US health care question

[Eddie Teach]

I've never had a homoerotic dream before.

But have you dreamed of vampire stripper ponies?

[Razgovory]

I saw some of the video of Frank's town hall. He acted like he tries to be so flip, glib and/or condescending with his peers or political opponents, and I think it had the opposite affect on his voters at the town hall. Voters may have gone too far but Frank didn't necessarily help himself out nor conduct an instructive meeting, at least not the parts I saw. However, I'm neutral on it - he'll get re-elected, or not, most likely will. Up to the voters in his district to decide.

Frank is for a government run health care system, single payer. Has said so and hasn't backed down from that. I don't agree with that view but at least he doesn't dance around the question and try to be all things to all people.

Proper response is to call the hospital and ask them to take away the lunatics disrupting the meeting.

[DGuller]

So you think it would be somewhat akin to the way car insurance premiums can be kept down by requiring drivers to have insurance, correct?

I don't think car insurance is mandatory for the same reason.  Adverse selection is not an issue with car insurance; some of the worst drivers (young men) think that they're in fact the world's best drivers, so without auto insurance mandate you won't have just the worst drivers getting insurance.  Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.

[alfred russel]

So you think it would be somewhat akin to the way car insurance premiums can be kept down by requiring drivers to have insurance, correct?

I don't think car insurance is mandatory for the same reason.  Adverse selection is not an issue with car insurance; some of the worst drivers (young men) think that they're in fact the world's best drivers, so without auto insurance mandate you won't have just the worst drivers getting insurance.  Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.

Another major difference is that you don't know you are going to get in an accident, while you may have a good idea you are about to need medical care. A contributor to slate.com recently wrote a piece complaining about "loopholes" in her privately purchased health insurance because pregnancy wasn't covered leaving her with a $20,000 tab (she ended up testifying to congress). The thing is insurance companies aren't being evil: it is just that 20 something women without jobs providing insurance are going to be far more likely to get insurance at $200 a month just before a pregnancy, leaving the insurance company with a $20k tab. The result would make it difficult to affordably insure 20 something women.

[Barrister]

I don't think car insurance is mandatory for the same reason.  Adverse selection is not an issue with car insurance; some of the worst drivers (young men) think that they're in fact the world's best drivers, so without auto insurance mandate you won't have just the worst drivers getting insurance.  Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.

I think auto insurance is not a bad example.  The fact that it covers people you hit, instead of yourself, has little practical difference - if everyone has auto insurance then everyone is covered, no matter how it works out.

Where the example breaks down is that auto insurance is reasonable easy to enforce - you have to provide proof of insurance to register a vehicle.  And the costs of free-riders (people who simply break the law) are low enough that they can be covered by the government without major problems.  UP here we have a govt fund to pay people hit by uninsured drivers, and it's a fairly minor expense.

[Baron von Schtinkenbutt]

Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.

Except in no-fault states, where it covers you.

[alfred russel]

And the costs of free-riders (people who simply break the law) are low enough that they can be covered by the government without major problems.  UP here we have a govt fund to pay people hit by uninsured drivers, and it's a fairly minor expense.

We have no such fund.

[Baron von Schtinkenbutt]

We have no such fund.

And that is why I have uninsured motorist coverage.

[Tonitrus]

I don't think car insurance is mandatory for the same reason.  Adverse selection is not an issue with car insurance; some of the worst drivers (young men) think that they're in fact the world's best drivers, so without auto insurance mandate you won't have just the worst drivers getting insurance.  Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.

I think auto insurance is not a bad example.  The fact that it covers people you hit, instead of yourself, has little practical difference - if everyone has auto insurance then everyone is covered, no matter how it works out.

Where the example breaks down is that auto insurance is reasonable easy to enforce - you have to provide proof of insurance to register a vehicle.  And the costs of free-riders (people who simply break the law) are low enough that they can be covered by the government without major problems.  UP here we have a govt fund to pay people hit by uninsured drivers, and it's a fairly minor expense.

Car insurance can also be obscenely expensive for people with multiple traffic infractions/accidents.

Translate that to health care, and it will become unaffordable to a lot of people, except in their case, it's health problems that may be entirely outside their control; unlike infractions or (at-fault) accidents.

It's silly to make something illegal (such as not carrying insurance) if one cannot afford it.  In the "ideal" legal world, people without, or whom cannot afford, auto insurance shouldn't drive...so those who cannot afford health insurance shouldn't live?

[sbr]

It's silly to make something illegal (such as not carrying insurance) if one cannot afford it.  In the "ideal" legal world, people without, or whom cannot afford, auto insurance shouldn't drive...so those who cannot afford health insurance shouldn't live?

I think that sums up the Conservative point of view pretty well.

[DontSayBanana]

We have no such fund.

We do. PLIGA.

http://www.njguaranty.org/infoCenter/pligaSurcharge.asp

[alfred russel]

It's silly to make something illegal (such as not carrying insurance) if one cannot afford it.  In the "ideal" legal world, people without, or whom cannot afford, auto insurance shouldn't drive...so those who cannot afford health insurance shouldn't live?

I agree, which is why it makes sense to subsidize people who can't afford insurance.

I have no problem paying (through taxes) doctor bills for people that can't afford them, so long as I'm not also paying for my neighbor down the street that decided he just doesn't want insurance. 

[Tonitrus]

I hate to say it...but I am warming to the idea of socialized medicine; even though I already exist in such a system, and generally despise it.

We should either cover everyone, or abandon health insurance as an entirety, and go back to the good old days where people who could afford it got a good doctor, and everyone else just died naturally.

Hell, if doctors had to market their services more, instead of just screwing Medicare or giant insurance conglomerates/HMOs, we'd probably be better off.  The downside to that, of course, is "emergency" care (heart attacks and the like), where you really don't have the luxury of shopping around.

But who really knows what a good solution would be.  The entire situation just sucks in general.

[DGuller]

Car insurance is mandatory for social considerations, as your insurance protects the people *you* hit.

Except in no-fault states, where it covers you.

Yes, true.  No-fault is on the way out, though.  I don't really know why no-fault insurance is mandatory.

[DGuller]

We have no such fund.

We do. PLIGA.

http://www.njguaranty.org/infoCenter/pligaSurcharge.asp

Those are guarantee funds.  Their purpose is to protect you against insurance company's insolvency, not against uninsured motorist's insolvency.  They're pretty much universal.