6 ms·

Why would those people die? I don't follow.

munk-a 5y ago
You'd make it illegal to pool costs by barring insurance - meaning that healthcare providers would either need to provide service gratis for the majority of the population (which is, really, just another form of insurance so that's out) or they'd need to secure a personal loan with their bank some time between getting hit by a truck and the operating table. And for pre-existing conditions and long term health disabilities - the individual would need to somehow justify the profitability of their existence to a private underwriter who was willing to bear the cost - in most cases those people "aren't worth the cost of keeping them alive" (assuming you're looking strictly at numbers). Hence - a lot of people would end up dead.
- notch656a 5y ago
  Can you really call it 'insurance' when it's a pre-existing condition? I realize we can call insurance whatever we want, but when I think of insurance I think of it a way to pool for mitigating risk of the unknown. No one would sell insurance that would fix your already destroyed roof.
  - giaour 5y ago
    > No one would sell insurance that would fix your already destroyed roof. But they will sell you homeowners insurance in areas prone to wildfires or hurricanes. The difference is that you are expected to know the amortized cost of disasters for your property and either insure against it or simply accept the risk. Either way, you as a homeowner are supposed to make an informed decision. If disaster is too likely to occur in a certain area, you can either move or not purchase a property in the first place. Science still hasn't figured out how to let us move into healthier bodies or choose our bodies prior to birth, so, alas, we are forced to seek fairness through other means.
    - com2kid 5y ago
      > But they will sell you homeowners insurance in areas prone to wildfires And in areas with wild fires, tar roofs aren't legal for new construction! Roofs have to be built out of something non-flammable. Lessons to be learned perhaps.
      - max599 5y ago
        Most of the building code is written with the blood of victims who died in a horrific accident. If you want to know why doors in public places have to open toward the outside in modern countries and why "panic bars" are often mandatory, the answer is large piles of dead children (literally). Depending on who you ask and the country they live in, they will refer to a different disaster, but the common element in all of them is 70 - 600 people stuck in hallways unable to escape due to bad exit designs (eg. people piling up against doors that open towards the inside).
        notch656a 5y ago
        The unseen deaths are those who are unhoused or unsheltered due to building codes causing elevated building prices. Secondary effects (for those who can afford up-to-code) include less money to spend on healthy foods, good health insurance, quality child education, and other victimized children at the hand of building codes and other regulation. You can virtually ramp up building codes ad-infinitum, until the house is as safe as can humanly be built, if your expense is to hurt a lot of children by bankrupting families of expenses to take care of other necessities in life.
  - munk-a 5y ago
    Well, whatever we call it we as a society need to choose whether we want to keep people with expensive preexisting conditions alive. I don't think it's really necessary to debate the point since almost every western country has decided that their ethics fall in the camp of "Yes, we support those people and give them the best life possible" whenever they're actually pressed on the matter. For a while the US skated by on budgetary excuses but all the while I think society still idealistically held on to that standard - I think this point is fairly debatable though. I think it's more a question of whether we'd be willing to install and maintain a roof on a building that had been designed without a roof in mind or whether we'd tear down the building to make room for a new one. You'd probably rationally lean in the second direction for a house - but when we're talking about a human life the math changes for a lot of people. Either way, a return to an insurance-less situation would leave people with preexisting situations out in the cold, unless your definition of insuranceless involves government subsidies for all preexisting conditions and at that point you're basically talking about medicare for all.
    - notch656a 5y ago
      I think as a society if we can't discuss this in an honest manner without deceptive terminology, we're doomed to be stuck in a bad spot. Perhaps phrasing it as charity of the healthy towards the less healthy would lead towards a more productive and honest starting point. It's something many, including myself, would be much more supportive of than feeling like I'm deceived by misrepresentation of a product. I'd feel like I'm taking part of a noble charity rather than this sort of deceptive 'insurance' product.
      - RHSeeger 5y ago
        I don't see it as a charity so much as we, as a group, are pooling our money so that those that need health care get health care. That can be people with pre-existing conditions, people with a new condition, people that are in an accident, preventative maintenance, or even just normal life situations (pregnancy, etc). In my mind, it's not charity because it's - For everyone. Maybe not for you today, but maybe tomorrow - For the benefit of society as a whole. If we let everyone who got sick just die, our society would be worse for it.
  - pyuser583 5y ago
    If you health insurance only covered “insurance events” in the normal definition of the phrase, much of medical care would not be insurable.
- giaour 5y ago
  > meaning that healthcare providers would either need to provide service gratis for the majority of the population (which is, really, just another form of insurance so that's out) or they'd need to secure a personal loan with their bank some time between getting hit by a truck and the operating table There's also the Chinese model, where you or your family are expected to have substantial cash savings on hand for any medical emergencies.
  - munk-a 5y ago
    I'm not particular familiar with Chinese health insurance - if you lack those cash savings are you left out in the cold? Does the government step in?
    - giaour 5y ago
      I don't have any direct experience with the Chinese health care system, but there's a lot that is not covered by insurance, and bribing doctors or hospital administrators to receive better or quicker care is supposedly widespread (and therefore is or is perceived to be necessary). https://www.newyorker.com/magazine/2014/08/25/under-the-knife https://www.newyorker.com/magazine/2014/08/25/under-the-knif... is a good overview.
  - jnwatson 5y ago
    Even with good insurance, medical costs in the US can exceed the savings of even the most thrifty. My uncle spent $1.7 million in 3 years to care for my aunt, and that is with excellent insurance.
    - rootusrootus 5y ago
      That’s way above any legal out of pocket max so I’m curious where most of that money went. Definitely wouldn’t call it good insurance. My mom is fighting cancer and her medication is better than 25K a month, but she pays 200. That’s closer to my definition of good insurance.
      - 5y ago
- jtbayly 5y ago
  "those who went bankrupt under the old system would instead be dead." The people who went bankrupt before were generally those without insurance. You've not said anything that explains to me why they wouldn't do the same under this supposed new system.
  - munk-a 5y ago
    Well, in this current system everyone (excepting those who choose to opt out and pay a fine instead) receives a basic level of coverage - it's definitely not perfect and it has issues, I'm not going to argue against that. In the 90s and early 2000s it was much easier to bankrupt yourself due to extremely unlucky life events - but if insurance was prohibited you'd be unable to access care so instead of losing your house you'd lose your life. I think I laid that out pretty clearly in the prior comment, is there some part of it that's unclear?
    - jtbayly 5y ago
      People without insurance used to get care and then go bankrupt. Today people without insurance still get care and then go bankrupt. What I’m not understanding is why people in this theoretical future without insurance wouldn’t do the same thing? I feel like we’re talking past each other. Sorry if I’m being dense.
      - mrtranscendence 5y ago
        The blanket statement "people without insurance used to get care and then go bankrupt" does not apply to every single instance. Sometimes people were (and are) already so close to bankruptcy that they simply cannot afford the care that they need, so "I'll get health care and then go bankrupt" is not a live option for them. Yes, emergency care has been essentially free in the US for those who can never pay for it, but that doesn't cover, say, chemotherapy. If you don't have insurance and don't have any way to generate significant cash (no house to sell and no wealthy generous friends) it's not that you're going to get chemo and it'll bankrupt you; you just won't get chemo at all (and you'll probably die). This is a little better now with the medicaid expansion, but not perfect, and not all states expanded medicaid. Even today we have people dying of complications related to diabetes -- a serious but very treatable affliction -- because they can't afford supplies. In the US! The world's richest country!
deleted 5y ago
[deleted]
deleted 5y ago
[deleted]
PeterisP 5y ago
Their life could be extended by some medical care they can't afford, so they would not get that care and die sooner instead.

You'd make it illegal to pool costs by barring insurance - meaning that healthcare providers would either need to provide service gratis for the majority of the population (which is, really, just another form of insurance so that's out) or they'd need to secure a personal loan with their bank some time between getting hit by a truck and the operating table. And for pre-existing conditions and long term health disabilities - the individual would need to somehow justify the profitability of their existence to a private underwriter who was willing to bear the cost - in most cases those people "aren't worth the cost of keeping them alive" (assuming you're looking strictly at numbers). Hence - a lot of people would end up dead.

notch656a 5y ago
Can you really call it 'insurance' when it's a pre-existing condition? I realize we can call insurance whatever we want, but when I think of insurance I think of it a way to pool for mitigating risk of the unknown. No one would sell insurance that would fix your already destroyed roof.
- giaour 5y ago
  > No one would sell insurance that would fix your already destroyed roof. But they will sell you homeowners insurance in areas prone to wildfires or hurricanes. The difference is that you are expected to know the amortized cost of disasters for your property and either insure against it or simply accept the risk. Either way, you as a homeowner are supposed to make an informed decision. If disaster is too likely to occur in a certain area, you can either move or not purchase a property in the first place. Science still hasn't figured out how to let us move into healthier bodies or choose our bodies prior to birth, so, alas, we are forced to seek fairness through other means.
  - com2kid 5y ago
    > But they will sell you homeowners insurance in areas prone to wildfires And in areas with wild fires, tar roofs aren't legal for new construction! Roofs have to be built out of something non-flammable. Lessons to be learned perhaps.
    - max599 5y ago
      Most of the building code is written with the blood of victims who died in a horrific accident. If you want to know why doors in public places have to open toward the outside in modern countries and why "panic bars" are often mandatory, the answer is large piles of dead children (literally). Depending on who you ask and the country they live in, they will refer to a different disaster, but the common element in all of them is 70 - 600 people stuck in hallways unable to escape due to bad exit designs (eg. people piling up against doors that open towards the inside).
      - notch656a 5y ago
        The unseen deaths are those who are unhoused or unsheltered due to building codes causing elevated building prices. Secondary effects (for those who can afford up-to-code) include less money to spend on healthy foods, good health insurance, quality child education, and other victimized children at the hand of building codes and other regulation. You can virtually ramp up building codes ad-infinitum, until the house is as safe as can humanly be built, if your expense is to hurt a lot of children by bankrupting families of expenses to take care of other necessities in life.
- munk-a 5y ago
  Well, whatever we call it we as a society need to choose whether we want to keep people with expensive preexisting conditions alive. I don't think it's really necessary to debate the point since almost every western country has decided that their ethics fall in the camp of "Yes, we support those people and give them the best life possible" whenever they're actually pressed on the matter. For a while the US skated by on budgetary excuses but all the while I think society still idealistically held on to that standard - I think this point is fairly debatable though. I think it's more a question of whether we'd be willing to install and maintain a roof on a building that had been designed without a roof in mind or whether we'd tear down the building to make room for a new one. You'd probably rationally lean in the second direction for a house - but when we're talking about a human life the math changes for a lot of people. Either way, a return to an insurance-less situation would leave people with preexisting situations out in the cold, unless your definition of insuranceless involves government subsidies for all preexisting conditions and at that point you're basically talking about medicare for all.
  - notch656a 5y ago
    I think as a society if we can't discuss this in an honest manner without deceptive terminology, we're doomed to be stuck in a bad spot. Perhaps phrasing it as charity of the healthy towards the less healthy would lead towards a more productive and honest starting point. It's something many, including myself, would be much more supportive of than feeling like I'm deceived by misrepresentation of a product. I'd feel like I'm taking part of a noble charity rather than this sort of deceptive 'insurance' product.
    - RHSeeger 5y ago
      I don't see it as a charity so much as we, as a group, are pooling our money so that those that need health care get health care. That can be people with pre-existing conditions, people with a new condition, people that are in an accident, preventative maintenance, or even just normal life situations (pregnancy, etc). In my mind, it's not charity because it's - For everyone. Maybe not for you today, but maybe tomorrow - For the benefit of society as a whole. If we let everyone who got sick just die, our society would be worse for it.
- pyuser583 5y ago
  If you health insurance only covered “insurance events” in the normal definition of the phrase, much of medical care would not be insurable.
giaour 5y ago
> meaning that healthcare providers would either need to provide service gratis for the majority of the population (which is, really, just another form of insurance so that's out) or they'd need to secure a personal loan with their bank some time between getting hit by a truck and the operating table There's also the Chinese model, where you or your family are expected to have substantial cash savings on hand for any medical emergencies.
- munk-a 5y ago
  I'm not particular familiar with Chinese health insurance - if you lack those cash savings are you left out in the cold? Does the government step in?
  - giaour 5y ago
    I don't have any direct experience with the Chinese health care system, but there's a lot that is not covered by insurance, and bribing doctors or hospital administrators to receive better or quicker care is supposedly widespread (and therefore is or is perceived to be necessary). https://www.newyorker.com/magazine/2014/08/25/under-the-knife https://www.newyorker.com/magazine/2014/08/25/under-the-knif... is a good overview.
- jnwatson 5y ago
  Even with good insurance, medical costs in the US can exceed the savings of even the most thrifty. My uncle spent $1.7 million in 3 years to care for my aunt, and that is with excellent insurance.
  - rootusrootus 5y ago
    That’s way above any legal out of pocket max so I’m curious where most of that money went. Definitely wouldn’t call it good insurance. My mom is fighting cancer and her medication is better than 25K a month, but she pays 200. That’s closer to my definition of good insurance.
    - 5y ago
jtbayly 5y ago
"those who went bankrupt under the old system would instead be dead." The people who went bankrupt before were generally those without insurance. You've not said anything that explains to me why they wouldn't do the same under this supposed new system.
- munk-a 5y ago
  Well, in this current system everyone (excepting those who choose to opt out and pay a fine instead) receives a basic level of coverage - it's definitely not perfect and it has issues, I'm not going to argue against that. In the 90s and early 2000s it was much easier to bankrupt yourself due to extremely unlucky life events - but if insurance was prohibited you'd be unable to access care so instead of losing your house you'd lose your life. I think I laid that out pretty clearly in the prior comment, is there some part of it that's unclear?
  - jtbayly 5y ago
    People without insurance used to get care and then go bankrupt. Today people without insurance still get care and then go bankrupt. What I’m not understanding is why people in this theoretical future without insurance wouldn’t do the same thing? I feel like we’re talking past each other. Sorry if I’m being dense.
    - mrtranscendence 5y ago
      The blanket statement "people without insurance used to get care and then go bankrupt" does not apply to every single instance. Sometimes people were (and are) already so close to bankruptcy that they simply cannot afford the care that they need, so "I'll get health care and then go bankrupt" is not a live option for them. Yes, emergency care has been essentially free in the US for those who can never pay for it, but that doesn't cover, say, chemotherapy. If you don't have insurance and don't have any way to generate significant cash (no house to sell and no wealthy generous friends) it's not that you're going to get chemo and it'll bankrupt you; you just won't get chemo at all (and you'll probably die). This is a little better now with the medicaid expansion, but not perfect, and not all states expanded medicaid. Even today we have people dying of complications related to diabetes -- a serious but very treatable affliction -- because they can't afford supplies. In the US! The world's richest country!

deleted 5y ago

[deleted]

deleted 5y ago

[deleted]

PeterisP 5y ago

Their life could be extended by some medical care they can't afford, so they would not get that care and die sooner instead.