6 ms·

I am a member of a community that takes care of its members. We are not perfect at it, but then neither are the more common social mechanisms like insurance.

by sverige 10y ago

I am a member of a community that takes care of its members. We are not perfect at it, but then neither are the more common social mechanisms like insurance. I recently had major surgery. The tremendous costs incurred are being paid. As fragmented as society is today, I can understand why people believe insurance is an absolute necessity, but I also believe that mechanisms like insurance contribute to and frequently cause that fragmentation. Insurance in particular warps normal market forces. For example, it seems likely to me that the very existence of huge pools of insurance money has contributed greatly to the hyperinflation in health care costs that has continued unabated and really unopposed for the last two generations. My mother told me recently that it cost a total of $80 for her to give birth to my sister in a hospital in 1959. I'm sure the billed cost for hospital birth today is many times that amount. That is an example of the great harm that insurance can do to society, as opposed to any perceived good.

avar 10y ago
> I am a member of a community that takes > care of its members. So you and your friends / family / community / church / cult / whatever are essentially implementing an insurance scheme, and yet you think insurance is a bad thing? > Insurance in particular warps normal > market forces. So would not having insurance and instead having everyone having to set up some ad-hoc insurance scheme as part of their own community.
- vanderZwan 10y ago
  I suspect the implication is that he believes insurance as a market is a bad thing
- ozim 10y ago
  Yes because insurance is instutionalized by for profit organizations that do not care about well beeing of those that buy insurance. Where church, family can be more down to earth and driven by moral obligations towards person that needs help. That is how I seen stuff working in asian societies, if you are not helping your fellows you quickly find out that no one will help you. Where for profit institution has all incentives to not help or help as little as they are obliged. They also can spend more on legal help which will protect them from spending. Predatory insurance companies are not insuring people who are likely to get sick. Family or church will provide help despite they know that person will have expensive treatment. Sad thing is that more and more people find themselves with no close family, organizations, because of how society in western countries (cities) develops.
  - tankenmate 10y ago
    World wide there are a large number of mutual organisations (member owned, democratic, member led organisations) that provide insurance. Indeed for a couple of hundred years this was the biggest segment of the insurance industry. If you don't want to hand over the gains to a private (or publicly) owned insurer then join an insurance mutual, or if one doesn't exist then start one.
  - valuearb 10y ago
    You are a little judgmental if you think that no insurance companies care about the welfare of their customers. If an insurance company doesn't care about customers, soon it has none. GEICO was founded because they though they could provide needed insurance cheaper direct through the mail, rather than through an expensive army of sales-people. They've saved their customers huge amounts of money over the last 60 years (for disclosure, I don't work for or use GEICO, I actually use USAA which is based on same premise). In church, you have a leader who is milking the flock for an unconscionable amount of tithing, and a bunch of people milking their religious connections to get more business. Of course they will all tell you to help each other out, it's part of how they scam the flock. And insurance can only work if it's priced according to it's risks. If you have an expensive illness or are likely to get one, it's actually selfish to think that an insurance company will take a massive loss to help you out. If you had purchased medical insurance from the company before you got sick, you'd still be covered and your costs/risks would have been part of a large pool that was correctly priced at the time. That's the problem with Obamacare, people wanting a free lunch. It destroyed the private insurance market by banning the consideration of prior health conditions, so now only sick people buy Obamacare. Before Obamacare I paid $400 a month for a $5,000 deductible coverage for my family. My first year of the ACA a similar plan cost $1,100 a month, second year $1,300 a month, and this year it's $1,800 a month. So now my family is on short term insurance and if I get sick it ends after 6 months. Plus I get to pay massive tax penalties for the privilege of having insurance that's not ACA approved. I'd like to go back to my old plan but the ACA banned it.
    - eutropia 10y ago
      >> That's the problem with Obamacare, people wanting a free lunch. It destroyed the private insurance market by banning the consideration of prior health conditions, so now only sick people buy Obamacare. This isn't true. The incentive of paying penalties is so that young healthy people like me get insurance, so that I can dilute the risk pool for my sicker, fellow citizens. Insurance companies denying you based off of pre-existing conditions was the status quo because it was profitable (for the insurance companies, not for society at large) to insurance mostly healthy people. However, those sick people still need care, and so they end up at the hospital anyways and in doing so, caused outsized (due to severity) externalized costs (that the insurance companies got to avoid by pitting it onto hospitals / government programs). I notice that everyone who claims the ACA's fundamental premise of getting more people into the insurance pool is flawed also mentions their insurance premiums going up. The people (companies) getting a free lunch in this country are those who get to externalize the true and total costs of their actions.
rb666 10y ago
You're living in a bubble. Almost all civilised countries have some form of single payer healthcare with for example required minimal insurance. It's the US that has hyperinflated healthcare simply because you do not regulate.
- abtinf 10y ago
  > you do not regulate Inflation of healthcare costs is directly caused by government regulation.
  - frgtpsswrdlame 10y ago
    Perhaps you could explain this more? It seems to me that many first-world countries regulate much more than the United States (ie single payer or similar) and have lower costs.
    - seanp2k2 10y ago
      This. The result here is if you run out of money, sorry pal, you're worthless to society, game over, no one cares, literally go die.
    - Xixi 10y ago
      Not all regulation is born equal. When the single payer is also the regulator (which is the case for nationalized healthcare), regulation is introduced to limit the costs. When the regulator is being reelected thanks to the money given to it by the players, there's much more variance in the outcome of the regulations. There's a lot of bad regulations in the US, on top of my head: public hospitals are not allowed to negotiate the price of medical equipment, so pay 5-10x the price paid in France, for instance. Gross margin of health insurances is capped as a % of the underlying medical cost, so the higher the costs, the higher the profits. US healthcare system is simply crazy. I (and my family) have very very good coverage thanks to my current job, but I'm out of the country as soon as the situation change (not that I'd have much merit doing so: my visa doesn't allow me to change job, so if I'm fired or my employer collapse, we will have to leave anyway).
nickonline 10y ago
Medical insurance in the form that the USA likes to make it might be bad. Something like automotive insurance or disaster insurance is completely different.
Guvante 10y ago
Don't conflate health insurance with real forms of insurance. Health insurance is a weird beast which has an ancillary purpose of what insurance really is. Most notably health insurance was previously used as a tax free way to provide benefits to employees, has always provided access to phenomenally lower healthcare costs and now legally provides some fashion of free preventative care.

by sverige 10y ago

avar 10y ago

> I am a member of a community that takes > care of its members. So you and your friends / family / community / church / cult / whatever are essentially implementing an insurance scheme, and yet you think insurance is a bad thing? > Insurance in particular warps normal > market forces. So would not having insurance and instead having everyone having to set up some ad-hoc insurance scheme as part of their own community.

vanderZwan 10y ago
I suspect the implication is that he believes insurance as a market is a bad thing
ozim 10y ago
Yes because insurance is instutionalized by for profit organizations that do not care about well beeing of those that buy insurance. Where church, family can be more down to earth and driven by moral obligations towards person that needs help. That is how I seen stuff working in asian societies, if you are not helping your fellows you quickly find out that no one will help you. Where for profit institution has all incentives to not help or help as little as they are obliged. They also can spend more on legal help which will protect them from spending. Predatory insurance companies are not insuring people who are likely to get sick. Family or church will provide help despite they know that person will have expensive treatment. Sad thing is that more and more people find themselves with no close family, organizations, because of how society in western countries (cities) develops.
- tankenmate 10y ago
  World wide there are a large number of mutual organisations (member owned, democratic, member led organisations) that provide insurance. Indeed for a couple of hundred years this was the biggest segment of the insurance industry. If you don't want to hand over the gains to a private (or publicly) owned insurer then join an insurance mutual, or if one doesn't exist then start one.
- valuearb 10y ago
  You are a little judgmental if you think that no insurance companies care about the welfare of their customers. If an insurance company doesn't care about customers, soon it has none. GEICO was founded because they though they could provide needed insurance cheaper direct through the mail, rather than through an expensive army of sales-people. They've saved their customers huge amounts of money over the last 60 years (for disclosure, I don't work for or use GEICO, I actually use USAA which is based on same premise). In church, you have a leader who is milking the flock for an unconscionable amount of tithing, and a bunch of people milking their religious connections to get more business. Of course they will all tell you to help each other out, it's part of how they scam the flock. And insurance can only work if it's priced according to it's risks. If you have an expensive illness or are likely to get one, it's actually selfish to think that an insurance company will take a massive loss to help you out. If you had purchased medical insurance from the company before you got sick, you'd still be covered and your costs/risks would have been part of a large pool that was correctly priced at the time. That's the problem with Obamacare, people wanting a free lunch. It destroyed the private insurance market by banning the consideration of prior health conditions, so now only sick people buy Obamacare. Before Obamacare I paid $400 a month for a $5,000 deductible coverage for my family. My first year of the ACA a similar plan cost $1,100 a month, second year $1,300 a month, and this year it's $1,800 a month. So now my family is on short term insurance and if I get sick it ends after 6 months. Plus I get to pay massive tax penalties for the privilege of having insurance that's not ACA approved. I'd like to go back to my old plan but the ACA banned it.
  - eutropia 10y ago
    >> That's the problem with Obamacare, people wanting a free lunch. It destroyed the private insurance market by banning the consideration of prior health conditions, so now only sick people buy Obamacare. This isn't true. The incentive of paying penalties is so that young healthy people like me get insurance, so that I can dilute the risk pool for my sicker, fellow citizens. Insurance companies denying you based off of pre-existing conditions was the status quo because it was profitable (for the insurance companies, not for society at large) to insurance mostly healthy people. However, those sick people still need care, and so they end up at the hospital anyways and in doing so, caused outsized (due to severity) externalized costs (that the insurance companies got to avoid by pitting it onto hospitals / government programs). I notice that everyone who claims the ACA's fundamental premise of getting more people into the insurance pool is flawed also mentions their insurance premiums going up. The people (companies) getting a free lunch in this country are those who get to externalize the true and total costs of their actions.

rb666 10y ago

You're living in a bubble. Almost all civilised countries have some form of single payer healthcare with for example required minimal insurance. It's the US that has hyperinflated healthcare simply because you do not regulate.

abtinf 10y ago
> you do not regulate Inflation of healthcare costs is directly caused by government regulation.
- frgtpsswrdlame 10y ago
  Perhaps you could explain this more? It seems to me that many first-world countries regulate much more than the United States (ie single payer or similar) and have lower costs.
  - seanp2k2 10y ago
    This. The result here is if you run out of money, sorry pal, you're worthless to society, game over, no one cares, literally go die.
  - Xixi 10y ago
    Not all regulation is born equal. When the single payer is also the regulator (which is the case for nationalized healthcare), regulation is introduced to limit the costs. When the regulator is being reelected thanks to the money given to it by the players, there's much more variance in the outcome of the regulations. There's a lot of bad regulations in the US, on top of my head: public hospitals are not allowed to negotiate the price of medical equipment, so pay 5-10x the price paid in France, for instance. Gross margin of health insurances is capped as a % of the underlying medical cost, so the higher the costs, the higher the profits. US healthcare system is simply crazy. I (and my family) have very very good coverage thanks to my current job, but I'm out of the country as soon as the situation change (not that I'd have much merit doing so: my visa doesn't allow me to change job, so if I'm fired or my employer collapse, we will have to leave anyway).

nickonline 10y ago

Medical insurance in the form that the USA likes to make it might be bad. Something like automotive insurance or disaster insurance is completely different.

Guvante 10y ago

Don't conflate health insurance with real forms of insurance. Health insurance is a weird beast which has an ancillary purpose of what insurance really is. Most notably health insurance was previously used as a tax free way to provide benefits to employees, has always provided access to phenomenally lower healthcare costs and now legally provides some fashion of free preventative care.