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Posted on 5/2/17 at 5:53 pm to roadGator
quote:
If you wreck more cars is your auto insurance higher?
If you eat fried food, fast food, pie and drink soda should you pay more for your insurance because you are a higher risk?
No one complains that life insurance is more costly for those with bad lifestyle choices.
Few complain that under the ACA you are penalized for being a smoker. Or that insurers reward people that do their due diligence and schedule and attend preventive screenings that over the long run save insurers money when adhered too.
The problem is healthcare is not 1:1 based on personal responsibility. To treat it as such would be a mis-diagnosis.
How does non-preventable anemia fall into your personal responsibility narrative? Or hereditary issues like Hyperoxaluria that leads to high kidney stone production throughout your life?
Health care is not the place you can apply bootstraps logic to all the problems. In areas where it is feasible to to do so, like smoking, the system does. It is just going to be a problem to ever fully optimize it because so much is interconnected and not able to be definitively determined. Like how do you deal with alcoholism? Is that personal responsibility? The common teaching for nearly a century says yes. More recent research suggests it is likely much less so. Or the opiod crisis? May of these people got to where they are because of drug companies and legitimate channels of medicine.
This post was edited on 5/2/17 at 6:00 pm
Posted on 5/2/17 at 5:57 pm to tigeraddict
It's the only sensible solution.
The frickers want the healthy to subsidize the unhealthy for the vote though. Politics?as usual, no real solutions in sight
The frickers want the healthy to subsidize the unhealthy for the vote though. Politics?as usual, no real solutions in sight
Posted on 5/2/17 at 5:57 pm to bonhoeffer45
Here's the issue: regardless of the debate of who should pay for the (very) likely increase in medical needs that a person with PE conditions brings to the pool, the fact of the matter is that there will be more costs.
You can make the ethical argument that somebody shouldn't have to pay more for something that was not their fault, but if you use that standard, how can you then argue that another unrelated person should pick up the tab, someone who is also not at fault for the other person's pre-existing condition?
The other way out is to focus on lowering costs for everybody.
You can make the ethical argument that somebody shouldn't have to pay more for something that was not their fault, but if you use that standard, how can you then argue that another unrelated person should pick up the tab, someone who is also not at fault for the other person's pre-existing condition?
The other way out is to focus on lowering costs for everybody.
Posted on 5/2/17 at 5:59 pm to HailHailtoMichigan!
quote:
You can make the ethical argument that somebody shouldn't have to pay more for something that was not their fault, but if you use that standard, how can you then argue that another unrelated person should pick up the tab, someone who is also not at fault for the other person's pre-existing condition?
Because they might have a pre-existing condition tomorrow, regardless of their having one now. And chances are it will be out of their control as to acquisition.
Posted on 5/2/17 at 6:04 pm to Zach
quote:
I highly recommend the TV show 'My 600 lb Life".
No thanks! That would depress me. I wonder how much they spend a month on food?
quote:
It's a great show.
I'll take your word for it.
Posted on 5/2/17 at 6:06 pm to BamaAtl
quote:
Because they might have a pre-existing condition tomorrow, regardless of their having one now. And chances are it will be out of their control as to acquisition.
I might have a wreck tomorrow, but I don't want my car insurance to go up today.
And you can't get a "Pre-existing" condition tomorrow. It is impossible.
Posted on 5/2/17 at 6:07 pm to BamaAtl
quote:
Because they might have a pre-existing condition tomorrow, regardless of their having one now. And chances are it will be out of their control as to acquisition.
what if they're willing to take the gamble?
Posted on 5/2/17 at 6:08 pm to DawgsLife
quote:
And you can't get a "Pre-existing" condition tomorrow. It is impossible.
Go get a BRCA test done and have that sent to your insurer before the ACA, and let me know how it turns out.
Posted on 5/2/17 at 6:08 pm to SlowFlowPro
i'll put it another way
why do you want to force almost a single, uniformed style of insurance choice on EVERYONE instead of letting people make their own decisions and allow vastly different plans to suit vastly different needs of this 300M+ population?
why do you want to force almost a single, uniformed style of insurance choice on EVERYONE instead of letting people make their own decisions and allow vastly different plans to suit vastly different needs of this 300M+ population?
Posted on 5/2/17 at 6:12 pm to SlowFlowPro
quote:
why do you want to force almost a single, uniformed style of insurance choice on EVERYONE instead of letting people make their own decisions and allow vastly different plans to suit vastly different needs of this 300M+ population?
Because of the free rider problem. If someone has a bare-bones insurance plan and becomes ill with a condition that surpasses their coverage, the cost will be passed onto all consumers. If, however, they have a plan meeting certain minimum requirements, they're much less likely to fall into that problem and force us to pay for their hubris.
Posted on 5/2/17 at 6:13 pm to BamaAtl
Nah, they just make us pay for it from the start. At least y'all are honest about stealing my money now.
Posted on 5/2/17 at 6:14 pm to The Spleen
Why did you have to post that? Now I want fried chicken.
Posted on 5/2/17 at 6:14 pm to HailHailtoMichigan!
quote:
Here's the issue: regardless of the debate of who should pay for the (very) likely increase in medical needs that a person with PE conditions brings to the pool, the fact of the matter is that there will be more costs.
You can make the ethical argument that somebody shouldn't have to pay more for something that was not their fault, but if you use that standard, how can you then argue that another unrelated person should pick up the tab, someone who is also not at fault for the other person's pre-existing condition?
The other way out is to focus on lowering costs for everybody.
So here's the natural conflict here. You reduce a lot of costs for everyone by putting everyone together in the same pool. Maximizing the risk that can be spread.
It also eliminates the free-rider problem of uncompensated care.
Where those who can't afford to pay(or choose to go without) get treatment and the cost is shifted to paying customers in the form of higher prices if they can't pay the bill.
However, that solution means that you are abandoning the moral tenant of not forcing people to pay for others or forcing someone against their will to support others..... Then again I am not sure how the current system upholds that either?
The cold solution is that if you can't pay, you die. Tough luck, no soup for you! Social darwinism rules the day if it comes to that. But what is the ethical justification in that? A baby is born into a situation he had no control over and is going to be left to die because his parents can't afford coverage? A person gets hit by a car while following the law and walking on the sidewalk and he will be left to die because he can't prove ability to pay for treatment?
I do not know how you can reconcile the inherent ethical conflict if you require all pillars to be fully satisfied? Full human agency, and basic human and social decency?
Even if you take the position that a person can willingly enter a contract to pool risk in order to take advantage of those benefits, we have seen that system leads to the free-rider problem and people, un-responsible for their own situation either due to pre-existing conditions or age or economic circumstance, left out in the cold.
This post was edited on 5/2/17 at 6:16 pm
Posted on 5/2/17 at 6:14 pm to BamaAtl
quote:So it's not right to charge someone more for having a PEC, but it is ok to charge someone more because they *may* get one tomorrow?
Because they might have a pre-existing condition tomorrow, regardless of their having one now.
Posted on 5/2/17 at 6:14 pm to BamaAtl
quote:
If someone has a bare-bones insurance plan and becomes ill with a condition that surpasses their coverage, the cost will be passed onto all consumers.
assuming they get the treatment, which is a major assumption
i don't think they should be allowed to game the system in this manner
the US government said my plan was illegal and it suited my needs perfectly (and still would to this day). i don't see why i have to get punished in this way as WELL as being forced to offset the bad decisions of others. i get totally fricked in this scenario and i don't even get a different option to make it hurt a bit less. how is that fair to me?
Posted on 5/2/17 at 6:17 pm to SlowFlowPro
why don't we just create a public option
eliminate Medicare, Medicaid, and other federal spending on care
take all that funding and slash it by 25-50%
then create a public insurance option and use that remaining 50-75% of the prior "federal health care spending" to supplement the issues of demographics to subsidize the public plans to make them cheaper for everyone who wants to use the government plan
allow everyone else to go back to choosing their own fricking insurance without the feds being involved
eliminate Medicare, Medicaid, and other federal spending on care
take all that funding and slash it by 25-50%
then create a public insurance option and use that remaining 50-75% of the prior "federal health care spending" to supplement the issues of demographics to subsidize the public plans to make them cheaper for everyone who wants to use the government plan
allow everyone else to go back to choosing their own fricking insurance without the feds being involved
Posted on 5/2/17 at 6:21 pm to bonhoeffer45
quote:You're neglecting the role of private charity and private assistance. You can argue as much as you want about whether it is sufficient or not, but you cannot just remove it from your analysis. So, no, that is not a "cold solution".
The cold solution is that if you can't pay, you die.
Also, American health care companies have pools that are larger than many european nations, yet they have not been able to lower costs. Furthermore, many people in that pool are paying premiums that are partially funded by taxpayers, and that's a cost in and of itself.
European nations haven't been able to decrease costs by pooling together, they decrease costs by making sure income in the medical sector does not rise above a certain level, and by telling people and health companies: "no, that treatment isn't going to happen"
Posted on 5/2/17 at 6:22 pm to SlowFlowPro
quote:
the US government said my plan was illegal and it suited my needs perfectly (and still would to this day). i don't see why i have to get punished in this way as WELL as being forced to offset the bad decisions of others. i get totally fricked in this scenario and i don't even get a different option to make it hurt a bit less. how is that fair to me?
Which brings up another interesting point. Covered California famously had no specialists in network. So if someone with an ACA compliant plan gets sick and needs a specialist, who pays for the medical costs their plan doesn't cover?
Posted on 5/2/17 at 6:23 pm to Bestbank Tiger
LA i think only has 2 companies offering plans here
BCBS of LA and Vantage (iirc)
Vantage was a bit cheaper and had almost nobody worth a frick in its network
BCBS of LA and Vantage (iirc)
Vantage was a bit cheaper and had almost nobody worth a frick in its network
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