4 ms·

> Otherwise, people at higher risk are subsidized more heavily by people at lower risk. This is basically how it works in Europe and it's fine. I see the conce

by d33 6y ago

> Otherwise, people at higher risk are subsidized more heavily by people at lower risk. This is basically how it works in Europe and it's fine. I see the concept of punishing people for how their body behaves deeply unethical. We can't control this, things happen randomly to many of us. Obviously you could sell cheap health insurances to people that you know will be healthy, but isn't this essentially a scam?

maxerickson 6y ago
US long term care insurance is asset protection. The payer of last resort for things like nursing home care is Medicaid. If you don't have any assets, it starts paying right away. If you have assets, those go first, then Medicaid kicks in. So long term care insurance is for people that want to preserve their assets and/or receive care beyond what Medicaid will fund.
- Spooky23 6y ago
  Long term care insurance is mostly a harebrained financial innovation that doesn’t work financially.
  - maxerickson 6y ago
    Fair enough.
NeutronStar 6y ago
> but isn't this essentially a scam? No because you pay for what you get instead of for someone else.
smabie 6y ago
Not anymore than selling cheap car insurance for safe drivers. But, in general, I'm not sure health insurance would work without risk pooling. A large part of the problem is that health insurance isn't exactly insurance: paying for medication that someone takes everyday doesn't really fit the definition. If we could start over from a clean slate, I don't see any reason why a health care system without insurance wouldn't work (it works it many other countries). But, as it stands, I fear that the only way we can fix our Healthcare problem is to implement single payer.
- maxerickson 6y ago
  Massively boosting the number of doctors (and other direct care providers) would almost certainly have a positive effect on the healthcare system. There's arguments against it, cost (not a good one, it would reduce costs) and 'quality' (not a good one, there's lots of great potential doctors not getting trained). There's no forcing anybody to do anything (just removing restrictions on educating people and providing funding for training). It wouldn't even cost all that much (a few trillion over a decade vs $4 trillion annually on medical care).
unishark 6y ago
> I see the concept of punishing people for how their body behaves deeply unethical. Your ethics is a bit roundabout. Nature is the one introducing unfairness and "punishment" to the world. In a sense you are blaming companies for treating them equally rather than taking it upon themselves to correct the unfairness of nature. Really what we have here is a situation where insurance is an appropriate solution for some people, while others need charity. You are presuming that there is no charity for some reason, and that those people who need it are the insurance systems responsibility too. And 20 years ago healthy young people could get insurance very cheap (Less than what people spend on phones today). It wasn't a scam. Sooner or later you might get food poisoning or fall off your bike and break your leg or something. And there's always a small chance something really horrible would happen.
- Brian_K_White 6y ago
  Attempting to invoke nature as a basis for a definition of ethical is not ethical. Yes, nature gave one person cancer and not another person, or nature makes a young person on average healthier than an old person. But what we do with the hand nature has dealt us is on us not nature. Saying "Hey it's nature that made that guy require so much resources, there's nothing we can do about that, they simply cost more and so they should have to pay more, or die more." Is both unethical and a lie, because, there IS something we can do about it. We are not unthinking animals with no capacity to bend nature to our will, or at least compensate for nature we can't bend. And the people who cost more among us are not objects with no other factors in their equations than what they cost vs what they produce. When you say "Nature is the one introducing the unfairness." You actually make the very point you think you are arguing against. You say "It's Nature's fault", which is true, but then you, with very swiss cheese ethics, select only 2 out of the 3 implications from that to care about. You only talk about how that means it's not your fault or any insurance companies fault, and you don't account for the equally true fact that it's also not the cancer victims fault. If something is "introduced by Nature" your own words remember, then you yourself are acknowledging that it's no one's fault, and therefor no one's responsibility. Your inventively kinked ethics interprets that to mean only that therefor it's not your responsibility to do anything about it, completely neglecting the perfectly valid opposite option that if it's no single persons responsibility, then it's everyone's responsibility equally. It doesn't matter what arguments you manage to muster in defense of the selfish and frankly sociopathic response to the given facts of life and "nature", it's all the damning it needs to be merely that you try, other than in a devil's advocate role.

by d33 6y ago

maxerickson 6y ago

US long term care insurance is asset protection. The payer of last resort for things like nursing home care is Medicaid. If you don't have any assets, it starts paying right away. If you have assets, those go first, then Medicaid kicks in. So long term care insurance is for people that want to preserve their assets and/or receive care beyond what Medicaid will fund.

Spooky23 6y ago
Long term care insurance is mostly a harebrained financial innovation that doesn’t work financially.
- maxerickson 6y ago
  Fair enough.

NeutronStar 6y ago

> but isn't this essentially a scam? No because you pay for what you get instead of for someone else.

smabie 6y ago

Not anymore than selling cheap car insurance for safe drivers. But, in general, I'm not sure health insurance would work without risk pooling. A large part of the problem is that health insurance isn't exactly insurance: paying for medication that someone takes everyday doesn't really fit the definition. If we could start over from a clean slate, I don't see any reason why a health care system without insurance wouldn't work (it works it many other countries). But, as it stands, I fear that the only way we can fix our Healthcare problem is to implement single payer.

maxerickson 6y ago
Massively boosting the number of doctors (and other direct care providers) would almost certainly have a positive effect on the healthcare system. There's arguments against it, cost (not a good one, it would reduce costs) and 'quality' (not a good one, there's lots of great potential doctors not getting trained). There's no forcing anybody to do anything (just removing restrictions on educating people and providing funding for training). It wouldn't even cost all that much (a few trillion over a decade vs $4 trillion annually on medical care).

unishark 6y ago

> I see the concept of punishing people for how their body behaves deeply unethical. Your ethics is a bit roundabout. Nature is the one introducing unfairness and "punishment" to the world. In a sense you are blaming companies for treating them equally rather than taking it upon themselves to correct the unfairness of nature. Really what we have here is a situation where insurance is an appropriate solution for some people, while others need charity. You are presuming that there is no charity for some reason, and that those people who need it are the insurance systems responsibility too. And 20 years ago healthy young people could get insurance very cheap (Less than what people spend on phones today). It wasn't a scam. Sooner or later you might get food poisoning or fall off your bike and break your leg or something. And there's always a small chance something really horrible would happen.

Brian_K_White 6y ago
Attempting to invoke nature as a basis for a definition of ethical is not ethical. Yes, nature gave one person cancer and not another person, or nature makes a young person on average healthier than an old person. But what we do with the hand nature has dealt us is on us not nature. Saying "Hey it's nature that made that guy require so much resources, there's nothing we can do about that, they simply cost more and so they should have to pay more, or die more." Is both unethical and a lie, because, there IS something we can do about it. We are not unthinking animals with no capacity to bend nature to our will, or at least compensate for nature we can't bend. And the people who cost more among us are not objects with no other factors in their equations than what they cost vs what they produce. When you say "Nature is the one introducing the unfairness." You actually make the very point you think you are arguing against. You say "It's Nature's fault", which is true, but then you, with very swiss cheese ethics, select only 2 out of the 3 implications from that to care about. You only talk about how that means it's not your fault or any insurance companies fault, and you don't account for the equally true fact that it's also not the cancer victims fault. If something is "introduced by Nature" your own words remember, then you yourself are acknowledging that it's no one's fault, and therefor no one's responsibility. Your inventively kinked ethics interprets that to mean only that therefor it's not your responsibility to do anything about it, completely neglecting the perfectly valid opposite option that if it's no single persons responsibility, then it's everyone's responsibility equally. It doesn't matter what arguments you manage to muster in defense of the selfish and frankly sociopathic response to the given facts of life and "nature", it's all the damning it needs to be merely that you try, other than in a devil's advocate role.