7 ms·

Whenever someone says that AI and IoT would automate insurance underwriting, I start to fret — because it very quickly starts to imply more and more data collec

by a_d 8y ago

Whenever someone says that AI and IoT would automate insurance underwriting, I start to fret — because it very quickly starts to imply more and more data collection. This is like pre-crime but for your health. Meaning, you start paying high premiums right away because later in life you might be at a high risk for a specific condition. (I know this already happens for smoking, but that is declared on a form — not by a company sending a drone to spy on you) Since this is a startup forum — I believe health insurance to be so dark and morbid (with things like companies haggling with living relatives about ventilator care) — there is got to be a better way! (I realize this is more of a lament than a constructive suggestion)

richrichardsson 8y ago
There is a better way, it's called single payer universal healthcare!
- frockington 8y ago
  Please no, I don't trust the government at all to handle healthcare efficiently. And I enjoy my insurance company through work, its the equivalent to a significant raise each year
  - shadowtree 8y ago
    DO you trust it with defence, etc.?
    - nostromo95 8y ago
      To play devil’s advocate, a government’s primary duty has been defense since the dawn of organized government. The U.S. government began in an armed rebellion. Moreover, there’s no reasonable alternative to the government having a monopoly on defense.
    - frockington 8y ago
      I trust it with defense and that's about it. I don;t even trust local governments to efficiently maintain roads
  - richrichardsson 8y ago
    There's nothing stopping companies providing extra private healthcare on top of government provided universal healthcare. It's very common in the UK.
    - mkirklions 8y ago
      This sounds like another way the rich get access while the poor are stuck with crappy government care.
      - crankylinuxuser 8y ago
        "Crappy government care" is better than none. And it's only "Crappy" because of the following: 1. Cut funding to govt services 2. Complain about bad govt services 3. Repeat
        mkirklions 8y ago
        idk, the US spends more than any country on their education, but we dont produce the smartest students. Money is minor compared to the culture found in a government agency
        crankylinuxuser 8y ago
        > the US spends more than any country on their education From a general review, it appears we're in the top of spending. There's a good reason why: government services have been privatized and contracted out. So when the govt could have did it for X$, the for-profit private entity charges 2*X$. And this happens across the government at all scales. I work in a regulated industry and have called three letter agencies over computing issues. 95% of the time, I end up getting another contractor. > but we dont produce the smartest students. But we create rich companies who suck on the public teet.
        mkirklions 8y ago
        You really found a way to do mental gymnastics around this. None of this is avoidable. Give money to the government, they are going to give it to their friends.
  - ceejayoz 8y ago
    > Please no, I don't trust the government at all to handle healthcare efficiently. If only we had literally the entire rest of the developed world to demonstrate that it's doable, with dramatically lower costs (and yes, that includes the tax portion) and similar health outcomes.
    - frockington 8y ago
      In the entire rest of the world it is much easier to mandate things to the people. It is much harder in America as many voter will see it as a slippery slope against individual liberties. "First its my health care, next its my guns, and finally its my freedom of speech" will be the argument preventing it from occuring
      - omegaworks 8y ago
        You're moving the goalposts. First "government can't do it efficiently," which is wrong, so now it's "it's not politically palatable." The first step to making something politically palatable is actually making the case for it and building momentum. If you frame it with political palatability as the metric for whether you actively pursue the policy, the whole discussion devolves into a chicken-and-egg problem.
        frockington 8y ago
        Okay we'll go back to the efficiency issue. Look at Europe and Canada's GDP, now look at Americas. Why would the US want to copy anything from those nations. I enjoy living in the most dominant country in the world. Europeans will respond with "Inequality and capitalism are bad" arguments that I don't buy because once again, the US is dominating socialist countries in Europe
        ceejayoz 8y ago
        > Okay we'll go back to the efficiency issue. Oh, let's. https://en.wikipedia.org/wiki/File:OECD_health_expenditure_per_capita_by_country.svg https://en.wikipedia.org/wiki/File:OECD_health_expenditure_p...
  - Gibbon1 8y ago
    Found that guy that's never ever had a serious health issue.
    - frockington 8y ago
      I had a few surgeries but nothing major. I enjoy my insurance but don't want to cover people who are overweight and/or lazy
      - ihsw2 8y ago
        How would you feel if insurers prodded overweight people to exercise and eat better, or else their rates go up or coverage cut altogether? How would you feel if insurers prodded lazy people to engage in healthier lifestyles? Empowering insurers could be useful in this regard.
        frockington 8y ago
        I would feel very good about both of those things. Insurers should be free to incentivize healthy behavior
      - Broken_Hippo 8y ago
        So, you are fine covering people's stupidity when being active? Or you are only interested in not covering people you perceive as being a moral blight?
    - chimeracoder 8y ago
      > Found that guy that's never ever had a serious health issue. No, people who have serious health issues are the ones who tend to prefer the more complex treatment options, shorter wait times, and customizable interventions that multi-payer systems have to offer. People who don't have complex health needs are the ones best served by single-payer systems like the NHS - and the data around treatments for complex conditions (like cancer) backs that up very plainly.
      - 8y ago
  - throwaway2048 8y ago
    The US government already pays more per capita (that is, more for every single living person in the USA) for healthcare than any other nation on earth. This is entirely WITHOUT universal public insurance, the US could easily save money by making public insurance avalible for everyone.
    - frockington 8y ago
      With public insurance you would have no customer base besides those who are high risk. As a healthy individual there is absolutely no way I would sign up for universal healthcare. Thankfully the government won't be able to mandate it anytime soon as we have a first and second amendment protecting citizens
      - ceejayoz 8y ago
        > As a healthy individual there is absolutely no way I would sign up for universal healthcare. That's fine, because you don't have to. It's just there if you need it. > Thankfully the government won't be able to mandate it anytime soon as we have a first and second amendment protecting citizens The First and Second Amendments didn't prevent Social Security or Medicare. Why would it be any different for Medicare-for-all?
    - chimeracoder 8y ago
      > The US government already pays more per capita (that is, more for every single living person in the USA) for healthcare than any other nation on earth. The US also implicitly subsidizes all of the research and operations of the rest of the world. Over half the medical research in the entire world is directly funded by the US, and a significant portion of the rest is indirectly funded by sales in the US market. Biomedical and pharmaceutical companies in Europe make the lion's share of their revenues from the US, despite the US being half the population. You can't compare the US and European healthcare markets without accounting for the fact that they're deeply interconnected, and the biggest beneficiaries of that interconnectedness are, in fact, European patients.
  - DesiLurker 8y ago
    except that every major industrialized nation out there has figured out how to do it well except us. if it works for them it can work for us. BTW what happens if you lose your job? do you know what the helthcare options for next job are going to be? Heck, your own company can have a few bad quarters and goto a sh*t insurer and you are back to averages.. never ignore the base rates and base rates suck in us healthcare.
    - chimeracoder 8y ago
      > except that every major industrialized nation out there has figured out how to do it well except us. if it works for them it can work for us. "every other major industrialized nation" has a healthcare system that's deeply interconnected with the global healthcare market, which is itself heavily dependent on the revenue that is generated from the US market. You can't compare the US to Europe without also factoring the massive benefits European patients get from the high costs in the US.
      - vilmosi 8y ago
        > You can't compare the US to Europe without also factoring the massive benefits European patients get from the high costs in the US Luckily for us all the major pharmaceutical companies are public and we can can see exactly where they generate their revenue. Maybe you can show us exactly by how much the US subsidises Europe then. I suspect not by much.
        chimeracoder 8y ago
        > Luckily for us all the major pharmaceutical companies are public and we can can see exactly where they generate their revenue. Maybe you can show us exactly by how much the US subsidises Europe then. I suspect not by much. All pharmaceutical companies - including those based in Europe - derive the lion's share of their revenue from the US market, despite the US having half the population. That's pretty obvious from the relative prices of drugs in the US versus Europe and the quantities sold, but take a look yourself if you want.
  - vilmosi 8y ago
    > Please no, I don't trust the government at all to handle healthcare efficiently. Universal healthcare doesn't mean the government handles healthcare. > And I enjoy my insurance company through work, its the equivalent to a significant raise each year You can still get your healthcare from your employer with universal healthcare. You'll just be covered in the event of losing your job. Probably paying less for it too.
  - TelmoMenezes 8y ago
    > And I enjoy my insurance company through work [...] This is something that always bothered me about the American healthcare system. Isn't it profoundly un-American to depend on your employer for such a personal matter? I know that work is highly valued in the US, but this is almost a slave-like relationship... If you are going to be so dependent on some orgnanization, wouldn't it be preferable to depend on a democratically elected one? I know that European-style healthcare smells too much of socialism to you guys, but doesn't your current system smell of feudalism?
rsync 8y ago
"there is(sic) got to be a better way!" There are two better ways - each at a different end of the spectrum. You can give up entirely on government intervention in health insurance and social "goods" being pursued - everyone is on their own and "healthcare" is a private, personal matter. You can play these agency/incentive games with insurers for better or for worse and you're on your own. OR We declare "healthcare" to be a public, common good and completely socialize it. Like roads and fire departments. What these two different strategies have in common is that both of them are intelligible, reasonable and give people a framework for planning and making long term decisions. Anything between these two points on the spectrum is unintelligible and unsustainable. You would probably be better off with (the option above that you like the least) than any option between them.
- bovine3dom 8y ago
  > We declare "healthcare" to be a public, common good and completely socialize it. Like roads and fire departments. 1. Lots of places have private roads without much trouble. France's autoroutes are perhaps the most famous example. 2. Many of the world's most successful universal healthcare systems are run at least partially privately. The first point of contact one has with the NHS, for example, is through a general practitioner via medical practice, all of whom are private businesses (free at the point of use). I don't see why you think a hodgepodge of private and public, as exists in many places already, would be such a problem; I totally fail to see how making everything completely private would be a better solution than that. You'd end up with horrendous lemon-dropping.
- mindslight 8y ago
  > Anything between these two points on the spectrum is unintelligible and ... very fucking profitable. I mean, the most significant part of "health insurance reform" was to penalize people if they choose to opt out of patronizing these private companies. Some reform! I'd actually nitpick and say there are sane ways to combine the two regimes. For instance, a base level of common care, and then a functioning market for elective care, additional care, and upgrades.
  - 8y ago

by a_d 8y ago

richrichardsson 8y ago

There is a better way, it's called single payer universal healthcare!

frockington 8y ago
Please no, I don't trust the government at all to handle healthcare efficiently. And I enjoy my insurance company through work, its the equivalent to a significant raise each year
- shadowtree 8y ago
  DO you trust it with defence, etc.?
  - nostromo95 8y ago
    To play devil’s advocate, a government’s primary duty has been defense since the dawn of organized government. The U.S. government began in an armed rebellion. Moreover, there’s no reasonable alternative to the government having a monopoly on defense.
  - frockington 8y ago
    I trust it with defense and that's about it. I don;t even trust local governments to efficiently maintain roads
- richrichardsson 8y ago
  There's nothing stopping companies providing extra private healthcare on top of government provided universal healthcare. It's very common in the UK.
  - mkirklions 8y ago
    This sounds like another way the rich get access while the poor are stuck with crappy government care.
    - crankylinuxuser 8y ago
      "Crappy government care" is better than none. And it's only "Crappy" because of the following: 1. Cut funding to govt services 2. Complain about bad govt services 3. Repeat
      - mkirklions 8y ago
        idk, the US spends more than any country on their education, but we dont produce the smartest students. Money is minor compared to the culture found in a government agency
        crankylinuxuser 8y ago
        > the US spends more than any country on their education From a general review, it appears we're in the top of spending. There's a good reason why: government services have been privatized and contracted out. So when the govt could have did it for X$, the for-profit private entity charges 2*X$. And this happens across the government at all scales. I work in a regulated industry and have called three letter agencies over computing issues. 95% of the time, I end up getting another contractor. > but we dont produce the smartest students. But we create rich companies who suck on the public teet.
        mkirklions 8y ago
        You really found a way to do mental gymnastics around this. None of this is avoidable. Give money to the government, they are going to give it to their friends.
- ceejayoz 8y ago
  > Please no, I don't trust the government at all to handle healthcare efficiently. If only we had literally the entire rest of the developed world to demonstrate that it's doable, with dramatically lower costs (and yes, that includes the tax portion) and similar health outcomes.
  - frockington 8y ago
    In the entire rest of the world it is much easier to mandate things to the people. It is much harder in America as many voter will see it as a slippery slope against individual liberties. "First its my health care, next its my guns, and finally its my freedom of speech" will be the argument preventing it from occuring
    - omegaworks 8y ago
      You're moving the goalposts. First "government can't do it efficiently," which is wrong, so now it's "it's not politically palatable." The first step to making something politically palatable is actually making the case for it and building momentum. If you frame it with political palatability as the metric for whether you actively pursue the policy, the whole discussion devolves into a chicken-and-egg problem.
      - frockington 8y ago
        Okay we'll go back to the efficiency issue. Look at Europe and Canada's GDP, now look at Americas. Why would the US want to copy anything from those nations. I enjoy living in the most dominant country in the world. Europeans will respond with "Inequality and capitalism are bad" arguments that I don't buy because once again, the US is dominating socialist countries in Europe
        ceejayoz 8y ago
        > Okay we'll go back to the efficiency issue. Oh, let's. https://en.wikipedia.org/wiki/File:OECD_health_expenditure_per_capita_by_country.svg https://en.wikipedia.org/wiki/File:OECD_health_expenditure_p...
- Gibbon1 8y ago
  Found that guy that's never ever had a serious health issue.
  - frockington 8y ago
    I had a few surgeries but nothing major. I enjoy my insurance but don't want to cover people who are overweight and/or lazy
    - ihsw2 8y ago
      How would you feel if insurers prodded overweight people to exercise and eat better, or else their rates go up or coverage cut altogether? How would you feel if insurers prodded lazy people to engage in healthier lifestyles? Empowering insurers could be useful in this regard.
      - frockington 8y ago
        I would feel very good about both of those things. Insurers should be free to incentivize healthy behavior
    - Broken_Hippo 8y ago
      So, you are fine covering people's stupidity when being active? Or you are only interested in not covering people you perceive as being a moral blight?
  - chimeracoder 8y ago
    > Found that guy that's never ever had a serious health issue. No, people who have serious health issues are the ones who tend to prefer the more complex treatment options, shorter wait times, and customizable interventions that multi-payer systems have to offer. People who don't have complex health needs are the ones best served by single-payer systems like the NHS - and the data around treatments for complex conditions (like cancer) backs that up very plainly.
    - 8y ago
- throwaway2048 8y ago
  The US government already pays more per capita (that is, more for every single living person in the USA) for healthcare than any other nation on earth. This is entirely WITHOUT universal public insurance, the US could easily save money by making public insurance avalible for everyone.
  - frockington 8y ago
    With public insurance you would have no customer base besides those who are high risk. As a healthy individual there is absolutely no way I would sign up for universal healthcare. Thankfully the government won't be able to mandate it anytime soon as we have a first and second amendment protecting citizens
    - ceejayoz 8y ago
      > As a healthy individual there is absolutely no way I would sign up for universal healthcare. That's fine, because you don't have to. It's just there if you need it. > Thankfully the government won't be able to mandate it anytime soon as we have a first and second amendment protecting citizens The First and Second Amendments didn't prevent Social Security or Medicare. Why would it be any different for Medicare-for-all?
  - chimeracoder 8y ago
    > The US government already pays more per capita (that is, more for every single living person in the USA) for healthcare than any other nation on earth. The US also implicitly subsidizes all of the research and operations of the rest of the world. Over half the medical research in the entire world is directly funded by the US, and a significant portion of the rest is indirectly funded by sales in the US market. Biomedical and pharmaceutical companies in Europe make the lion's share of their revenues from the US, despite the US being half the population. You can't compare the US and European healthcare markets without accounting for the fact that they're deeply interconnected, and the biggest beneficiaries of that interconnectedness are, in fact, European patients.
- DesiLurker 8y ago
  except that every major industrialized nation out there has figured out how to do it well except us. if it works for them it can work for us. BTW what happens if you lose your job? do you know what the helthcare options for next job are going to be? Heck, your own company can have a few bad quarters and goto a sh*t insurer and you are back to averages.. never ignore the base rates and base rates suck in us healthcare.
  - chimeracoder 8y ago
    > except that every major industrialized nation out there has figured out how to do it well except us. if it works for them it can work for us. "every other major industrialized nation" has a healthcare system that's deeply interconnected with the global healthcare market, which is itself heavily dependent on the revenue that is generated from the US market. You can't compare the US to Europe without also factoring the massive benefits European patients get from the high costs in the US.
    - vilmosi 8y ago
      > You can't compare the US to Europe without also factoring the massive benefits European patients get from the high costs in the US Luckily for us all the major pharmaceutical companies are public and we can can see exactly where they generate their revenue. Maybe you can show us exactly by how much the US subsidises Europe then. I suspect not by much.
      - chimeracoder 8y ago
        > Luckily for us all the major pharmaceutical companies are public and we can can see exactly where they generate their revenue. Maybe you can show us exactly by how much the US subsidises Europe then. I suspect not by much. All pharmaceutical companies - including those based in Europe - derive the lion's share of their revenue from the US market, despite the US having half the population. That's pretty obvious from the relative prices of drugs in the US versus Europe and the quantities sold, but take a look yourself if you want.
- vilmosi 8y ago
  > Please no, I don't trust the government at all to handle healthcare efficiently. Universal healthcare doesn't mean the government handles healthcare. > And I enjoy my insurance company through work, its the equivalent to a significant raise each year You can still get your healthcare from your employer with universal healthcare. You'll just be covered in the event of losing your job. Probably paying less for it too.
- TelmoMenezes 8y ago
  > And I enjoy my insurance company through work [...] This is something that always bothered me about the American healthcare system. Isn't it profoundly un-American to depend on your employer for such a personal matter? I know that work is highly valued in the US, but this is almost a slave-like relationship... If you are going to be so dependent on some orgnanization, wouldn't it be preferable to depend on a democratically elected one? I know that European-style healthcare smells too much of socialism to you guys, but doesn't your current system smell of feudalism?

rsync 8y ago

"there is(sic) got to be a better way!" There are two better ways - each at a different end of the spectrum. You can give up entirely on government intervention in health insurance and social "goods" being pursued - everyone is on their own and "healthcare" is a private, personal matter. You can play these agency/incentive games with insurers for better or for worse and you're on your own. OR We declare "healthcare" to be a public, common good and completely socialize it. Like roads and fire departments. What these two different strategies have in common is that both of them are intelligible, reasonable and give people a framework for planning and making long term decisions. Anything between these two points on the spectrum is unintelligible and unsustainable. You would probably be better off with (the option above that you like the least) than any option between them.

bovine3dom 8y ago
> We declare "healthcare" to be a public, common good and completely socialize it. Like roads and fire departments. 1. Lots of places have private roads without much trouble. France's autoroutes are perhaps the most famous example. 2. Many of the world's most successful universal healthcare systems are run at least partially privately. The first point of contact one has with the NHS, for example, is through a general practitioner via medical practice, all of whom are private businesses (free at the point of use). I don't see why you think a hodgepodge of private and public, as exists in many places already, would be such a problem; I totally fail to see how making everything completely private would be a better solution than that. You'd end up with horrendous lemon-dropping.
mindslight 8y ago
> Anything between these two points on the spectrum is unintelligible and ... very fucking profitable. I mean, the most significant part of "health insurance reform" was to penalize people if they choose to opt out of patronizing these private companies. Some reform! I'd actually nitpick and say there are sane ways to combine the two regimes. For instance, a base level of common care, and then a functioning market for elective care, additional care, and upgrades.
- 8y ago