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Read the rules in the OP before posting, please.In order to ensure that this thread continues to meet TL standards and follows the proper guidelines, we will be enforcing the rules in the OP more strictly. Be sure to give them a re-read to refresh your memory! The vast majority of you are contributing in a healthy way, keep it up! NOTE: When providing a source, explain why you feel it is relevant and what purpose it adds to the discussion if it's not obvious. Also take note that unsubstantiated tweets/posts meant only to rekindle old arguments can result in a mod action. |
On November 04 2013 11:02 DoubleReed wrote:Show nested quote +On November 04 2013 10:33 Introvert wrote:On November 04 2013 10:28 KwarK wrote:On November 04 2013 10:23 Introvert wrote:On November 04 2013 10:18 Gorsameth wrote:On November 04 2013 10:16 ZeaL. wrote:On November 04 2013 10:00 Roe wrote:
I always find it odd when conservatives in the US attribute the reason for its decline to its communism and socialism, when the countries that have something like universal healthcare are doing much better than the US. Maybe your system isn't working? You can't keep pinning your problems on flaws that don't exist. - The successful countries are all 100% one type of people. Diversity, aka poor black/hispanic people, means it's pointless to even compare the USA to other countries because they don't have a statue of liberty that lets people immigrate. - Culturally we are like no other country. Americans eat hamburgers, drive Harleys, and shoot animals. This means that we can't have single payer. - As we all know, life under communist rule was brutal and sad. Capitalism, the foundation of America, is the polar opposite which has given us American exceptionalism. Socialism is a terrible mix of capitalism and communism, a half breed philosophy which will fail ... eventually. Someday Germany and Switzerland and Norway are going to look like Greece, just you wait. Socialism will take its toll. god i actually got to the 3e point before i realized the sarcasm.... On November 04 2013 10:13 Introvert wrote:On November 04 2013 10:08 Gorsameth wrote:On November 04 2013 10:07 Introvert wrote:On November 04 2013 10:05 Gorsameth wrote:On November 04 2013 09:44 Introvert wrote:
"You can't go without healthcare." Millions of young people do, of their own choice. And I would hope to discourage being a freeloader, unfortunately with Ocare's rates, it's going to make MORE freeloaders who would rather pay the "tax" then pay extreme prices for care.
Yes and all those millions of young people are utterly and permanently ruined if they actually catch something bad, and yet the rest of the people will stay be pay for them to be dragged from ER to ER to let them live another day in there financially ruined world because there medicine costs more then they make which means there so sick they cant even work. Wonderful system. The stupidity of millions because they gamble with there lives and other peoples money (to pay for the ER they use) is not an argument against universal healthcare..... I didn't say it was, it's an argument against Obamacare. Let me check.... nope, not an argument against Obamacare either. If anything your trying to show Obamacare isnt invasive enough. It still gives you a choice not to get insurance which it shouldn't. Sure it is. Obamacare is increasing prices. Therefore, more people will pay the fine. Therefore, there are more people going from ER to ER. It does the exact opposite of what it intended. Except the part where reports are showing a decrease in prices. But hey dont let facts stand in your way. Oh and as i said before. If paying the fine is cheaper then insurance the fine isnt high enough. Ok, so 7-15 million will have to pay more for being kicked off of what they had. The other stat I heard only said that Obamacare is only "slowing the increase." Maybe it's going down if you count the newly subsidized? Where did you get this new information? Is it more than the 15 million that will see an increase? Fine not high enough? Man, this really amusing. People advocating government coercion. As opposed to everything else the government does which isn't coercive? Government is coercion, deal with it or find your own country. The government is trying to get people to pay into healthcare so people who need healthcare can get healthcare. If people are opting out then yeah, you need to disincentivise that. In other news the government disincentivises fraud with the legal system and that's coercion too. That's pretty much how it works and crying coercion as if you're in the middle of a Tea Party rally won't actually score you any points. I advocate as little coercion as possible, that's the thing. As for "deal with it or leave." No? Why should I just give up and give in? I'm not the one advocating more government, that's them. THEY want the heavier change, not me. They can leave and go to some other country that already has the system they want. Why change this one when they can just move! This is the fundamental difference. I don't trust the fallible human beings who are in charge, so I oppose giving them more power, generally speaking. Right, you care about your theoretical ideology of theoretical coercion. I care about real people in the real world. Pragmatism vs Ideology. "Government is less efficient than the private sector" is ideology. It is empirically wrong in this case, as has been demonstrated numerous times in this thread, yet you keep saying it because ideology does not yield to evidence. And yes you definitely trust fallible human beings in charge, as long as they're driven by profits. Personally, if the free market kills a bunch of people, I blame the government for letting people die. You just shrug and say "that's the way the cookie crumbles" and people continue to die. That's the difference between you and me. Inaction does not absolve you of responsibility.
Glad I checked again.
Theoretical coercion? What's theorectical about it? It exists in the law, and you support it. It's very real, you just like it.
I trust them to observe a contract if doing so is better than not doing so. What is the government's incentive to keep their word? People die under any system. I'm not advocating for what we have, that's the mistaken assumption you are making. I want a system with lots of people covered, I just think that government is the wrong way to do it. But you have displayed that it's very hard for you to leave the "right-wingers hate everyone" box, so you don't get it.
Edit: everyone is still confused. I'm not against government, I'm just for making it as small and as out of the way as possible.
Fun talking with you guys.
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United States42778 Posts
On November 04 2013 11:08 JonnyBNoHo wrote:Show nested quote +On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:On November 04 2013 10:21 KwarK wrote:On November 04 2013 09:59 JonnyBNoHo wrote:On November 04 2013 09:23 KwarK wrote:On November 04 2013 08:52 JonnyBNoHo wrote:On November 04 2013 08:24 KwarK wrote:On November 04 2013 08:20 JonnyBNoHo wrote:On November 04 2013 07:55 KwarK wrote:
Of course the average person has no fucking clue how to pick insurance. He doesn't know the likelihood of a given affliction hitting him, nor how much it costs to treat, nor how it will impact his life. This is a lot of actuarial information that an average person has no access to and wouldn't know what to do with even if he had and yet he is supposed to work out which insurance plan best suits his situation? Insurance isn't a loaf of bread and treating it like one helps no-one. Healthcare costing is where complex statistics, actuarial calculations, public health policy, specialised knowledge about pretty much every ailment and their treatments and cutting edge pharmacology all meet. You get bureaucrats working for the state or for the insurance companies but it's basically the same group of people trying to work out what is going to go wrong and how much it'd cost to keep you working in a giant equation that you couldn't begin to understand. Only in a private insurance system it pads their bottom line to mislead you about costs, deny you unprofitable care you need, sell you shit you don't and drop you the moment you need them to do anything.
Public healthcare in my country is decided by bureaucracy and I wouldn't want it any other way. If you really think you're qualified to judge your own healthcare needs then yeah, you are so stupid that you need the government to hold your hand. That's why it's the American public, pretty much uniquely in the world, who actually believe they're qualified it in spite of their constant catastrophic failures. No other nation has such incredibly unqualified self belief in their own exceptionalism. Buying insurance isn't really complicated. You aren't figuring your odds of getting sick, or the cost of getting sick - that's built into the price of the insurance. What you're figuring for the most part is what fits into your budget - co-pays, max out of pocket, etc. Insurance is, at its most basic level, a bet. You're betting that something will happen and they pay out if it does and you lose your stake if it does not. The issue with health insurance is that you don't know what you're betting will happen beyond bad stuff, you don't know anything about how likely it is too happen and you don't know what the payout is if you "win". And yet you're meant to distinguish between the different bets on offer. If you think you have a grasp on it you don't know what it is. It's similar to buying car, homeowner's, or life insurance. You just look at the plan, what's covered, what your exposure is, and decide between them. You don't have to do the actuarial work, that's built into the price of the plan. All you have to do is figure out the costs / risks between the different iterations and decide between those. Ex. max out of pocket $10K vs $5K. Can you afford paying out $10K in a year? If so you may want to take that, if not, or if that sounds too scary, than don't. Inevitably some people will "over insure" and others will "under insure" - but that's always the case. A national plan would be sub-'optimal' at individual levels too. Actuarial work is built into the price of the plan but this is a plan devised by a for profit company that serves its shareholders, it is not out there to provide you with the most comprehensive care possible for the lowest cost possible (incidentally that is what public provision is for). There are endless sad stories about insurance letting people down. Oddly enough creating a minimum standard of insurance to be comprehensive and not fuck people over was included in Obamacare as far as I recall. The idea that you can just compare the financials and ignore the healthcare side assumes all insurance always pays out (rather than fucking you over cause for profit company), never tries to sell you anything you don't actually need (cause for profit company), never doesn't include anything you do actually need that'd cost it money (cause for profit company) and that how much you can afford to pay out of pocket at any given time is a meaningful factor in which insurance you need for your personal situation. Also that your judgement of which risks are worth taking is good judgement (regular checkups are a good investment because if you find shit early it is way cheaper to fix but if you have to pay out of pocket for those you might skip them and rely on the insurance to bail you out if shit goes wrong). Also insurance is shitty at dealing with macro health problems and at preventative care. You're being an irrational lefty, the tea party in reverse. Instead of "of course it's bad it's the government" you crack out the "of course it's bad it's for profit". To some of your individual points, for profit companies don't only serve their shareholders and they do have competition, regardless. The government isn't out there to provide the most comprehensive coverage at the lowest cost either (governments do ration healthcare and do overpay in instances), and stories of government letting people down do exist as well. Also, the ACA is also not the first instance of government regulation in health insurance. Plans have to be approved by regulators before they can be sold with or without the ACA. I still don't see why you think deciding on health insurance is so hard. Have you ever bought health insurance? I'm sure the plans are simplified to an extent but I'll give you an example of the problem as I see it. You probably won't know your statistically biggest risk, nor the costs of treating it. Given this how are you meant to decide if you want a plan that locks them in if you develop an expensive chronic condition or one that gives you a lot of treatments which would add up to a lot for free or one that limits your expenses in the case of one hugely expensive accident. The plans may not be complicated but the factors that influence which one is right for you certainly are. I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit. How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance.
NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public.
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United States42778 Posts
On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million.
The number I gave was per year of life adjusted for quality of life.
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Theoretical coercion? What's theorectical about it?
Coercion usually refers to violent threats, extortion, blackmail, and torture. IMO, to compare this to "pay your taxes" or "get healthcare" is pretty insulting to people who have actually had coercion done to them.
I'd rather have "implicit violence" than explicit violence.
On November 04 2013 11:21 KwarK wrote:The number I gave was per year of life adjusted for quality of life.
Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars."
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On November 04 2013 11:20 KwarK wrote:Show nested quote +On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:On November 04 2013 10:21 KwarK wrote:On November 04 2013 09:59 JonnyBNoHo wrote:On November 04 2013 09:23 KwarK wrote:On November 04 2013 08:52 JonnyBNoHo wrote:On November 04 2013 08:24 KwarK wrote:On November 04 2013 08:20 JonnyBNoHo wrote:
[quote]
Buying insurance isn't really complicated. You aren't figuring your odds of getting sick, or the cost of getting sick - that's built into the price of the insurance. What you're figuring for the most part is what fits into your budget - co-pays, max out of pocket, etc. Insurance is, at its most basic level, a bet. You're betting that something will happen and they pay out if it does and you lose your stake if it does not. The issue with health insurance is that you don't know what you're betting will happen beyond bad stuff, you don't know anything about how likely it is too happen and you don't know what the payout is if you "win". And yet you're meant to distinguish between the different bets on offer. If you think you have a grasp on it you don't know what it is. It's similar to buying car, homeowner's, or life insurance. You just look at the plan, what's covered, what your exposure is, and decide between them. You don't have to do the actuarial work, that's built into the price of the plan. All you have to do is figure out the costs / risks between the different iterations and decide between those. Ex. max out of pocket $10K vs $5K. Can you afford paying out $10K in a year? If so you may want to take that, if not, or if that sounds too scary, than don't. Inevitably some people will "over insure" and others will "under insure" - but that's always the case. A national plan would be sub-'optimal' at individual levels too. Actuarial work is built into the price of the plan but this is a plan devised by a for profit company that serves its shareholders, it is not out there to provide you with the most comprehensive care possible for the lowest cost possible (incidentally that is what public provision is for). There are endless sad stories about insurance letting people down. Oddly enough creating a minimum standard of insurance to be comprehensive and not fuck people over was included in Obamacare as far as I recall. The idea that you can just compare the financials and ignore the healthcare side assumes all insurance always pays out (rather than fucking you over cause for profit company), never tries to sell you anything you don't actually need (cause for profit company), never doesn't include anything you do actually need that'd cost it money (cause for profit company) and that how much you can afford to pay out of pocket at any given time is a meaningful factor in which insurance you need for your personal situation. Also that your judgement of which risks are worth taking is good judgement (regular checkups are a good investment because if you find shit early it is way cheaper to fix but if you have to pay out of pocket for those you might skip them and rely on the insurance to bail you out if shit goes wrong). Also insurance is shitty at dealing with macro health problems and at preventative care. You're being an irrational lefty, the tea party in reverse. Instead of "of course it's bad it's the government" you crack out the "of course it's bad it's for profit". To some of your individual points, for profit companies don't only serve their shareholders and they do have competition, regardless. The government isn't out there to provide the most comprehensive coverage at the lowest cost either (governments do ration healthcare and do overpay in instances), and stories of government letting people down do exist as well. Also, the ACA is also not the first instance of government regulation in health insurance. Plans have to be approved by regulators before they can be sold with or without the ACA. I still don't see why you think deciding on health insurance is so hard. Have you ever bought health insurance? I'm sure the plans are simplified to an extent but I'll give you an example of the problem as I see it. You probably won't know your statistically biggest risk, nor the costs of treating it. Given this how are you meant to decide if you want a plan that locks them in if you develop an expensive chronic condition or one that gives you a lot of treatments which would add up to a lot for free or one that limits your expenses in the case of one hugely expensive accident. The plans may not be complicated but the factors that influence which one is right for you certainly are. I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit. How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public.
Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused.
As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims.
You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time.
I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically.
Edit:On November 04 2013 11:28 DoubleReed wrote:Show nested quote +On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars."
EPA (clumsily) uses it. Using it for healthcare would seem rational.
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An interesting turn of events:
Germany 'should offer Edward Snowden asylum after NSA revelations'
An increasing number of public figures are calling for Edward Snowden to be offered asylum in Germany, with more than 50 asking Berlin to step up it support of the US whistleblower in the new edition of Der Spiegel magazine
Heiner Geissler, the former general secretary of Angela Merkel's Christian Democrats, says in the appeal: "Snowden has done the western world a great service. It is now up to us to help him."
The writer and public intellectual Hans Magnus Enzensberger argues in his contribution that "the American dream is turning into a nightmare" and suggests that Norway would be best placed to offer Snowden refuge, given its track record of offering political asylum to Leon Trotsky in 1935. He bemoans the fact that in Britain, "which has become a US colony", Snowden is regarded as a traitor.
Other public figures on the list include the actor Daniel Brühl, the novelist Daniel Kehlmann, the entrepreneur Dirk Rossmann, the feminist activist Alice Schwarzer and the German football league president, Reinhard Rauball.
The weekly news magazine also publishes a "manifesto for truth", written by Snowden, in which the former NSA employee warns of the danger of spy agencies setting the political agenda.
"At the beginning, some of the governments who were exposed by the revelations of mass surveillance initiated an unprecedented smear campaign. They intimidated journalists and criminalised the publication of the truth
"Today we know that this was a mistake, and that such behaviour is not in the public interest. The debate they tried to stop is now taking place all over the world", Snowden writes in the short comment piece sent to Der Spiegel via an encrypted channel.
Source
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United States42778 Posts
On November 04 2013 12:36 JonnyBNoHo wrote:Show nested quote +On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:On November 04 2013 10:21 KwarK wrote:On November 04 2013 09:59 JonnyBNoHo wrote:On November 04 2013 09:23 KwarK wrote:On November 04 2013 08:52 JonnyBNoHo wrote:On November 04 2013 08:24 KwarK wrote:
[quote]
Insurance is, at its most basic level, a bet. You're betting that something will happen and they pay out if it does and you lose your stake if it does not. The issue with health insurance is that you don't know what you're betting will happen beyond bad stuff, you don't know anything about how likely it is too happen and you don't know what the payout is if you "win". And yet you're meant to distinguish between the different bets on offer. If you think you have a grasp on it you don't know what it is. It's similar to buying car, homeowner's, or life insurance. You just look at the plan, what's covered, what your exposure is, and decide between them. You don't have to do the actuarial work, that's built into the price of the plan. All you have to do is figure out the costs / risks between the different iterations and decide between those. Ex. max out of pocket $10K vs $5K. Can you afford paying out $10K in a year? If so you may want to take that, if not, or if that sounds too scary, than don't. Inevitably some people will "over insure" and others will "under insure" - but that's always the case. A national plan would be sub-'optimal' at individual levels too. Actuarial work is built into the price of the plan but this is a plan devised by a for profit company that serves its shareholders, it is not out there to provide you with the most comprehensive care possible for the lowest cost possible (incidentally that is what public provision is for). There are endless sad stories about insurance letting people down. Oddly enough creating a minimum standard of insurance to be comprehensive and not fuck people over was included in Obamacare as far as I recall. The idea that you can just compare the financials and ignore the healthcare side assumes all insurance always pays out (rather than fucking you over cause for profit company), never tries to sell you anything you don't actually need (cause for profit company), never doesn't include anything you do actually need that'd cost it money (cause for profit company) and that how much you can afford to pay out of pocket at any given time is a meaningful factor in which insurance you need for your personal situation. Also that your judgement of which risks are worth taking is good judgement (regular checkups are a good investment because if you find shit early it is way cheaper to fix but if you have to pay out of pocket for those you might skip them and rely on the insurance to bail you out if shit goes wrong). Also insurance is shitty at dealing with macro health problems and at preventative care. You're being an irrational lefty, the tea party in reverse. Instead of "of course it's bad it's the government" you crack out the "of course it's bad it's for profit". To some of your individual points, for profit companies don't only serve their shareholders and they do have competition, regardless. The government isn't out there to provide the most comprehensive coverage at the lowest cost either (governments do ration healthcare and do overpay in instances), and stories of government letting people down do exist as well. Also, the ACA is also not the first instance of government regulation in health insurance. Plans have to be approved by regulators before they can be sold with or without the ACA. I still don't see why you think deciding on health insurance is so hard. Have you ever bought health insurance? I'm sure the plans are simplified to an extent but I'll give you an example of the problem as I see it. You probably won't know your statistically biggest risk, nor the costs of treating it. Given this how are you meant to decide if you want a plan that locks them in if you develop an expensive chronic condition or one that gives you a lot of treatments which would add up to a lot for free or one that limits your expenses in the case of one hugely expensive accident. The plans may not be complicated but the factors that influence which one is right for you certainly are. I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit. How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: Show nested quote +On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational.
NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary.
As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices.
The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides.
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On November 04 2013 12:59 DoubleReed wrote:An interesting turn of events: Show nested quote +Germany 'should offer Edward Snowden asylum after NSA revelations'
An increasing number of public figures are calling for Edward Snowden to be offered asylum in Germany, with more than 50 asking Berlin to step up it support of the US whistleblower in the new edition of Der Spiegel magazine
Heiner Geissler, the former general secretary of Angela Merkel's Christian Democrats, says in the appeal: "Snowden has done the western world a great service. It is now up to us to help him."
The writer and public intellectual Hans Magnus Enzensberger argues in his contribution that "the American dream is turning into a nightmare" and suggests that Norway would be best placed to offer Snowden refuge, given its track record of offering political asylum to Leon Trotsky in 1935. He bemoans the fact that in Britain, "which has become a US colony", Snowden is regarded as a traitor.
Other public figures on the list include the actor Daniel Brühl, the novelist Daniel Kehlmann, the entrepreneur Dirk Rossmann, the feminist activist Alice Schwarzer and the German football league president, Reinhard Rauball.
The weekly news magazine also publishes a "manifesto for truth", written by Snowden, in which the former NSA employee warns of the danger of spy agencies setting the political agenda.
"At the beginning, some of the governments who were exposed by the revelations of mass surveillance initiated an unprecedented smear campaign. They intimidated journalists and criminalised the publication of the truth
"Today we know that this was a mistake, and that such behaviour is not in the public interest. The debate they tried to stop is now taking place all over the world", Snowden writes in the short comment piece sent to Der Spiegel via an encrypted channel. Source
I dunno about this part. The recent leaks implies that Norway's one of the most important listening posts for the US, which at least shows some covert cooperation between governments. Troskij was a critic of Stalinism, which could have made his asylum acceptable, and this was also before McCarthy brought the hysteria to the US. Sure, you had the Red Scare in the 20s, but the end of the World War 2 is when the escalation of east-verus-west really happened. Snowden, on the other hand, is in the middle of a current conflict - the US might be more willing to use its long arms and grabby hands in this sitaution than it was with Trotskij.
In addition, the right-side parties of Norway won the last election, parties who seek closer connections to the US than the previous government did. While I would hope them to be mindful of Norway's history in regards to neutrality and supporting the weak, I wouldn't put it past them to tilt towards the US if enough reasons would be made.
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On November 04 2013 21:57 KwarK wrote:Show nested quote +On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:On November 04 2013 10:21 KwarK wrote:On November 04 2013 09:59 JonnyBNoHo wrote:On November 04 2013 09:23 KwarK wrote:On November 04 2013 08:52 JonnyBNoHo wrote:
[quote]
It's similar to buying car, homeowner's, or life insurance. You just look at the plan, what's covered, what your exposure is, and decide between them.
You don't have to do the actuarial work, that's built into the price of the plan. All you have to do is figure out the costs / risks between the different iterations and decide between those. Ex. max out of pocket $10K vs $5K. Can you afford paying out $10K in a year? If so you may want to take that, if not, or if that sounds too scary, than don't.
Inevitably some people will "over insure" and others will "under insure" - but that's always the case. A national plan would be sub-'optimal' at individual levels too. Actuarial work is built into the price of the plan but this is a plan devised by a for profit company that serves its shareholders, it is not out there to provide you with the most comprehensive care possible for the lowest cost possible (incidentally that is what public provision is for). There are endless sad stories about insurance letting people down. Oddly enough creating a minimum standard of insurance to be comprehensive and not fuck people over was included in Obamacare as far as I recall. The idea that you can just compare the financials and ignore the healthcare side assumes all insurance always pays out (rather than fucking you over cause for profit company), never tries to sell you anything you don't actually need (cause for profit company), never doesn't include anything you do actually need that'd cost it money (cause for profit company) and that how much you can afford to pay out of pocket at any given time is a meaningful factor in which insurance you need for your personal situation. Also that your judgement of which risks are worth taking is good judgement (regular checkups are a good investment because if you find shit early it is way cheaper to fix but if you have to pay out of pocket for those you might skip them and rely on the insurance to bail you out if shit goes wrong). Also insurance is shitty at dealing with macro health problems and at preventative care. You're being an irrational lefty, the tea party in reverse. Instead of "of course it's bad it's the government" you crack out the "of course it's bad it's for profit". To some of your individual points, for profit companies don't only serve their shareholders and they do have competition, regardless. The government isn't out there to provide the most comprehensive coverage at the lowest cost either (governments do ration healthcare and do overpay in instances), and stories of government letting people down do exist as well. Also, the ACA is also not the first instance of government regulation in health insurance. Plans have to be approved by regulators before they can be sold with or without the ACA. I still don't see why you think deciding on health insurance is so hard. Have you ever bought health insurance? I'm sure the plans are simplified to an extent but I'll give you an example of the problem as I see it. You probably won't know your statistically biggest risk, nor the costs of treating it. Given this how are you meant to decide if you want a plan that locks them in if you develop an expensive chronic condition or one that gives you a lot of treatments which would add up to a lot for free or one that limits your expenses in the case of one hugely expensive accident. The plans may not be complicated but the factors that influence which one is right for you certainly are. I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit. How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides.
Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance.
You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things.
When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens.
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On November 05 2013 00:20 JonnyBNoHo wrote:Show nested quote +On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:On November 04 2013 10:21 KwarK wrote:On November 04 2013 09:59 JonnyBNoHo wrote:On November 04 2013 09:23 KwarK wrote:
[quote]
Actuarial work is built into the price of the plan but this is a plan devised by a for profit company that serves its shareholders, it is not out there to provide you with the most comprehensive care possible for the lowest cost possible (incidentally that is what public provision is for). There are endless sad stories about insurance letting people down. Oddly enough creating a minimum standard of insurance to be comprehensive and not fuck people over was included in Obamacare as far as I recall.
The idea that you can just compare the financials and ignore the healthcare side assumes all insurance always pays out (rather than fucking you over cause for profit company), never tries to sell you anything you don't actually need (cause for profit company), never doesn't include anything you do actually need that'd cost it money (cause for profit company) and that how much you can afford to pay out of pocket at any given time is a meaningful factor in which insurance you need for your personal situation. Also that your judgement of which risks are worth taking is good judgement (regular checkups are a good investment because if you find shit early it is way cheaper to fix but if you have to pay out of pocket for those you might skip them and rely on the insurance to bail you out if shit goes wrong). Also insurance is shitty at dealing with macro health problems and at preventative care. You're being an irrational lefty, the tea party in reverse. Instead of "of course it's bad it's the government" you crack out the "of course it's bad it's for profit". To some of your individual points, for profit companies don't only serve their shareholders and they do have competition, regardless. The government isn't out there to provide the most comprehensive coverage at the lowest cost either (governments do ration healthcare and do overpay in instances), and stories of government letting people down do exist as well. Also, the ACA is also not the first instance of government regulation in health insurance. Plans have to be approved by regulators before they can be sold with or without the ACA. I still don't see why you think deciding on health insurance is so hard. Have you ever bought health insurance? I'm sure the plans are simplified to an extent but I'll give you an example of the problem as I see it. You probably won't know your statistically biggest risk, nor the costs of treating it. Given this how are you meant to decide if you want a plan that locks them in if you develop an expensive chronic condition or one that gives you a lot of treatments which would add up to a lot for free or one that limits your expenses in the case of one hugely expensive accident. The plans may not be complicated but the factors that influence which one is right for you certainly are. I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit. How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens.
He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances...
In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to.
I don't know about NICE and I am interested to know more, but having a transdisciplinary perspective on health insurance is really important. The question of the cost efficience of said insurance plan is not enough to really understands the problem. That's why in France we talk about "social security" and not health insurance. It is better to over insure someone than to under insure the same person, even if it is less optimal in term of costs and risks, because at a macroeconomic level, health have various impacts on the society and the economy as a whole.
It's not really, as you make it look, a simple question of taking this insurance plan or this one, like you're buying a candy trying to maximize your utility with a budgetary constraint : there are a lot of indirect impact on the society by the choice you make in health insurance, indirect impacts that are not taken in account through the market - which here means private insurance business.
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On November 05 2013 02:17 WhiteDog wrote:Show nested quote +On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:On November 04 2013 10:21 KwarK wrote:On November 04 2013 09:59 JonnyBNoHo wrote:
[quote]
You're being an irrational lefty, the tea party in reverse. Instead of "of course it's bad it's the government" you crack out the "of course it's bad it's for profit".
To some of your individual points, for profit companies don't only serve their shareholders and they do have competition, regardless. The government isn't out there to provide the most comprehensive coverage at the lowest cost either (governments do ration healthcare and do overpay in instances), and stories of government letting people down do exist as well. Also, the ACA is also not the first instance of government regulation in health insurance. Plans have to be approved by regulators before they can be sold with or without the ACA.
I still don't see why you think deciding on health insurance is so hard. Have you ever bought health insurance? I'm sure the plans are simplified to an extent but I'll give you an example of the problem as I see it. You probably won't know your statistically biggest risk, nor the costs of treating it. Given this how are you meant to decide if you want a plan that locks them in if you develop an expensive chronic condition or one that gives you a lot of treatments which would add up to a lot for free or one that limits your expenses in the case of one hugely expensive accident. The plans may not be complicated but the factors that influence which one is right for you certainly are. I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit. How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to.
If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans.
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United States42778 Posts
On November 05 2013 02:41 JonnyBNoHo wrote:Show nested quote +On November 05 2013 02:17 WhiteDog wrote:On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:On November 04 2013 10:21 KwarK wrote:
[quote]
I'm sure the plans are simplified to an extent but I'll give you an example of the problem as I see it. You probably won't know your statistically biggest risk, nor the costs of treating it. Given this how are you meant to decide if you want a plan that locks them in if you develop an expensive chronic condition or one that gives you a lot of treatments which would add up to a lot for free or one that limits your expenses in the case of one hugely expensive accident. The plans may not be complicated but the factors that influence which one is right for you certainly are. I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit. How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to. If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans.
National plans don't seek to be optimal to the individual but rather optimal to the group, something they are very successful in achieving. Individual insurance plans don't seek to be optimal to either, they're selling what people want, not what they need.
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On November 05 2013 02:41 JonnyBNoHo wrote:Show nested quote +On November 05 2013 02:17 WhiteDog wrote:On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:On November 04 2013 10:21 KwarK wrote:
[quote]
I'm sure the plans are simplified to an extent but I'll give you an example of the problem as I see it. You probably won't know your statistically biggest risk, nor the costs of treating it. Given this how are you meant to decide if you want a plan that locks them in if you develop an expensive chronic condition or one that gives you a lot of treatments which would add up to a lot for free or one that limits your expenses in the case of one hugely expensive accident. The plans may not be complicated but the factors that influence which one is right for you certainly are. I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit. How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to. If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans.
As a macroeconomic actor the state and the public health services have access to more informations and can take into consideration macroeconomic effect and "transactions" that doesn't pass through the market.
They are suboptimal anyway, but not in the same regard.
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On November 05 2013 02:48 KwarK wrote:Show nested quote +On November 05 2013 02:41 JonnyBNoHo wrote:On November 05 2013 02:17 WhiteDog wrote:On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:
[quote]
I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit.
How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to. If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans. National plans don't seek to be optimal to the individual but rather optimal to the group, something they are very successful in achieving. Individual insurance plans don't seek to be optimal to either, they're selling what people want, not what they need.
Optimal to the group is still sup-optimal. Some will over buy coverage and others will under buy.
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On November 05 2013 03:02 WhiteDog wrote:Show nested quote +On November 05 2013 02:41 JonnyBNoHo wrote:On November 05 2013 02:17 WhiteDog wrote:On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:On November 04 2013 10:41 JonnyBNoHo wrote:
[quote]
I don't think those factors matter very much. The goal is to limit your risk exposure, not arbitrage various options to turn a profit.
How do you pay taxes to fund the NHS in the UK? Does the government calculate your individual risk profile and tax you accordingly? Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to. If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans. As a macroeconomic actor the state and the public health services have access to more informations and can take into consideration macroeconomic effect and "transactions" that doesn't pass through the market. They are suboptimal anyway, but not in the same regard.
Sure, but the state can also be influenced by political decisions. Having access to information doesn't mean the state always makes good decisions 
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United States42778 Posts
On November 05 2013 03:09 JonnyBNoHo wrote:Show nested quote +On November 05 2013 02:48 KwarK wrote:On November 05 2013 02:41 JonnyBNoHo wrote:On November 05 2013 02:17 WhiteDog wrote:On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:On November 04 2013 11:03 KwarK wrote:
[quote]
Nope. They come up with an amount of money first and then hand it to the experts to spend it as wisely as they can by death panels. They work out the value of a human life, then adjust it for quality and quantity of life and work out which treatments are worth paying for. The current value of a year of high quality human life in the UK is about $45,000. OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation. If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:On November 04 2013 11:14 DoubleReed wrote:There is the notion of Value of Statistical Life. I think it's somewhere around $6-7 million. The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to. If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans. National plans don't seek to be optimal to the individual but rather optimal to the group, something they are very successful in achieving. Individual insurance plans don't seek to be optimal to either, they're selling what people want, not what they need. Optimal to the group is still sup-optimal. Some will over buy coverage and others will under buy.
This criticism doesn't bother me in the slightest as optimal for the group is what I'm aiming for. A public health system will take tax from some people knowing it's likely to spend more than it gets and tax from others knowing it's likely to get more than it spends. A private insurance institution only does the latter, statistically everyone getting private health insurance is a loser, now obviously some people get really sick and therefore win, but assuming that they described their health accurately every single customer ought to be a loser. But you're not addressing my criticism, a private system can allow an individual to buy insufficient, or surplus in useless areas, coverage to actually meet his healthcare needs because he doesn't know what his needs are.
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On November 05 2013 03:34 KwarK wrote:Show nested quote +On November 05 2013 03:09 JonnyBNoHo wrote:On November 05 2013 02:48 KwarK wrote:On November 05 2013 02:41 JonnyBNoHo wrote:On November 05 2013 02:17 WhiteDog wrote:On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:On November 04 2013 11:08 JonnyBNoHo wrote:
[quote]
OK, but the $45K average value of a human life, and the taxes you pay to cover it, may differ from your individual situation.
If you are OK with that, I don't see what problem you are having with insurance. NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:On November 04 2013 11:21 KwarK wrote:
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The number I gave was per year of life adjusted for quality of life. Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to. If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans. National plans don't seek to be optimal to the individual but rather optimal to the group, something they are very successful in achieving. Individual insurance plans don't seek to be optimal to either, they're selling what people want, not what they need. Optimal to the group is still sup-optimal. Some will over buy coverage and others will under buy. This criticism doesn't bother me in the slightest as optimal for the group is what I'm aiming for. A public health system will take tax from some people knowing it's likely to spend more than it gets and tax from others knowing it's likely to get more than it spends. A private insurance institution only does the latter, statistically everyone getting private health insurance is a loser, now obviously some people get really sick and therefore win, but assuming that they described their health accurately every single customer ought to be a loser. But you're not addressing my criticism, a private system can allow an individual to buy insufficient, or surplus in useless areas, coverage to actually meet his healthcare needs because he doesn't know what his needs are.
How are you figuring that everyone ought to be a loser with private insurance?
Private insurance can allow an individual to buy insufficient, or surplus in useless areas. I already addressed this by pointing out that public systems do exactly the same thing... which you dismiss as irrelevant because optimal for the group (or is it optimal for the average?) is what you're after. So is your criticism relevant or not? If it's relevant than you must apply the same criticism to public plans. If it's not, drop it.
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United States42778 Posts
On November 05 2013 03:44 JonnyBNoHo wrote:Show nested quote +On November 05 2013 03:34 KwarK wrote:On November 05 2013 03:09 JonnyBNoHo wrote:On November 05 2013 02:48 KwarK wrote:On November 05 2013 02:41 JonnyBNoHo wrote:On November 05 2013 02:17 WhiteDog wrote:On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:On November 04 2013 11:20 KwarK wrote:
[quote]
NICE (the name for the death panel) are out to make sure that my health needs are met, I'm not being missold anything because there is no sale involved, the money is taken and spent meeting my actuarial needs. If I'm dumb and think "I don't need checkups, I feel fine" and opt for a policy where checkups are extra and I save money by not having any then I'm gonna end up fucked. The insurance company was happy to offer me that option because it's offering a service and that was a service I wanted, the issue is that I didn't know that hypothetically the biggest potentially devastating threat to my health didn't have immediately obvious symptoms because I'm not an expert on health. The insurance company is not looking to make everyone as healthy as possible, it's looking to sell you as much health as you want to buy and you are not equipped to make a judgement there. It's a fundamentally different business model, insurance is trying to give you something you want and uses the calculations to come up with a costing model for what you want. If you want stuff you don't need they'll still happily sell it to you, if you need stuff you don't want then they'll leave it out. The public system uses the same calculations to come up with what you need and gives you that and as much as Introvert wishes to claim otherwise doctors actually know more about medicine than the American public. Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused. As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims. You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time. I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically. Edit: On November 04 2013 11:28 DoubleReed wrote:
[quote]
Yea, I know. I think VSL is used more for safety and security measures, where they want to say "we saved X lives and therefore X dollars." EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to. If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans. National plans don't seek to be optimal to the individual but rather optimal to the group, something they are very successful in achieving. Individual insurance plans don't seek to be optimal to either, they're selling what people want, not what they need. Optimal to the group is still sup-optimal. Some will over buy coverage and others will under buy. This criticism doesn't bother me in the slightest as optimal for the group is what I'm aiming for. A public health system will take tax from some people knowing it's likely to spend more than it gets and tax from others knowing it's likely to get more than it spends. A private insurance institution only does the latter, statistically everyone getting private health insurance is a loser, now obviously some people get really sick and therefore win, but assuming that they described their health accurately every single customer ought to be a loser. But you're not addressing my criticism, a private system can allow an individual to buy insufficient, or surplus in useless areas, coverage to actually meet his healthcare needs because he doesn't know what his needs are. How are you figuring that everyone ought to be a loser with private insurance? Private insurance can allow an individual to buy insufficient, or surplus in useless areas. I already addressed this by pointing out that public systems do exactly the same thing... which you dismiss as irrelevant because optimal for the group (or is it optimal for the average?) is what you're after. So is your criticism relevant or not? If it's relevant than you must apply the same criticism to public plans. If it's not, drop it.
I figure everyone ought to be a loser (statistically speaking) in the same way I figure everyone out to be a loser sports betting against the house or playing blackjack. This is a service being offered by a profit making entity, assuming no gross incompetence on their part they ought to be charging more for the bet than the payout divided by likelihood of it happening.
I don't think you're getting what I mean by surplus or insufficient. Public systems give you the service that best matches your actual needs, rather than the things you thought you needed. Yes if you're a high earner you may pay more than you get out of it or a low earner may get more out of it than they pay in but that isn't what I mean by surplus.
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On November 05 2013 04:14 KwarK wrote:Show nested quote +On November 05 2013 03:44 JonnyBNoHo wrote:On November 05 2013 03:34 KwarK wrote:On November 05 2013 03:09 JonnyBNoHo wrote:On November 05 2013 02:48 KwarK wrote:On November 05 2013 02:41 JonnyBNoHo wrote:On November 05 2013 02:17 WhiteDog wrote:On November 05 2013 00:20 JonnyBNoHo wrote:On November 04 2013 21:57 KwarK wrote:On November 04 2013 12:36 JonnyBNoHo wrote:
[quote]
Well doctors know about needs, but they don't know a lot about costs. That's one of the main problems in the US - the system is excessively doctor focused.
As for your insurance comments, you don't have it entirely correct. Insurance companies, the employers that pay for insurance, and insurance customers all have an incentive to provide a reasonably correct amount of coverage. No one, even the insurance company, is completely agnostic towards a person's health. More sick people mean higher claims.
You can certainly have problems where people are myopic and choose less healthcare now only to require more later. But universal coverage doesn't really change that. People still make bad healthcare decisions. I still see it all the time.
I don't see why you'd need to know what the hypothetical biggest threat to your health is. I'd like you to address that specifically.
Edit:[quote]
EPA (clumsily) uses it. Using it for healthcare would seem rational. NICE isn't just doctors, a lot of what it does is statistics. It's not just "does the treatment work?", it's "how well does it work for how many people?", "how cost effective is it?", "how viable is implementation?" and so forth. It's interdisciplinary. As long as the premium was accurately assessed to make them a profit on average an insurance company could not give a fuck if you got sick. There's no real need to drive down costs if you're passing them straight on based upon their choices. The issue with not knowing what health stuff is likely to happen to you is that you're meant to make a decision regarding which payment plans and coverage are best suited to your needs and you don't really know what your needs are. You don't know if you want your expenses capped in the case of a single catastrophic accident or if you'd do better with a plan that provided regular prescriptions for a chronic condition for free because you don't know what's likely to happen to you. A co-pay could not be an issue or it could be crippling and unless you're an expert on your own health and statistics you can't make a meaningful comparison. You're making financial planning with only half the information whereas they have both sides. Yeah, I know NICE does that. What's your point anyway? I don't see how NICE is relevant to discussing insurance. You can't on one hand complain that insurance companies are motivated out of greed to deny coverage to "fuck you" and on the other hand argue that once a premium has been paid they don't give a fuck if you get sick. It's one or the other. You're arguing two mutually exclusive things. When you buy insurance you're buying for all that. You want to cap total expenses and receive discounts on recurring expenses. The only way you can get screwed is if you don't buy enough insurance and you get something really expensive happen to you. Other than that it's easy. You just look at your own financial situation and see how much tolerance you have for unexpected expenses and pick a plan to cover that. You don't need to know the statistics, just how much cost you can bear if something bad happens. He is basically saying that you need more informations than what you are actually given to make the most optimal decision regarding health care, and that those informations will not be given to individuals by the private insurances... In my opinion it's not really a question because those informations are not even understandable by a big part of the population, and even if they do understands, people are not rational when it comes to risk - the risk aversion model have been proved empirically wrong over and over. People will not chose their healthcare plan based on their risks, but rather by "getting their fingers wet" : they will minimize the costs as long as they will be able to. If the complaint is that an individual buyer of insurance may pick a plan that is sub-optimal to his or her individual needs, than the same complaint must be levied against national plans. National plans don't seek to be optimal to the individual but rather optimal to the group, something they are very successful in achieving. Individual insurance plans don't seek to be optimal to either, they're selling what people want, not what they need. Optimal to the group is still sup-optimal. Some will over buy coverage and others will under buy. This criticism doesn't bother me in the slightest as optimal for the group is what I'm aiming for. A public health system will take tax from some people knowing it's likely to spend more than it gets and tax from others knowing it's likely to get more than it spends. A private insurance institution only does the latter, statistically everyone getting private health insurance is a loser, now obviously some people get really sick and therefore win, but assuming that they described their health accurately every single customer ought to be a loser. But you're not addressing my criticism, a private system can allow an individual to buy insufficient, or surplus in useless areas, coverage to actually meet his healthcare needs because he doesn't know what his needs are. How are you figuring that everyone ought to be a loser with private insurance? Private insurance can allow an individual to buy insufficient, or surplus in useless areas. I already addressed this by pointing out that public systems do exactly the same thing... which you dismiss as irrelevant because optimal for the group (or is it optimal for the average?) is what you're after. So is your criticism relevant or not? If it's relevant than you must apply the same criticism to public plans. If it's not, drop it. I figure everyone ought to be a loser (statistically speaking) in the same way I figure everyone out to be a loser sports betting against the house or playing blackjack. This is a service being offered by a profit making entity, assuming no gross incompetence on their part they ought to be charging more for the bet than the payout divided by likelihood of it happening. I don't think you're getting what I mean by surplus or insufficient. Public systems give you the service that best matches your actual needs, rather than the things you thought you needed. Yes if you're a high earner you may pay more than you get out of it or a low earner may get more out of it than they pay in but that isn't what I mean by surplus.
Than they're all a loser with the government plan as governments have capital costs too.
No, the public plan does not give you the service that best matches your actual needs. Government plans will offer people services they don't need or ever use. Government plans will deny people services they do need to save money. It's the same situation with insurance, just without the variable of different plans.
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EPT
