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> Which is why any sane health care reform will likely include a mandate requiring people like you to carry coverage; insurance works best with a large pool of
by tjic 18y ago
> Which is why any sane health care reform will likely include a mandate requiring people like you to carry coverage; insurance works best with a large pool of risk, where coverage isn't biased towards those at most risk of making claims.
The point you make is technically true, but seems a bit bizarre.
It's like saying "if we had an financial instrument that paid for people's airline tickets, we wouldn't want to allow people to choose to join or not join - if we did that, we'd just have all the people who like to travel a lot join, and it would cost a lot! So what we really need to do is force EVERYONE to contribute, so that there are a lot of people who get no benefits who can subsidize those people who draw a lot of benefits".
Yes, you're right - unless we do that, people who draw a lot of benefits will have to pay for a lot of benefits.
...but it seems a bit morally autistic to me.
- akeefer 18y agoDepends if you're a believer in the "genetic lottery" (to use John Rawls's term) or not. If you believe that things like catastrophic accidents or health conditions have a large amount of "luck" involved in them, then morally speaking it's more fair to spread the cost of them out over the whole population rather than concentrating it in whoever happens to get unlucky enough to develop leukemia or get hit by a bus. Of course, health is something that people have some amount of control over, but exactly how much is obviously a big open question. Unsurprisingly, people who are on the "winning" side of the lottery (be it health, talent, or success in things like sports and business) tend to under-estimate how much luck has to do with it, over-estimate their own contribution, and thus also over-estimate how much someone else's actions have to do with their "loss" in that lottery.
- tptacek 18y agoYour analogy doesn't hold, because people choose not to travel, but nobody can really choose to avoid medical attention. There are people who are --- right now --- less likely to avail themselves of care, yes; if they don't insure themselves, and others do, you have adverse selection. The term for those young people who avoid insurance is "free rider".