8 ms·

This trend towards manditory quantified health risks discrimination aginst chronically unwell people. Your data, even from healthy employees, is being weilded b

This trend towards manditory quantified health risks discrimination aginst chronically unwell people. Your data, even from healthy employees, is being weilded by unaccountable corporate goons to disenfranchise people, like digital star of David.

tomp 8y ago
> risks discrimination aginst chronically unwell people Technically it's not discrimination, they actually cost more, and their insurance would therefore be more expensive, in a free market. To the extent that the society values "fairness" and wants to help those people, government / non-free-market solutions are needed, with the society paying for them collectively.
- Tarq0n 8y ago
  The whole point of insurance, especially health insurance, is collectivizing risk. Otherwise you might as well put the money in a savings account.
  - lotsofpulp 8y ago
    There’s a gray area where insurance goes from protecting against unpredictable losses to becoming a subsidy from those experiencing fewer losses to those experiencing more losses. In a true insurance market, people’s entire health is not insurable, since it’s guaranteed to have losses therefore it’s simply a subsidy from those who are not currently experiencing losses to those who are. What would be more akin to actual insurance is insuring specific events within a specific timeframe, such as broken bones from year x to year y, and then the insurance can charge more to people who play sports versus people who don’t, since obviously they would experience more losses, just like people who drive more pay more for auto insurance. However, this all gets murky with our requirement to force everyone to be provided with healthcare and people being in control of some things about their health (via diet and lifestyle) and not others (genetics, environment) and the inability to tease out causal factors. The primary purpose of health “insurance” in today’s world is to serve as an agent for the buyer since the buyer typically has no idea about what they’re buying from healthcare providers and at what cost, so theoretically, the doctors, pharmacists, and statisticians employed by insurance companies can do proper vetting of treatments for the patient.
    - stirfrykitty 8y ago
      Huge proponent of socialized medicine here. Lived under it for 18 years. It works. You are utterly correct when you say the "buyer" has no idea. American "healthcare" is a sham in many ways. It's the only "transaction" a person enters into whereby you have zero idea of the final costs. I buy a car, I can negotiate and know before I sign. Ditto a house. Medical care in the US is designed to make money. Full stop. Not long ago, maybe even here on HN, an article was posted about American hospitals trawling the Internet for every bit of info they could glean about patients to both see if they would be monetary donors, as well as to ascertain if they were hiding their "wealth". This is what results from a for-profit system. I have always believed that healthcare is a basic human right. I will never change my beliefs on this point. Profit and healthcare are mutually exclusive. When a cancer patient is literally refused treatment because a) their "health insurance" runs out or b) they cannot afford to pay, the system is morally bankrupt. A friend of mine has a family member who needed a helicopter ambulance to save his life, as his accident was rural and he would have died. The 15-minute flight was almost $60k and they were billed for the full amount almost overnight. Insurance did not cover this. Another friend had a seizure and an ambulance was called, and the ensuing ride took about 10 minutes. Cost for the ambulance ride? $1200. This was in addition to the medical care, which in this case only paid 80%, even after deductions, etc. Anyone who defends for-profit healthcare for reasons of "I'm not paying for others' mistakes, etc." is being short sighted. There is no way a cancer doctor should be making millions off the back of dying patients, many of whom have cancer through no fault of their own. Even smokers deserve compassion, because addiction is a beast that many play hell getting out from under. So many factors at play here. It's easy to sit back and play moral general, but unless and until it's you or yours, it's an entirely different animal. We could easily afford single-payer in the US. The numbers being tossed out by various mouthpieces are intentionally misquoting to support the lobbyists and their ilk. Many of you may know that almost all hospitals lease their equipment. The leases are not that expensive for most stuff, even MRI and like equipment. For the prices charged, they have paid their leases in full after less than a week, yet they charge for all manner of false bullshit, and I quote from personal experience: "Mucous recovery system: $120" WTF is that, you may ask? After deciphering the code by obtaining a medical billing handbook, it turns out this is a box of Kleenex. I'm 50 and I refuse to go to the doctor unless I have either an infection or I have to go because life demands it. Eat right, brush your teeth, exercise, and call it good. I cannot afford the insurance, deductibles, co-pays, additional money always being asked for, plus RX costs. Not everyone has the money for the sham that is American healthcare. When I do go, I go the low-income clinic, pay cash and get as good or better care than the expensive places. Remember, massive debt in America is largely brought on by medical crises.
- drilldrive 8y ago
  It is technically discrimination though, as the company would be treating unfit people differently than fit people on the average. I think that the word discrimination is unjustly given a sort of taboo meaning in that any actual discrimination is horrible. And yet nearly everything that we do relies on discriminating.
  - tomp 8y ago
    Indeed, it has a strong connotation, I guess I should have used unfair discrimination or bigoted discrimination or something... Although to avoid confusion, I prefer to use a different word for "legitimate differences", such as distinguish or differentiate.
- ses1984 8y ago
  Technically that is discrimination. Discrimination applies any time two different groups get two different outcomes. It's a term that is used in economics without the negative connotation of things like racial discrimination. Senior discount at the diner? That is literally called price discrimination, look it up.
  - stirfrykitty 8y ago
    I find this interesting for several reasons. I've lived in 5 countries. America is the only country where I've seen the senior/veteran/police/whatever discounts trotted out. Isn't it funny, however, that "we" claim to value seniors, but almost to a man, elderly mom and dad are tossed into care homes as soon as it's inconvenient for their adult kids. Sadly, this is done for many reasons, many of which are to bilk people for their money. Most countries bring mom and dad or surviving parent into the home for the remainder of their natural life. In other cultures, not doing so is tantamount to an anathema. Welcome to America, land of the free to be bilked, and home of the brave should you step foot into hospital.
- MiroF 8y ago
  Discrimination doesn't stop being discrimination even if it causes lower costs and/or might be rational from the perspective of the business. It may be possible, for instance, due to a combination of structural and cycle of poverty factors that a black person in the part of town your store is would be more likely to commit a crime - that doesn't mean the store is non-discriminatory if they choose to ban all black people. The point is that you can't make decisions about people based on a protected trait, like race or disability. (To be clear, the black crime example was used because I think that we can all see the most blatant forms of discrimination in race-based discrimination and the "black crime" trope is one of the drivers of that discrimination)
- ptero 8y ago
  I agree with your point, and there is likely a business case, society wide, to average health care costs across the population. People are less productive when they have major, long-term worries, and even folks who are young and healthy today think about the possibility of being very sick. And in a society where sickness implies economic misery, people plan by building their own, ad-hoc mini-safety nets which are often less valuable and more expensive than a standardized solution. So most people would support averaging health costs if they perceive it as mostly efficient. That is, they would not mind a sick person next door getting treatment while paying the same cost as themselves. But if they think a bunch of doctors and crooks milking the system by making up and billing for fake services they will strongly push back. My 2c.
nerdponx 8y ago
What scares me is that people who are, say, addicted to sugary soda, will be treated punitively by the system for making poor choices, rather than as someone who is afflicted with an expensive pre-existing condition (sugar addiction). You don't have the same problem with, e.g. car insurance. Either you're speeding or you're not.
- saiya-jin 8y ago
  Well, I have general sympathy for the privacy topics discussed here just as any other average Joe, but painting sugar addicts as some helpless victims is a bit of a stretch to be polite. At least we can agree it is something negative. But I fail to have much sympathy for people who simply have to buy ice cream, chocolate, soda etc. You put the products in the shopping cart yourself knowing well it harms you, you use your cash/card to pay for it. Sugar addiction is real, but it doesn't make you a zombie without any free will. If you want to paint yourself as pathetic weakling without your own will, that's your own personal choice and be clear about this with everybody, especially yourself. But you are not describing sugar issues, but your own underlying mental issues that can and should be tackled by professional. Man up (or woman up), own your shit and have some respect for yourself.
  - koboll 8y ago
    There is a spectrum here. On one hand, people at a healthy weight throughout their adolescence who start a slow and gradual weight gain with their 'Freshman 15' that ends with being moderately chubby in middle age - yes, you're correct, that's not only the result of poor life choices, but it can probably be corrected with better ones. On the other hand, some people have negligent or ignorant parents and are (as a result) overweight or obese from a young age. This dramatically cripples their ability to make healthy food choices at an adult because it bakes in their psychological weight set point at an unhealthily high level very early on, and so normal attempts at intervention make their body think it is being starved. These folks need more than just life advice, they need medical intervention, or they stand a low chance of digging themselves out of their holes. And if they can't do that, it's a detriment not just to them but to society as a whole, which will eventually have to foot the bill for their medical costs later in life.
JustSomeNobody 8y ago
Most of the top health insurers in the US are publicly traded. The only thing you can expect from them is for them to return as much money as possible to investors.
- AnIdiotOnTheNet 8y ago
  Maybe part of the solution is to, as a culture, stop believing that it is ok for the sole purpose of a corporation to be profiting its shareholders.

tomp 8y ago

> risks discrimination aginst chronically unwell people Technically it's not discrimination, they actually cost more, and their insurance would therefore be more expensive, in a free market. To the extent that the society values "fairness" and wants to help those people, government / non-free-market solutions are needed, with the society paying for them collectively.

Tarq0n 8y ago
The whole point of insurance, especially health insurance, is collectivizing risk. Otherwise you might as well put the money in a savings account.
- lotsofpulp 8y ago
  There’s a gray area where insurance goes from protecting against unpredictable losses to becoming a subsidy from those experiencing fewer losses to those experiencing more losses. In a true insurance market, people’s entire health is not insurable, since it’s guaranteed to have losses therefore it’s simply a subsidy from those who are not currently experiencing losses to those who are. What would be more akin to actual insurance is insuring specific events within a specific timeframe, such as broken bones from year x to year y, and then the insurance can charge more to people who play sports versus people who don’t, since obviously they would experience more losses, just like people who drive more pay more for auto insurance. However, this all gets murky with our requirement to force everyone to be provided with healthcare and people being in control of some things about their health (via diet and lifestyle) and not others (genetics, environment) and the inability to tease out causal factors. The primary purpose of health “insurance” in today’s world is to serve as an agent for the buyer since the buyer typically has no idea about what they’re buying from healthcare providers and at what cost, so theoretically, the doctors, pharmacists, and statisticians employed by insurance companies can do proper vetting of treatments for the patient.
  - stirfrykitty 8y ago
    Huge proponent of socialized medicine here. Lived under it for 18 years. It works. You are utterly correct when you say the "buyer" has no idea. American "healthcare" is a sham in many ways. It's the only "transaction" a person enters into whereby you have zero idea of the final costs. I buy a car, I can negotiate and know before I sign. Ditto a house. Medical care in the US is designed to make money. Full stop. Not long ago, maybe even here on HN, an article was posted about American hospitals trawling the Internet for every bit of info they could glean about patients to both see if they would be monetary donors, as well as to ascertain if they were hiding their "wealth". This is what results from a for-profit system. I have always believed that healthcare is a basic human right. I will never change my beliefs on this point. Profit and healthcare are mutually exclusive. When a cancer patient is literally refused treatment because a) their "health insurance" runs out or b) they cannot afford to pay, the system is morally bankrupt. A friend of mine has a family member who needed a helicopter ambulance to save his life, as his accident was rural and he would have died. The 15-minute flight was almost $60k and they were billed for the full amount almost overnight. Insurance did not cover this. Another friend had a seizure and an ambulance was called, and the ensuing ride took about 10 minutes. Cost for the ambulance ride? $1200. This was in addition to the medical care, which in this case only paid 80%, even after deductions, etc. Anyone who defends for-profit healthcare for reasons of "I'm not paying for others' mistakes, etc." is being short sighted. There is no way a cancer doctor should be making millions off the back of dying patients, many of whom have cancer through no fault of their own. Even smokers deserve compassion, because addiction is a beast that many play hell getting out from under. So many factors at play here. It's easy to sit back and play moral general, but unless and until it's you or yours, it's an entirely different animal. We could easily afford single-payer in the US. The numbers being tossed out by various mouthpieces are intentionally misquoting to support the lobbyists and their ilk. Many of you may know that almost all hospitals lease their equipment. The leases are not that expensive for most stuff, even MRI and like equipment. For the prices charged, they have paid their leases in full after less than a week, yet they charge for all manner of false bullshit, and I quote from personal experience: "Mucous recovery system: $120" WTF is that, you may ask? After deciphering the code by obtaining a medical billing handbook, it turns out this is a box of Kleenex. I'm 50 and I refuse to go to the doctor unless I have either an infection or I have to go because life demands it. Eat right, brush your teeth, exercise, and call it good. I cannot afford the insurance, deductibles, co-pays, additional money always being asked for, plus RX costs. Not everyone has the money for the sham that is American healthcare. When I do go, I go the low-income clinic, pay cash and get as good or better care than the expensive places. Remember, massive debt in America is largely brought on by medical crises.
drilldrive 8y ago
It is technically discrimination though, as the company would be treating unfit people differently than fit people on the average. I think that the word discrimination is unjustly given a sort of taboo meaning in that any actual discrimination is horrible. And yet nearly everything that we do relies on discriminating.
- tomp 8y ago
  Indeed, it has a strong connotation, I guess I should have used unfair discrimination or bigoted discrimination or something... Although to avoid confusion, I prefer to use a different word for "legitimate differences", such as distinguish or differentiate.
ses1984 8y ago
Technically that is discrimination. Discrimination applies any time two different groups get two different outcomes. It's a term that is used in economics without the negative connotation of things like racial discrimination. Senior discount at the diner? That is literally called price discrimination, look it up.
- stirfrykitty 8y ago
  I find this interesting for several reasons. I've lived in 5 countries. America is the only country where I've seen the senior/veteran/police/whatever discounts trotted out. Isn't it funny, however, that "we" claim to value seniors, but almost to a man, elderly mom and dad are tossed into care homes as soon as it's inconvenient for their adult kids. Sadly, this is done for many reasons, many of which are to bilk people for their money. Most countries bring mom and dad or surviving parent into the home for the remainder of their natural life. In other cultures, not doing so is tantamount to an anathema. Welcome to America, land of the free to be bilked, and home of the brave should you step foot into hospital.
MiroF 8y ago
Discrimination doesn't stop being discrimination even if it causes lower costs and/or might be rational from the perspective of the business. It may be possible, for instance, due to a combination of structural and cycle of poverty factors that a black person in the part of town your store is would be more likely to commit a crime - that doesn't mean the store is non-discriminatory if they choose to ban all black people. The point is that you can't make decisions about people based on a protected trait, like race or disability. (To be clear, the black crime example was used because I think that we can all see the most blatant forms of discrimination in race-based discrimination and the "black crime" trope is one of the drivers of that discrimination)
ptero 8y ago
I agree with your point, and there is likely a business case, society wide, to average health care costs across the population. People are less productive when they have major, long-term worries, and even folks who are young and healthy today think about the possibility of being very sick. And in a society where sickness implies economic misery, people plan by building their own, ad-hoc mini-safety nets which are often less valuable and more expensive than a standardized solution. So most people would support averaging health costs if they perceive it as mostly efficient. That is, they would not mind a sick person next door getting treatment while paying the same cost as themselves. But if they think a bunch of doctors and crooks milking the system by making up and billing for fake services they will strongly push back. My 2c.

nerdponx 8y ago

What scares me is that people who are, say, addicted to sugary soda, will be treated punitively by the system for making poor choices, rather than as someone who is afflicted with an expensive pre-existing condition (sugar addiction). You don't have the same problem with, e.g. car insurance. Either you're speeding or you're not.

saiya-jin 8y ago
Well, I have general sympathy for the privacy topics discussed here just as any other average Joe, but painting sugar addicts as some helpless victims is a bit of a stretch to be polite. At least we can agree it is something negative. But I fail to have much sympathy for people who simply have to buy ice cream, chocolate, soda etc. You put the products in the shopping cart yourself knowing well it harms you, you use your cash/card to pay for it. Sugar addiction is real, but it doesn't make you a zombie without any free will. If you want to paint yourself as pathetic weakling without your own will, that's your own personal choice and be clear about this with everybody, especially yourself. But you are not describing sugar issues, but your own underlying mental issues that can and should be tackled by professional. Man up (or woman up), own your shit and have some respect for yourself.
- koboll 8y ago
  There is a spectrum here. On one hand, people at a healthy weight throughout their adolescence who start a slow and gradual weight gain with their 'Freshman 15' that ends with being moderately chubby in middle age - yes, you're correct, that's not only the result of poor life choices, but it can probably be corrected with better ones. On the other hand, some people have negligent or ignorant parents and are (as a result) overweight or obese from a young age. This dramatically cripples their ability to make healthy food choices at an adult because it bakes in their psychological weight set point at an unhealthily high level very early on, and so normal attempts at intervention make their body think it is being starved. These folks need more than just life advice, they need medical intervention, or they stand a low chance of digging themselves out of their holes. And if they can't do that, it's a detriment not just to them but to society as a whole, which will eventually have to foot the bill for their medical costs later in life.

JustSomeNobody 8y ago

Most of the top health insurers in the US are publicly traded. The only thing you can expect from them is for them to return as much money as possible to investors.

AnIdiotOnTheNet 8y ago
Maybe part of the solution is to, as a culture, stop believing that it is ok for the sole purpose of a corporation to be profiting its shareholders.