in the article. My only comeback to your initial question is: why does the 80yo need a kidney? Is it because he burned the old one out with drugs? I'm all for holding people accountable for health problems they can prevent (like obesity - many health insurance plans give you a discount (rightfully so) for being in the healthy BMI range), but the problem comes up when insurance is run as a business, and of course the first way to cut costs (and increase profits) is to stop insuring those who you know will cost more (whether it's their fault or not).
    - pavel_lishin 11y ago
      Who gets to decide what's a morally acceptable way to become injured and what isn't? If the 80 year old has turned their life around at 65, and has been mentoring at-youth kids, do we still reject them for their earlier mistakes? Should we give it to a 25 year old who injured himself playing hockey, despite that being a high-risk activity as well? If there is a scarcity and we can't heal everyone, those choices have to be made, but my original context was that the answer is that we can afford to help everyone. In that situation, I don't think there's an ethical reason to not help everyone.
deleted 11y ago
[deleted]