4 ms·

... I had it tough, therefore others should too? What if those others had it tougher than you? have you apologized to them for having it so much easier? Or, he

by olliej 3y ago

... I had it tough, therefore others should too? What if those others had it tougher than you? have you apologized to them for having it so much easier? Or, hear me out, maybe the goal should be for tomorrow to be better than today, or yesterday, and that definitionally means a lot of stuff gets easier. Complaining as you're doing here is the same as saying "this cancer treatment should be banned because I lost family members to cancer when it wasn't available, and it's unfair for cancer patients today to have it easier than we did" Also as an addendum because you're pulling the I had it tough card: my parents had me as teenagers, then they were uni students with no money until I was 6 or 7, and I was deaf, had severe asthma, and so was relentlessly bullied due to a lisp I had because, you know, I was deaf until I was 5. We lived in a house that would be better described as a shed - corrugated steel walls and siding, etc we were not anywhere near "middle class". Guess what: I still think people should not have to go through that just because I did. JFC.

echelon 3y ago
My original post suggests that costs should be attributed to risks. If you take an outsized portion of health care relative to the rest of society, there's a chance that may be linked to behavioral choice. If you smoke a pack every day, eat two McGriddles every morning, film parkour stunts for your YouTube channel, go to the STD clinic monthly, are an alcoholic, etc. Society should not be paying for this in the same way it pays for cancer and freak accidents. It's malinvestment that could have been prevented.
- foldr 3y ago
  If health insurance were priced according to individual risk then a huge swathe of the population wouldn’t be able to afford health insurance (as indeed is still the case to some extent, even after Obamacare). And that’s assuming that you leave Medicare and Medicaid in place - which logically you shouldn’t, according to your line of argument. How it could be a malinvestment for a society to invest in the health of...its very own constituents, is a nut that I won’t attempt to crack.
  - olliej 3y ago
    Yeah, it’s really amazing I had a republican/now-maga coworker who vehemently opposed Obamacare and said it was unnecessary as people who were risky should shoulder increased insurance costs, and could not understand that my partner literally could not get insurance for any amount, every insurance company was literally saying “you donated a kidney [were healthy enough to donate a kidney] and because you only have one kidney we will not cover you, good luck!”. It wasn’t even “we won’t cover kidney issues” (ignoring that finding a kidney donor saves insurance companies money) it was a blanket “we will not accept you as a customer”. To this day the dude thinks Obamacare is bad, and that people should “take responsibility”. (I’m unsure how people born with congenital defects are meant to take responsibility but dudes a maga and thinks a bunch of his coworkers aren’t people so I assume the same applies to people with congenital issues)
- olliej 3y ago
  Sounds like you want to apply value calculation to people - is this person's life worth the same or more than this other person's? Then they can get healthcare. And we can see that because you're complaining about, for example, parkour stunts, but not the much more common sports that cause significant injuries. I get that it's a common desire to say "this person does not deserve to live because I don't like their choices", but like so many other things it turns out that the cost of trying to do this is always more significant than just not assigning value to people's lives, and those policies have a tendency to capture people you don't think it should apply to. Take the various conservative anti-women laws that suddenly became a problem when they interfered with IVF for middle aged white women, despite that being a completely consistent application of the claimed rationale for the law (if an embryo is a live human, then IVF requires murder, but everyone knows an embryo is not a person, the goal of these laws, much like your desire to restrict access to healthcare, is about punishing people for perceived slights). I might have thought you could also see how the costs associated with many illnesses might contribute to the proportionally higher tax rates on things like alcohol and tobacco in countries with public health services. But there's more to it than that, you're arguing against a Public Health Service as though your claimed concern about unreasonable costs from bad life choices does not apply to private healthcare+insurance, but that's simply not true. Your insurance premiums are priced to cover the YouTube stunters, the alcoholics, the people playing sports, the people driving, etc just like a Public Health Service. The only difference is that your insurance companies and hospitals are making a profit as well so definitionally cost more as applied to the total economy (a statistic that has been repeatedly shown is that the US spends more on healthcare than countries with PHS, but has lower coverage and worse outcomes). Because the metric for success in a public health service is treatment, the system is optimized to treat the most people. For private health care the metric is income, which means hospitals charge more, and optimize their billing to maximize the amount that can extract from insurance companies (that's why your anesthesia for a surgery is inexplicably billed as a separate procedure), and insurance companies optimize to deny or delay coverage as much as possible.
  - echelon 3y ago
    > Sounds like you want to apply value calculation to people To behavior. If you buy a sports car, you pay higher car insurance. If you buy a motorcycle, you should pay higher health insurance. If you live riskily or unhealthily, your coverage should cost more and not be averaged out over the less risky. Risk calculus should be considered with everything. It's essential to extending a home loan, but not when granting a college loan. Decoupling risk leads to bad outcomes. > but not the much more common sports that cause significant injuries. I think sports players should pay more for injury insurance. And roofers, loggers, etc. Those costs will be absorbed by their respective industries where the costs are generated. > this person does not deserve to live because I don't like their choices I'm not saying that at all, and that's such a cartoon way of looking at this. You walk into a hospital in America and you get treatment. That doesn't mean you don't have to pay for it. > I might have thought you could also see how the costs associated with many illnesses might contribute to the proportionally higher tax rates on things like alcohol and tobacco in countries with public health services. I never said do not tax negative externalities. By all means, please do. We should tax drugs too. > Your insurance premiums are priced to cover the YouTube stunters, the alcoholics, the people playing sports, the people driving, etc just like a Public Health Service. I would like them to not. I would like to cover my risk profile. Everyone should cover their own risk profile. That's fair and equitable. > Because the metric for success in a public health service is treatment, the system is optimized to treat the most people. It already does this. This is simply about who gets the bill.

by olliej 3y ago

echelon 3y ago

My original post suggests that costs should be attributed to risks. If you take an outsized portion of health care relative to the rest of society, there's a chance that may be linked to behavioral choice. If you smoke a pack every day, eat two McGriddles every morning, film parkour stunts for your YouTube channel, go to the STD clinic monthly, are an alcoholic, etc. Society should not be paying for this in the same way it pays for cancer and freak accidents. It's malinvestment that could have been prevented.

foldr 3y ago
If health insurance were priced according to individual risk then a huge swathe of the population wouldn’t be able to afford health insurance (as indeed is still the case to some extent, even after Obamacare). And that’s assuming that you leave Medicare and Medicaid in place - which logically you shouldn’t, according to your line of argument. How it could be a malinvestment for a society to invest in the health of...its very own constituents, is a nut that I won’t attempt to crack.
- olliej 3y ago
  Yeah, it’s really amazing I had a republican/now-maga coworker who vehemently opposed Obamacare and said it was unnecessary as people who were risky should shoulder increased insurance costs, and could not understand that my partner literally could not get insurance for any amount, every insurance company was literally saying “you donated a kidney [were healthy enough to donate a kidney] and because you only have one kidney we will not cover you, good luck!”. It wasn’t even “we won’t cover kidney issues” (ignoring that finding a kidney donor saves insurance companies money) it was a blanket “we will not accept you as a customer”. To this day the dude thinks Obamacare is bad, and that people should “take responsibility”. (I’m unsure how people born with congenital defects are meant to take responsibility but dudes a maga and thinks a bunch of his coworkers aren’t people so I assume the same applies to people with congenital issues)
olliej 3y ago
Sounds like you want to apply value calculation to people - is this person's life worth the same or more than this other person's? Then they can get healthcare. And we can see that because you're complaining about, for example, parkour stunts, but not the much more common sports that cause significant injuries. I get that it's a common desire to say "this person does not deserve to live because I don't like their choices", but like so many other things it turns out that the cost of trying to do this is always more significant than just not assigning value to people's lives, and those policies have a tendency to capture people you don't think it should apply to. Take the various conservative anti-women laws that suddenly became a problem when they interfered with IVF for middle aged white women, despite that being a completely consistent application of the claimed rationale for the law (if an embryo is a live human, then IVF requires murder, but everyone knows an embryo is not a person, the goal of these laws, much like your desire to restrict access to healthcare, is about punishing people for perceived slights). I might have thought you could also see how the costs associated with many illnesses might contribute to the proportionally higher tax rates on things like alcohol and tobacco in countries with public health services. But there's more to it than that, you're arguing against a Public Health Service as though your claimed concern about unreasonable costs from bad life choices does not apply to private healthcare+insurance, but that's simply not true. Your insurance premiums are priced to cover the YouTube stunters, the alcoholics, the people playing sports, the people driving, etc just like a Public Health Service. The only difference is that your insurance companies and hospitals are making a profit as well so definitionally cost more as applied to the total economy (a statistic that has been repeatedly shown is that the US spends more on healthcare than countries with PHS, but has lower coverage and worse outcomes). Because the metric for success in a public health service is treatment, the system is optimized to treat the most people. For private health care the metric is income, which means hospitals charge more, and optimize their billing to maximize the amount that can extract from insurance companies (that's why your anesthesia for a surgery is inexplicably billed as a separate procedure), and insurance companies optimize to deny or delay coverage as much as possible.
- echelon 3y ago
  > Sounds like you want to apply value calculation to people To behavior. If you buy a sports car, you pay higher car insurance. If you buy a motorcycle, you should pay higher health insurance. If you live riskily or unhealthily, your coverage should cost more and not be averaged out over the less risky. Risk calculus should be considered with everything. It's essential to extending a home loan, but not when granting a college loan. Decoupling risk leads to bad outcomes. > but not the much more common sports that cause significant injuries. I think sports players should pay more for injury insurance. And roofers, loggers, etc. Those costs will be absorbed by their respective industries where the costs are generated. > this person does not deserve to live because I don't like their choices I'm not saying that at all, and that's such a cartoon way of looking at this. You walk into a hospital in America and you get treatment. That doesn't mean you don't have to pay for it. > I might have thought you could also see how the costs associated with many illnesses might contribute to the proportionally higher tax rates on things like alcohol and tobacco in countries with public health services. I never said do not tax negative externalities. By all means, please do. We should tax drugs too. > Your insurance premiums are priced to cover the YouTube stunters, the alcoholics, the people playing sports, the people driving, etc just like a Public Health Service. I would like them to not. I would like to cover my risk profile. Everyone should cover their own risk profile. That's fair and equitable. > Because the metric for success in a public health service is treatment, the system is optimized to treat the most people. It already does this. This is simply about who gets the bill.