6 ms·

Because if you don't mandate insurance, then the entire system falls apart. Sick people need it, healthy people don't want to pay for it. You need everyone to p

Because if you don't mandate insurance, then the entire system falls apart. Sick people need it, healthy people don't want to pay for it. You need everyone to pay to make it affordable.

arcbyte 9y ago
If it's cheap enough, everyone will buy it.
subverter 9y ago
Affordable for whom? It has become much less affordable for those who are healthy. How do you justify the healthy paying for the unhealthy? And is it really affordable, even for the unhealthy?
- bjl 9y ago
  > How do you justify the healthy paying for the unhealthy? Because we live in a society, and in a society people help one another.
  - subverter 9y ago
    I absolutely agree that people should help one another. In fact, it's inherently built in to a lot of people. I'm not arguing against that. I'm arguing against being forced to help others who I have no relationship with, live in far off places, hold different health standards than me, etc. Believe me, if a family member of close friend needed help with medical expenses, I'd be the first to volunteer.
    - bjl 9y ago
      But what about the millions of people with poor family/friends? Are they supposed to just roll over and die if they get sick? And don't say 'but charity', we already know charity is massively insufficient.
      - subverter 9y ago
        No, absolutely not. You're assuming that if the government didn't mandate health insurance, nobody would step in to help those people, which I don't believe is true. Lots of different groups – religious, businesses, municipalities, etc. – could fill that role. Individuals could even give directly to strangers in need through something like https://donorsee.com/ https://donorsee.com/.
        frgtpsswrdlame 9y ago
        >You're assuming that if the government didn't mandate health insurance, nobody would step in to help those people No, the assumption is that if government mandated dollars stopped coming in, voluntary contributions wouldn't make up the difference. And that seems pretty obvious to anyone who pays attention to the political dialogue. Look at the Republicans who believe Obamacare is too costly. Their sole goal is to have less of their own dollars subsidize the sick.
        subverter 9y ago
        That's also assuming the costs would stay the same, which they wouldn't if government stopped intervening. With lower costs, more people could afford to pay for healthcare out-of-pocket, which would reduce the amount of voluntary money necessary to cover those who truly need it.
        bjl 9y ago
        >which they wouldn't if government stopped intervening. That's a very strong assumption, and I see no reason to believe its true.
        subverter 9y ago
        Look at health care costs pre- and post-1965. They began increasing in 1965 with the passage of Medicare and Medicaid, and have continued to increase as more and more government regulations have been added since.
    - dragonwriter 9y ago
      > I'm arguing against being forced to help others who I have no relationship with, live in far off places, hold different health standards than me, etc. How is that any difference from defense, law enforcement, fire protection, or property rights standards?
    - thingification 9y ago
      This idea, which lies behind a lot of American libertarianism, says that theft (as taxation is construed here) outranks most or all other moral values, but does not explain why. Instead, it hopes dogmatically that other moral values will be met as a side effect of following this one.
      - subverter 9y ago
        Not just theft, but aggression of any sort, including the most serious offenses such as rape and murder. Is there not a more fundamental moral value that we can all agree on?
        bjl 9y ago
        Equating theft with rape and murder is just one of the reasons rational people ignore right-libertarianism.
        arcbyte 9y ago
        Stealing a mans food can be just as lethal as stabbing him.
    - pjc50 9y ago
      > forced to help others It's good to know that you're against your tax money being used for the most expensive military in the world.
      - subverter 9y ago
        Absolutely.
- gnaritas 9y ago
  > How do you justify the healthy paying for the unhealthy? Over the course of time, everyone falls into both categories; this idea that there are healthy people is silly, everyone's health fails eventually and often randomly. Healthy is a temporary state. Everyone should contribute so everyone is covered when they become the unhealthy, as they all will. Better to pay a little bit all of the time than to pay nothing and be unable to afford a giant medical bill that hits you all at once. This is why everyone should pay all of the time, then there's enough money to cover the every changing subset of people, which will eventually include you, who are sick.
  - subverter 9y ago
    But not everyone is (or becomes) healthy or unhealthy to the same degree. If I have no family history of health issues, or I simply want to take a chance that I'll remain healthy, why should anyone else tell me how much I should value my health?
    - frgtpsswrdlame 9y ago
      It's really about double jeopardy. For a second put yourself behind the veil of ignorance. You are prebirth, you have no control over any factor of your birth other than one. That factor is that you get to pick whether you are born into a country with universal healthcare or one with non-mandated insurance where companies are able to discriminate on pre-existing conditions. Anyone who is risk averse is going to pick the universal healthcare one, otherwise you are risking a life where you are both sick but also bankrupted by medical costs. That some people in society look at the circumstances of their birth and post-hoc reason that they don't want universal healthcare because it wouldn't have benefitted them is not the point really.
    - gnaritas 9y ago
      > But not everyone is (or becomes) healthy or unhealthy to the same degree. Incorrect, everyone gets sick to the same eventual degree: death. You will require medical care. > or I simply want to take a chance that I'll remain healthy No one remains healthy, period, everyone gets sick, everyone.
- dragonwriter 9y ago
  > How do you justify the healthy paying for the unhealthy? How do you justify those whose property isn't on fire paying for firefighters?
  - subverter 9y ago
    I don't. I think paying for firefighters should be voluntary. Either I pay for it individually, or as part of my neighborhood, or at some other level that's much closer to me. If I don't want to protect against my house burning down, why should I pay for it? And before you go and say, "because your neighbor's house could burn down too", they could choose to pay for firefighters and have them come out to douse my house in defense of their own.
    - ajurna 9y ago
      > they could choose to pay for firefighters and have them come out to douse my house in defense of their own. Good to see you support others taking on your risk. This is the essence of universal healthcare.
      - subverter 9y ago
        The point is it's completely voluntary for everyone involved. No one is being forced into anything.
r_smart 9y ago
You're confusing insurance with healthcare. Insurance is supposed to be for risk mitigation, rare but extremely damaging events. If everyone uses insurance for everything health related, like we all want to do now, it's impossible for insurance to be anything other than a premium you pay on top of your healthcare costs. Insurance shouldn't be used for routine stuff, and people shouldn't be required to have it unless they want it.
- subverter 9y ago
  A salient distinction that's very important in the whole debate.
- maxerickson 9y ago
  it's impossible for insurance to be anything other than a premium you pay on top of your healthcare costs. And yet each year there are millions of people that receive medical services in excess of their insurance payments (including premiums, copays, etc).
  - antisthenes 9y ago
    Which doesn't invalidate what the parent comment in any way, because we're talking about the aggregate costs. So what was your point?
    - maxerickson 9y ago
      The premium on top of aggregate cost complaint would also apply to "pure insurance". Or else no one would bother selling it. Anyway, I'm pretty sure they were saying that insurance didn't work, which is manifestly untrue. If they are complaining that it makes healthcare more expensive, well fine, but that is probably more about the principal agent problem than the administrative costs and profits of insurers.
- ZeroGravitas 9y ago
  "insurance" in this case is also a savings account. People need to be forced to put money into the system when young and/or healthy so that's there's enough money available when they are not. If they're not forced to do this, then they won't and people are forced to stand by and watch as they fall ill and due which is bad for the economy and may already disease, even if you don't care about the moral aspects. There's little benefit to seperating these things out and obvious downsides to them not being mandated.

Because if you don't mandate insurance, then the entire system falls apart. Sick people need it, healthy people don't want to pay for it. You need everyone to pay to make it affordable.

arcbyte 9y ago

If it's cheap enough, everyone will buy it.

subverter 9y ago

Affordable for whom? It has become much less affordable for those who are healthy. How do you justify the healthy paying for the unhealthy? And is it really affordable, even for the unhealthy?

bjl 9y ago
> How do you justify the healthy paying for the unhealthy? Because we live in a society, and in a society people help one another.
- subverter 9y ago
  I absolutely agree that people should help one another. In fact, it's inherently built in to a lot of people. I'm not arguing against that. I'm arguing against being forced to help others who I have no relationship with, live in far off places, hold different health standards than me, etc. Believe me, if a family member of close friend needed help with medical expenses, I'd be the first to volunteer.
  - bjl 9y ago
    But what about the millions of people with poor family/friends? Are they supposed to just roll over and die if they get sick? And don't say 'but charity', we already know charity is massively insufficient.
    - subverter 9y ago
      No, absolutely not. You're assuming that if the government didn't mandate health insurance, nobody would step in to help those people, which I don't believe is true. Lots of different groups – religious, businesses, municipalities, etc. – could fill that role. Individuals could even give directly to strangers in need through something like https://donorsee.com/ https://donorsee.com/.
      - frgtpsswrdlame 9y ago
        >You're assuming that if the government didn't mandate health insurance, nobody would step in to help those people No, the assumption is that if government mandated dollars stopped coming in, voluntary contributions wouldn't make up the difference. And that seems pretty obvious to anyone who pays attention to the political dialogue. Look at the Republicans who believe Obamacare is too costly. Their sole goal is to have less of their own dollars subsidize the sick.
        subverter 9y ago
        That's also assuming the costs would stay the same, which they wouldn't if government stopped intervening. With lower costs, more people could afford to pay for healthcare out-of-pocket, which would reduce the amount of voluntary money necessary to cover those who truly need it.
        bjl 9y ago
        >which they wouldn't if government stopped intervening. That's a very strong assumption, and I see no reason to believe its true.
        subverter 9y ago
        Look at health care costs pre- and post-1965. They began increasing in 1965 with the passage of Medicare and Medicaid, and have continued to increase as more and more government regulations have been added since.
  - dragonwriter 9y ago
    > I'm arguing against being forced to help others who I have no relationship with, live in far off places, hold different health standards than me, etc. How is that any difference from defense, law enforcement, fire protection, or property rights standards?
  - thingification 9y ago
    This idea, which lies behind a lot of American libertarianism, says that theft (as taxation is construed here) outranks most or all other moral values, but does not explain why. Instead, it hopes dogmatically that other moral values will be met as a side effect of following this one.
    - subverter 9y ago
      Not just theft, but aggression of any sort, including the most serious offenses such as rape and murder. Is there not a more fundamental moral value that we can all agree on?
      - bjl 9y ago
        Equating theft with rape and murder is just one of the reasons rational people ignore right-libertarianism.
        arcbyte 9y ago
        Stealing a mans food can be just as lethal as stabbing him.
  - pjc50 9y ago
    > forced to help others It's good to know that you're against your tax money being used for the most expensive military in the world.
    - subverter 9y ago
      Absolutely.
gnaritas 9y ago
> How do you justify the healthy paying for the unhealthy? Over the course of time, everyone falls into both categories; this idea that there are healthy people is silly, everyone's health fails eventually and often randomly. Healthy is a temporary state. Everyone should contribute so everyone is covered when they become the unhealthy, as they all will. Better to pay a little bit all of the time than to pay nothing and be unable to afford a giant medical bill that hits you all at once. This is why everyone should pay all of the time, then there's enough money to cover the every changing subset of people, which will eventually include you, who are sick.
- subverter 9y ago
  But not everyone is (or becomes) healthy or unhealthy to the same degree. If I have no family history of health issues, or I simply want to take a chance that I'll remain healthy, why should anyone else tell me how much I should value my health?
  - frgtpsswrdlame 9y ago
    It's really about double jeopardy. For a second put yourself behind the veil of ignorance. You are prebirth, you have no control over any factor of your birth other than one. That factor is that you get to pick whether you are born into a country with universal healthcare or one with non-mandated insurance where companies are able to discriminate on pre-existing conditions. Anyone who is risk averse is going to pick the universal healthcare one, otherwise you are risking a life where you are both sick but also bankrupted by medical costs. That some people in society look at the circumstances of their birth and post-hoc reason that they don't want universal healthcare because it wouldn't have benefitted them is not the point really.
  - gnaritas 9y ago
    > But not everyone is (or becomes) healthy or unhealthy to the same degree. Incorrect, everyone gets sick to the same eventual degree: death. You will require medical care. > or I simply want to take a chance that I'll remain healthy No one remains healthy, period, everyone gets sick, everyone.
dragonwriter 9y ago
> How do you justify the healthy paying for the unhealthy? How do you justify those whose property isn't on fire paying for firefighters?
- subverter 9y ago
  I don't. I think paying for firefighters should be voluntary. Either I pay for it individually, or as part of my neighborhood, or at some other level that's much closer to me. If I don't want to protect against my house burning down, why should I pay for it? And before you go and say, "because your neighbor's house could burn down too", they could choose to pay for firefighters and have them come out to douse my house in defense of their own.
  - ajurna 9y ago
    > they could choose to pay for firefighters and have them come out to douse my house in defense of their own. Good to see you support others taking on your risk. This is the essence of universal healthcare.
    - subverter 9y ago
      The point is it's completely voluntary for everyone involved. No one is being forced into anything.

r_smart 9y ago

You're confusing insurance with healthcare. Insurance is supposed to be for risk mitigation, rare but extremely damaging events. If everyone uses insurance for everything health related, like we all want to do now, it's impossible for insurance to be anything other than a premium you pay on top of your healthcare costs. Insurance shouldn't be used for routine stuff, and people shouldn't be required to have it unless they want it.

subverter 9y ago
A salient distinction that's very important in the whole debate.
maxerickson 9y ago
it's impossible for insurance to be anything other than a premium you pay on top of your healthcare costs. And yet each year there are millions of people that receive medical services in excess of their insurance payments (including premiums, copays, etc).
- antisthenes 9y ago
  Which doesn't invalidate what the parent comment in any way, because we're talking about the aggregate costs. So what was your point?
  - maxerickson 9y ago
    The premium on top of aggregate cost complaint would also apply to "pure insurance". Or else no one would bother selling it. Anyway, I'm pretty sure they were saying that insurance didn't work, which is manifestly untrue. If they are complaining that it makes healthcare more expensive, well fine, but that is probably more about the principal agent problem than the administrative costs and profits of insurers.
ZeroGravitas 9y ago
"insurance" in this case is also a savings account. People need to be forced to put money into the system when young and/or healthy so that's there's enough money available when they are not. If they're not forced to do this, then they won't and people are forced to stand by and watch as they fall ill and due which is bad for the economy and may already disease, even if you don't care about the moral aspects. There's little benefit to seperating these things out and obvious downsides to them not being mandated.