4 ms·

we should just stop calling it insurance, and call it socialised medicine the young pay for the old "insurance" means there's some chance you're having an adv

by tomp 2y ago

we should just stop calling it insurance, and call it socialised medicine the young pay for the old "insurance" means there's some chance you're having an adverse event, and a lot of chance you don't but with medicine, (almost) all of us will get old, and require tons of it

teeray 2y ago
> "insurance" means there's some chance you're having an adverse event, and a lot of chance you don't Exactly. Classic insurance is a bet: the insured is betting that something bad will happen (e.g. house burns down), and the insurer is betting that it will be fine. The problem with health insurance is that the insured will always be correct eventually. The model fundamentally doesn’t work, except if you adjust the parameters of timescale, population, etc. (which tends to be grossly discriminatory except for voluntary behaviors like smoking).
- wjnc 2y ago
  I disagree. Insurance isn’t a bet. Bets are zero sum (or worse). Insurance isn’t zero sum. It’s a structured redistribution of risk bringing both an improved expected utility (if we assume risk aversion) And expected profits to the risk takers. (The funny economist would argue that a casino is the same if we assume the opposite of risk aversion (tolerance / seeking)). I agree with the point that for high chance, low impact events insurance is less efficient. Follows from the same basic utility theory. Insurance is not costless and costs will start to dominate benefits. The intergenerational aspects of health insurance are a good point. Inflation and medical-technological progress still make insurance a good solution in my book. You can save for a pension (still looking at most of the Western world for saving too little); it’s harder to save for unknown future costs whose height is dependent on where the medical risk falls.
wjnc 2y ago
People pay for each other all the time? The old pay the tuition of the young. (Well, not in the US.) Older people pay way more income and wealth tax. Via that logic any re-distribution leads to the conclusion of socialization? I cannot argue pro insurance with Milton Freedman or proper libertarians. (And even have my share of attraction to that part of the spectrum of political philosophy.) I can point out that insurance that works is a staple in large parts of the capitalist world, and has been for some 4 centuries.
- tomp 2y ago
  Redistribution = socialisation, I see no practical distinction or differences, but I’m open to you clarifying any that I’m missing. I’m not arguing against socialisation of medicine per se (though there are obviously worse (UK) and better (Switzerland) models), I’m arguing against using propaganda words for it like “insurance” when it’s anything but.
  - wjnc 2y ago
    I guess I agree with you? A mandatory insurance is a socialized solution. But I think the market for a mandatory insurance can still have mostly capitalist intent. Competition, private ownership of capital, the functioning of a market. Health care is the harder example. No perfect system exists AFAIK. Although I do believe that the real socialist Or capitalist solutions fail a lot sooner than the somewhat mixed approaches in this world. That’s also why I keep looking for other insurance markets as examples. The easy examples of functioning markets tell us that something can work. The hard problems are left for humans to solve.
  - Rinzler89 2y ago
    Swiss medicine is not socialized, it's private.
    - tomp 2y ago
      Well, "private". Every resident is required by law to have health insurance, if you can't afford it, the state will pay it for you. Insurance companies cannot reject you. There's a limited list of personal characteristics they can use to discriminate on price (I think it's basically just where you live, and your age). The list of required benefits covered by insurance is also prescribed by the state. So it's socialized in the sense that "everybody is covered" but the implementation is very "private" i.e. competitive market, which is why I like it, yes.
      - Rinzler89 2y ago
        > if you can't afford it, the state will pay it for you. So like in the US?

by tomp 2y ago

teeray 2y ago

> "insurance" means there's some chance you're having an adverse event, and a lot of chance you don't Exactly. Classic insurance is a bet: the insured is betting that something bad will happen (e.g. house burns down), and the insurer is betting that it will be fine. The problem with health insurance is that the insured will always be correct eventually. The model fundamentally doesn’t work, except if you adjust the parameters of timescale, population, etc. (which tends to be grossly discriminatory except for voluntary behaviors like smoking).

wjnc 2y ago
I disagree. Insurance isn’t a bet. Bets are zero sum (or worse). Insurance isn’t zero sum. It’s a structured redistribution of risk bringing both an improved expected utility (if we assume risk aversion) And expected profits to the risk takers. (The funny economist would argue that a casino is the same if we assume the opposite of risk aversion (tolerance / seeking)). I agree with the point that for high chance, low impact events insurance is less efficient. Follows from the same basic utility theory. Insurance is not costless and costs will start to dominate benefits. The intergenerational aspects of health insurance are a good point. Inflation and medical-technological progress still make insurance a good solution in my book. You can save for a pension (still looking at most of the Western world for saving too little); it’s harder to save for unknown future costs whose height is dependent on where the medical risk falls.

wjnc 2y ago

People pay for each other all the time? The old pay the tuition of the young. (Well, not in the US.) Older people pay way more income and wealth tax. Via that logic any re-distribution leads to the conclusion of socialization? I cannot argue pro insurance with Milton Freedman or proper libertarians. (And even have my share of attraction to that part of the spectrum of political philosophy.) I can point out that insurance that works is a staple in large parts of the capitalist world, and has been for some 4 centuries.

tomp 2y ago
Redistribution = socialisation, I see no practical distinction or differences, but I’m open to you clarifying any that I’m missing. I’m not arguing against socialisation of medicine per se (though there are obviously worse (UK) and better (Switzerland) models), I’m arguing against using propaganda words for it like “insurance” when it’s anything but.
- wjnc 2y ago
  I guess I agree with you? A mandatory insurance is a socialized solution. But I think the market for a mandatory insurance can still have mostly capitalist intent. Competition, private ownership of capital, the functioning of a market. Health care is the harder example. No perfect system exists AFAIK. Although I do believe that the real socialist Or capitalist solutions fail a lot sooner than the somewhat mixed approaches in this world. That’s also why I keep looking for other insurance markets as examples. The easy examples of functioning markets tell us that something can work. The hard problems are left for humans to solve.
- Rinzler89 2y ago
  Swiss medicine is not socialized, it's private.
  - tomp 2y ago
    Well, "private". Every resident is required by law to have health insurance, if you can't afford it, the state will pay it for you. Insurance companies cannot reject you. There's a limited list of personal characteristics they can use to discriminate on price (I think it's basically just where you live, and your age). The list of required benefits covered by insurance is also prescribed by the state. So it's socialized in the sense that "everybody is covered" but the implementation is very "private" i.e. competitive market, which is why I like it, yes.
    - Rinzler89 2y ago
      > if you can't afford it, the state will pay it for you. So like in the US?