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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 insuran

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 6y 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 6y 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 6y 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 6y 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 6y 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 6y ago
    Very well and succinctly put
- NovemberWhiskey 6y 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?

stryan 6y 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 6y 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 6y 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 6y 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 6y 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 6y ago
  Very well and succinctly put
NovemberWhiskey 6y 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?