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Moral argument: functioning society's don't expect their member to act perfectly and always make the right choices. Would you expect a hospital not to treat you

by stryan 5y ago

Moral argument: functioning society's don't expect their member to act perfectly and always make the right choices. Would you expect a hospital not to treat you because you got injured while committing risky behavior (e.g. extreme sports, trying strange foods, or arguably driving a car)? Treatments like this support "repeat offenders" and the poor bastards who make a wrong choice once alike. Pragmatic argument: It's better economically and for productivity for people to not have HIV, Syphilis, etc. It's far easier to provide treatment and testing then to tell people to stop having sex.

leetcrew 5y ago
I think it's actually fine to charge higher premiums to people who take significantly greater risks than the average person. we already do this with car insurance for people who drive certain models, have been in at-fault collisions, have traffic infractions on record, etc. no one "needs" to go skiing or drive a fast car, but a.) we should let them and b.) they ought to pay a bit more into the pool.
- stryan 5y ago
  I can see the argument for that, however from my reading OP was arguing that people who take greater risks shouldn't get treatment at all or be "subsidized" by people who don't. You seem to be arguing (and correct me if I'm wrong) that people making riskier choices pay more for themselves to make up for that.
  - leetcrew 5y ago
    yes, that is exactly what I'm arguing. if everyone pays into a pool without any risk adjustment, that is effectively a subsidy to the risk-takers. I think that is a more fair way to understand rayiner's objection to "subsidies". I don't think he is seriously arguing that risk-takers should be denied care/testing/whatever altogether. of course this is all hypothetical with the current state of US healthcare. step one has to be a reasonable cost baseline for people who don't elect a bunch of extra risk.
    - bradlys 5y ago
      How is this different from healthcare as it is set out now or in the past? (Pre existing condition? Too bad. Too expensive to keep you around. Pay out of pocket.) Hypothetically, you don’t need healthcare if you live/lived a near fundamentally perfect lifestyle. Accidents happen but then maybe don’t use knives or ever leave your home too. Be a bubble boy.
      - leetcrew 5y ago
        you are strawmanning me a bit. > people who don't elect a bunch of extra risk I'm not talking about preexisting conditions. I'm talking about conscious choices people make that increase their risk level. I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more.
        bradlys 5y ago
        > I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more. Charging people more for coverage is telling them how to live their life. And where is the line drawn? "Oh, you like to go 10mph over the limit? Higher medical coverage fees, sir. You're likely to get hurt. Oh, sir, you live in a rough neighborhood? Very likely to get shot sir, you should definitely have higher premiums, yes." You may as well ask people to not have health insurance and just pay out of pocket for everything. Btw - do you really think if you do this that costs will go down for you in this hypothetical system? They won't. Premiums will go up for everyone and the people who will profit are executive leadership.
    - ahthat 5y ago
      Very well and succinctly put
  - NovemberWhiskey 5y ago
    I don't really understand the distinction you're trying to draw between "make those who choose to live risky lives pay more" vs. "people who take risks shouldn't be subsidized by people who don't". Aren't those the same thing?
lodi 5y ago
If we're just handing out everything for free then I'd argue it's also better economically for people (and particularly kids) to have free eye care, free dental care, and a million other things I'd rather see subsidized over free Syphilis tests.
- stryan 5y ago
  Economically, I absolutely agree and fortunately we have the power to do both. Plus Syphilis testing is very cheap, relative to most testing (about $20-$50 for early infections) and testing costs are only going down. Rapid testing is even cheaper, down to something like $5 per test.
- fao_ 5y ago
  Why does it have to be either/or?
- Perseids 5y ago
  I 100% agree with you and I'm sorry this is not the case in the country you live in. I keep forgetting how bad the health care system is in some parts of the rich and developed world. I agree with my sibling comments that fortunately you can have all of those for free, for affordable prices for society, if the right policies are implemented.
blacktriangle 5y ago
Moral argument: functioning societies don't move the burden of the consequences of known risky behavior from those doing such behavior to those who are not. In fact, that's a recepie for a civilizational death spiral.
- stryan 5y ago
  I think I'd need to see a better argument that we're moving the burden of consequences. Riding a bike with no helmet is known risky behavior; if they get hit by a car or fall or their bike and have to go to the hospital, would you say that's shifting the burden of consequence? People with Syphilis who get tested and help for it still pay their taxes, which helped fund their treatment. They still have consequences such as having to see a doctor, take medicine which may be unpleasant (ever have GI side-effects from an anti-biotic?), and of course they experience the side-effects of, you know, having Syphilis. The government isn't taking $20 out of your wallet to bribe the bacteria to not infect someone.
- maximente 5y ago
  strange: drunk driving continues to cause grave personal, public health and economic harm to non-participants and has for, what, well over 50 years? yet the US seems to be largely "functioning".
- emodendroket 5y ago
  By this standard we’re arguably at greater risk of civilizational death spiral, e.g., helping homeowners to rebuild in natural disaster-prone areas than trying to treat venereal disease.
- deleted 5y ago
  [deleted]
dysrend 5y ago
It's better economically and for productivity for people to not have HIV, Syphilis, etc. Stop this. It isn't an economics issue. This is a moral issue. Your tract of reasoning is precisely why the world is growing so untenable for the human element. There needn't exist laws or programs or any other edifice by which regulation is effected. People need to be made to realize that they're being wholly indiscretionate and their disposition to do so comes at a cost, and it should be personal to make the point manifest.
- stryan 5y ago
  With all due respect, the first half of comment is literally prefaced with "the moral argument". Personally I believe that argument should be enough, but you gotta play to the audience.

by stryan 5y ago

leetcrew 5y ago

I think it's actually fine to charge higher premiums to people who take significantly greater risks than the average person. we already do this with car insurance for people who drive certain models, have been in at-fault collisions, have traffic infractions on record, etc. no one "needs" to go skiing or drive a fast car, but a.) we should let them and b.) they ought to pay a bit more into the pool.

stryan 5y ago
I can see the argument for that, however from my reading OP was arguing that people who take greater risks shouldn't get treatment at all or be "subsidized" by people who don't. You seem to be arguing (and correct me if I'm wrong) that people making riskier choices pay more for themselves to make up for that.
- leetcrew 5y ago
  yes, that is exactly what I'm arguing. if everyone pays into a pool without any risk adjustment, that is effectively a subsidy to the risk-takers. I think that is a more fair way to understand rayiner's objection to "subsidies". I don't think he is seriously arguing that risk-takers should be denied care/testing/whatever altogether. of course this is all hypothetical with the current state of US healthcare. step one has to be a reasonable cost baseline for people who don't elect a bunch of extra risk.
  - bradlys 5y ago
    How is this different from healthcare as it is set out now or in the past? (Pre existing condition? Too bad. Too expensive to keep you around. Pay out of pocket.) Hypothetically, you don’t need healthcare if you live/lived a near fundamentally perfect lifestyle. Accidents happen but then maybe don’t use knives or ever leave your home too. Be a bubble boy.
    - leetcrew 5y ago
      you are strawmanning me a bit. > people who don't elect a bunch of extra risk I'm not talking about preexisting conditions. I'm talking about conscious choices people make that increase their risk level. I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more.
      - bradlys 5y ago
        > I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more. Charging people more for coverage is telling them how to live their life. And where is the line drawn? "Oh, you like to go 10mph over the limit? Higher medical coverage fees, sir. You're likely to get hurt. Oh, sir, you live in a rough neighborhood? Very likely to get shot sir, you should definitely have higher premiums, yes." You may as well ask people to not have health insurance and just pay out of pocket for everything. Btw - do you really think if you do this that costs will go down for you in this hypothetical system? They won't. Premiums will go up for everyone and the people who will profit are executive leadership.
  - ahthat 5y ago
    Very well and succinctly put
- NovemberWhiskey 5y ago
  I don't really understand the distinction you're trying to draw between "make those who choose to live risky lives pay more" vs. "people who take risks shouldn't be subsidized by people who don't". Aren't those the same thing?

lodi 5y ago

If we're just handing out everything for free then I'd argue it's also better economically for people (and particularly kids) to have free eye care, free dental care, and a million other things I'd rather see subsidized over free Syphilis tests.

stryan 5y ago
Economically, I absolutely agree and fortunately we have the power to do both. Plus Syphilis testing is very cheap, relative to most testing (about $20-$50 for early infections) and testing costs are only going down. Rapid testing is even cheaper, down to something like $5 per test.
fao_ 5y ago
Why does it have to be either/or?
Perseids 5y ago
I 100% agree with you and I'm sorry this is not the case in the country you live in. I keep forgetting how bad the health care system is in some parts of the rich and developed world. I agree with my sibling comments that fortunately you can have all of those for free, for affordable prices for society, if the right policies are implemented.

blacktriangle 5y ago

Moral argument: functioning societies don't move the burden of the consequences of known risky behavior from those doing such behavior to those who are not. In fact, that's a recepie for a civilizational death spiral.

stryan 5y ago
I think I'd need to see a better argument that we're moving the burden of consequences. Riding a bike with no helmet is known risky behavior; if they get hit by a car or fall or their bike and have to go to the hospital, would you say that's shifting the burden of consequence? People with Syphilis who get tested and help for it still pay their taxes, which helped fund their treatment. They still have consequences such as having to see a doctor, take medicine which may be unpleasant (ever have GI side-effects from an anti-biotic?), and of course they experience the side-effects of, you know, having Syphilis. The government isn't taking $20 out of your wallet to bribe the bacteria to not infect someone.
maximente 5y ago
strange: drunk driving continues to cause grave personal, public health and economic harm to non-participants and has for, what, well over 50 years? yet the US seems to be largely "functioning".
emodendroket 5y ago
By this standard we’re arguably at greater risk of civilizational death spiral, e.g., helping homeowners to rebuild in natural disaster-prone areas than trying to treat venereal disease.
deleted 5y ago
[deleted]

dysrend 5y ago

It's better economically and for productivity for people to not have HIV, Syphilis, etc. Stop this. It isn't an economics issue. This is a moral issue. Your tract of reasoning is precisely why the world is growing so untenable for the human element. There needn't exist laws or programs or any other edifice by which regulation is effected. People need to be made to realize that they're being wholly indiscretionate and their disposition to do so comes at a cost, and it should be personal to make the point manifest.

stryan 5y ago
With all due respect, the first half of comment is literally prefaced with "the moral argument". Personally I believe that argument should be enough, but you gotta play to the audience.