Page 6 of 6 FirstFirst ... 456
Results 51 to 52 of 52
Thanks Tree34Thanks

Thread: Obamacare Replacement - Patient Freedom Act of 2017

  1. #51
    vulgar? Rasselas's Avatar
    Joined
    Feb 2010
    Posts
    56,950
    Thanks
    29472

    From
    in my head
    Quote Originally Posted by Neomalthusian View Post
    Only if taken to the absolute extreme, and even then, people can't predict the medical conditions they'll get, so foregoing insurance coverage a la carte does not necessarily create adverse selection. In the case of sex, at least half the population is female so for men to "self-select" into gender based insurance pools, or even if the pools were completely separated, it wouldn't risk any adverse selection, all it would mean is women would then pay roughly 20% more than men for health insurance. And that would make quite a bit of logical sense given the stats show them consuming about 20% more health care dollars than men (even after accounting for lifespan differences). That's a fact that we know. There's no prejudice inherent to an observed fact.
    It is prejudicial and wrong to charge women more than men for an essential service, and health care is an essential service. You might as well limit maritime insurance to boats that don't sink.



    There's a big difference. People with no familial cancer history do get cancer, and if you opted out, you'd save money and the insurance company would have less risk, quid pro quo, because there is a chance of you getting cancer.
    And yet we've never let insurance companies do this, because it's wrong.
    In theory, yes, assuming of course that an insurer was willing to design an a la carte plan like that for you. You'd be saving some money in premiums in exchange for the insurance company saving on actuarial risk regarding the things you assumed wouldn't happen to you (but still could).
    And its only in theory because we've always had laws to prevent them from doing such things.


    The extremely expensive plans would be a result of adverse selection and the group of unlucky souls left over after adverse selection whose health care costs are already known to be immense on an ongoing basis. These types of people are uninsurable, from a private sector actuarial standpoint. They aren't in need of "insurance" in the first place, i.e. they aren't looking to protect against unknown, relatively unlikely possible future events, they're looking for someone to pay for their health care now. The entire private sector insurance model falls apart for people like this. No system of private insurance works for those who would be left holding the bag and have no choice other than "incredibly expensive plans." There is no actuarial math that fixes their situation or causes any private sector insurance plan to work for these people.
    All of this goes away if we simply require everyone to have insurance all the time. That way they pay into the system BEFORE they have those problems that make them "unlucky souls." I'm thinking its moral to allow "unlucky souls" to lack opportunities in some cases--not everyone is smart enough to be a doctor or an engineer. But when it comes to health, being an "unlucky soul" is just unconscionable.

    This will become even an even more acute problem when genetic testing will let us know a great deal more about the relative risks that various insureds might pose. The fact that we know women have health issues that men do not, but not who will likely get cancer, is a happenstance of our moment in history.



    Then the private for-profit insurance model falls apart.
    No, for fundamental reasons related to what you and most Americans believe health insurance should do, which run counter to the way insurance actually works.
    You're right that health insurance isn't really insurance--it's an alternate way of paying for health care. But uninsured people are a risk for everyone, just as uninsured drivers are a risk for everyone. We should require everyone to have insurance.

  2. #52
    Veteran Member
    Joined
    Feb 2011
    Posts
    13,414
    Thanks
    3597

    From
    AK
    Quote Originally Posted by Rasselas View Post
    It is prejudicial and wrong to charge women more than men for an essential service, and health care is an essential service.
    No it isn't prejudicial and wrong, and we don't charge women more than men for health care. Health care costs are basically the same for men and women, it's just that women consume more of it. Is metering people's utilities "prejudicial and wrong?" People who consume more of something spend more money on it.

    From an insurance standpoint, a significantly and undeniably greater risk of payouts basically requires some variability of premium pricing, so as to avoid adverse selection. Obviously you can't allow complete a la carte customization of the insurable events you want, because that causes adverse selection problems too, but on the other hand if you have no pricing variability, you nonetheless also have adverse selection problems because those who know they're lower risk know they're getting a bad deal will just not accept the bad deal. This is very rational.

    You might as well limit maritime insurance to boats that don't sink.
    I'm not talking about "limiting insurance," but using your analogy, if an insurance company offered full in-kind replacement insurance for fishing boats, and if it were known that 30-year old wood trawlers sink and incur more expensive damage way more often than do similar sized and aged aluminum boats, and the insurance company and its actuaries said it made sense to vary the premium cost based on the type of boat that it is, only an idiot (who probably owns a wooden boat) would be up in arms and declaring injustice. It's basically just a protest against math and a refusal to acknowledge what insurance is and how it's priced.

    You are continuing to be far too black and white about this. Certain people statistically, irrefutably, are vastly more consumptive of insurance pool dollars than others, and there is nothing "wrong" with the notion that premiums should vary according to where risks are statistically higher. If this is intolerable to you, then what you are arguing (or should be arguing) is basically that there should be no such thing as insurance for this particular thing, that it should just be publicly funded via general taxes so that contributions have nothing to do with benefits and tough shit for anyone who disagrees with that. That's where this all leads, ultimately.

    And yet we've never let insurance companies do this, because it's wrong. And its only in theory because we've always had laws to prevent them from doing such things.
    Being subjectively "wrong" according to you isn't the reason though. There are other, more objective reasons certain things aren't permitted when it comes to health insurance, usually having to do with adverse selection, which isn't good for anyone, insurance company, customer, other policyholders, or taxpayers.

    All of this goes away if we simply require everyone to have insurance all the time.
    That's not insurance. It's tax-financed social benefits.

    That way they pay into the system BEFORE they have those problems that make them "unlucky souls."
    Not necessarily. Some have been "unlucky souls" for years and will continue to be indefinitely and have no real money to speak with which they can pay into any system, public or private.

    I'm thinking its moral to allow "unlucky souls" to lack opportunities in some cases--not everyone is smart enough to be a doctor or an engineer. But when it comes to health, being an "unlucky soul" is just unconscionable.
    But no policy erases that bad luck. Large numbers of people get sick, end up with zero or negative net worth, suffer and die no matter what policy is in place. Even Bernie Sanders can't change that.

    You're right that health insurance isn't really insurance--it's an alternate way of paying for health care. But uninsured people are a risk for everyone
    They're actually not. Uninsured people are a risk to themselves to the extent they have assets they'd like to preserve and protect. Beyond that, there is no particular extra risk that uninsured people pose to others. Comparatively, poor people are, along this line of thinking, not just risks for everyone, but straight up burdens for everyone, because even if their net assets are zero or negative and their income is zero, they get as much medical care as they need. We don't refuse care and let them die or even suffer significantly. They get the services.

    And the uninsured are even less "a risk to others" now than they were 10 years ago. Why? Because 1) we literally financially penalize people if they forego insurance, which is ultimately just a catastrophic health policy in that they essentially pay the government a fee in return for enjoying the entitlement to just go and sign up for insurance whenever they start needing significant medical care for something. And 2) most of the people who were uninsured tend to have very little in the way of net assets and not much money to pay for anything, which is often the reason they chose not to buy insurance, hence no matter what, they are not going to be contributing significantly into any system, public or private. They're going to skate on the money contributed by others. So whether they were to remain "uninsured" or become "insured" (thanks to subsidies or Medicaid or whatever combination thereof), it ultimately makes little difference because they're paying almost nothing, because they don't possess money with which they could pay for it, so they don't. Others do. It was basically this way before and it's basically this way now.

Page 6 of 6 FirstFirst ... 456

Similar Threads

  1. Ben Carson- No repeal of Obamacare without a replacement
    By GordonGecko in forum Current Events
    Replies: 37
    Last Post: 13th January 2017, 02:40 PM
  2. Rand Paul rolling out Obamacare replacement this week
    By Spookycolt in forum Current Events
    Replies: 1
    Last Post: 9th January 2017, 04:58 PM
  3. Ryan: ObamaCare replacement coming this year
    By Spookycolt in forum Current Events
    Replies: 64
    Last Post: 6th January 2017, 11:02 PM
  4. Replies: 0
    Last Post: 8th December 2016, 09:03 AM
  5. Replies: 123
    Last Post: 28th October 2016, 08:56 AM

Tags for this Thread


Facebook Twitter RSS Feed