It’s a Car Wreck

Sooo … here’s a fable for our time. Suppose some guy gets into a car wreck in his lovely old car. It’s pristine and perfectly preserved 1963 Ferrari, a very valuable car. He’s had it just sitting in a garage for decades, and one day decides to take it for a spin.

ferrari 1963

This proves to be a bad choice, as he proves once again that two solid objects cannot occupy the same volume of space at the same instant.

The Ferrari is not totaled, but it needs major and expensive work to return it to its original condition and get it back on the road.

Unfortunately, when he checks he finds out that he had never bothered to modify his automobile insurance policy to include the Ferrari. His Tesla is covered, as is his wife’s Prius … but the Ferrari has no insurance.

So he goes to Geico, and he asks them to sell him collision insurance for his Ferrari. They say “OK”, and tell him it will cost roughly a thousand dollars per month … and because of the claimed value of the car is pushing a million dollars, they send their top agent to go to inspect the Ferrari before insuring it.

ferrari 1963 crashOf course, when she sees the car, she says “Wait a minute … this car has already been in a collision! We can’t sell you collision insurance”.

“Sure you can”, he says, “you insured all of my friends’ cars. It’s not fair to single out my car!”.

“Look”, the Geico woman says, “it will take over a hundred thousand dollars to fix your car. We can’t sell you car insurance for $1,243 per month starting now, you’ll just get your car fixed and stop paying.”

“No”, he replies “I have a right to be insured. You insured my wife’s car. This is simply discrimination.”

“Say what?” the woman asks. “How on earth is this discrimination?”.

“It’s discrimination because you are refusing to sell me insurance on the basis of a pre-existing condition! he says, and folds his arms in triumph.

I leave it to the reader to consider the many implications of this fable in the world of health insurance …

w.

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65 thoughts on “It’s a Car Wreck

    • Thanks, Roy, that’s the problem. The US hasn’t decided whether quadruple bypass surgery for a 37-year-old chronic methamphetamine addict is a “fundamental human right” or a colossal waste of scarce medical resources …

      w.

      Liked by 1 person

      • The problem here is when someone else decides the death sentence (even if deserved). Not only do most not trust the deciding parties (death panel), most shy away from allowing third party decisions of this nature. One could also argue, based on required auto insurance, that there should be a penalty for refusing health insurance coverage with the proceeds going to support the taxpayer or insurers (Obama care). There could even be a surcharge required for say, smokers, as with the increased auto rates for the accident or ticket prone. Oklahoma, for example, is trying to pass a law for an additional tobacco tax that goes into the state heath care fund.
        I think that a major part of the problem is the AMA and pharmaceuticals pushing the concept of living to the very last day possible regardless of cost. But just how much is an extra year worth, $1million, $100 million; how much is the system willing to bear to support complex long term support costs per person; 1 billion per year? Obviously there has to be a cutoff, but who decides? A purely free enterprise system could decide, unevenly, based on cost/profit; but unfortunately there is always that citizenry that encourages the government to interfere, especially after the stories about that hospitalized person on life support in a 20 year coma waking up. There are expensive cancer drugs that give, on average, say an extra 3 months for say $100,000 and probably not with much quality of life. I wouldn’t personally pay $10,000 for an extra 3 months but that’s just me. However I know of those that would face fiscal ruination to fight for that time at any cost, but especially so if it wasn’t their cost.
        All arguments are complicated by morality and empathy with the result being unsavory decisions that end in expensive half baked answers.

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        • “One could also argue, based on required auto insurance, that there should be a penalty for refusing health insurance coverage with the proceeds going to support the taxpayer or insurers (Obama care).”

          But the problem with that is there is no opt out possibility. With auto insurance if you do not drive or own a car, you do not have to buy the insurance. The only opt out in the ACA is death.

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        • We are conflating two different subjects: health care and insurance. Insurance is intended to cover rare but expensive events. Health care is one of the normal costs of being alive. If we legislated a prohibition against “insuring” normal expenses, the costs of insuring against major medical events would go down.
          People are always willing to have someone else pay the bill.

          Liked by 1 person

          • I agree in principal but legislating against anything a person may want to pay insurance for is very bad. Insurance is about providing a safety net from unexpected financial burdens. Each individual has their own threshold for what constitutes financial burden. To me, the cost of the ACA WAS the financial burden. One of the problems in this Country is that very few people take it upon themselves to learn about insurance and what options there are when setting up their individual insurance portfolio.

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          • well, to be fair, most people in this country get their health insurance through their employer, who offers very few choices.

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          • Tom: You are right, of course, but people will want everything to be paid by the insurer unless it is constrained.

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          • it wasn’t always that way, and it doesn’t have to remain that way.

            The biggest reason why people want/need insurance to pay for everything is that it’s so much cheaper if insurance does pay (even if it’s in the deductable period where you are paying 100%) because the false discounting that’s taking place.

            eliminate that and many people will be willing to pay for small things themselves (especially out of a HSA) rather than paying large monthly insurance payments.

            But right now, it’s illegal to sell insurance policies that would work this way.

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          • We pay $1100 a month for insurance policy to cover 3 adults, and we pay CASH for ALL appointments and prescriptions. Prior to 2010 we paid $230 a month for the exact same “coverage”. That is what Obamacare has done “for” us.

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        • The required auto insurance is for liability (that is, for damages you caused to others), not for damage to your own vehicle. The appropriate analogy would be to require medical insurance that would pay for other people’s treatment, when they became ill because they were exposed to a disease that you contracted and then spread.

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          • MIght be awful hard to prove how it was you gave who someone else a disease.

            In Florida we have insurance where every auto policy has PIP, Personal Injury Protection. This covers the first $10,000 of injury you receive from any auto accident no matter whose fault it was. Any amount over that must be sued for. So if someone hits you and you have $20,000 in claims, your insurance covers the first $10,000 and you sue the person who hits you for the other $10,000. This keeps all minor claims out of the hand of lawyers. You do not need collision or comprehensive unless you finance the vehicle.

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    • The idea that healthcare is a fundamental human right is absurd. Why? Because it necessarily enslaves some people, to some degree, in order to provide this so-called fundamental right to others (unless we manage to find a fairy godmother somewhere that is able to conjure healthcare out of thin air). That, by definition, cannot be a natural right.

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      • I keep hearing this and respond with “Healthcare is not a human right, free association is. You have the right to freely associate with whatever doctor chooses to accept you as a patient. You don’t have a right to compel a doctor to treat you by using the armed force of government.” And the response to this is nearly universal and most politely rephrased “Well, well, well, you are a poopyhead!”

        Socialized healthcare advocates spin&twirl when confronted with the reality that their “free healthcare for all” ends in slavery for doctors and nurses, because they are not willingly going to work for free.

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          • Steward as a spouse of a health care professional, whom works in a clinic specializing in Medicare patients, yes i would say near slavery. I know the hours spent working on paper work and seeing the low income patients.

            Gadman

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          • Yes, stewie, if you want free healthcare you are going to have to force someone to give it to you. Who you planning to force to give you healthcare, your trashman? Plumber? Astrologer? Forcing people to give you things, such as their professional services, is slavery. Who you voting for to enforce this so you get free healthcare? Give us their names.

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  1. Similar to what I have told people to get around high premiums and deductibles of ACA. Get all your tests done in Oct and Nov. If they are clean, no need to enroll. If a serious issue pops up, enroll during open enrollment. If your condition is cured, drop the insurance. Repeat annually.

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  2. this is why we need to fix health care, not health insurance.

    continuing the analogy, say all he got was a nail in his tire and wanted to get it fixed. Going to a tire shop and asking how much it would cost, they would have to first ask what insurance he has to pay for it, and then bill the insurance $400, and then give insurance a $360 discount instead of the real process of just telling you that it was $20 and avoiding all the extra handling of the claim (you could call your insurance for the $20, but probably wouldn’t bother)

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    • The other likely scenario is that you will be billed 2400 bucks with no discount. You point out the nail but tests need to be run and x-rays taken. Then the x-rays need to be sent to another office to be read to verify if it is a nail or a screw. That takes several weeks. You explain that you don’t care if it is a nail or a screw and you just want it fixed and will pay cash. The shop tells you their rates are set by the insurance company even if you don’t have insurance and they don’t have any idea what it will cost you. They don’t fix the nail and bill you 2400 bucks for the visit.

      You should have gone to the local box store and bought an aspirin and a new tire or a plug kit from the automotive section. The medical profession (aka shop) and the insurance industry feed each other. Others need not apply least you will be robbed.

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  3. “I leave it to the reader to consider the many implications of this fable in the world of health insurance …”

    As I said in a comment in the previous thread on ‘healthcare’,

    “The problem is that Obamacare created entitlements, namely subsidies for insurance premiums, and notably the proscription against pre-existing conditions, which essentially undermines the basis of insurance: you can’t insure your home after the fire has burned it down. Has the 20th-21st century USA ever rescinded an entitlement?”

    Take a look at my “Principles of Freedom and Medical Care,” where I offer some proposals to return rationality to both insurance, medical care (they are not the same thing), and making sure no one is left out:

    https://walkingcreekworld.wordpress.com/2017/01/09/the-principles-of-freedom-and-medical-care/

    “How to to make free choice and free markets work in the increasingly complex world of contemporary healthcare.”

    /Mr Lynn

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  4. I have yet to receive a legitimate explanation as to why government, in any form, is involved in my purchase of insurance, medical or otherwise.

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    • How about this from a Canadian perspective: The ratio of Canada’s healthcare costs to GDP is 10.4%, while America’s is 17.1% (the highest in the world). What do Americans get for spending 70% more on healthcare than Canadians? They get a shorter life-span, higher child mortality rates, and more people with no healthcare coverage than Canada. Canada’s life-span is ranked 18th in the world, while America’s is 43rd. America’s child mortality rate is 6.5 per 100,000, while Canada’s is 4.9. Before Obamacare, the U.S. had as many as 40 million people without healthcare, while Canada has universal health coverage.
      Looking across from Canada, we are at a loss when it comes to explaining Americans’ attitude toward healthcare. They seem to be fighting tooth-and-nail for freedom from healthcare, even though it is the number one reason for household bankruptcy. Why would they not want every citizen, regardless of wealth, to stay healthy for as long as possible? If nothing else, it makes good sound economic sense to have a healthy America; you can’t be productive if you are sick.

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      • You keep trotting out Canada, all the Canadians I know hate your socialist medical system, that is why they are down here BUYING medical care.

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        • And I call bullshit on your lies. I had colon cancer 3 years ago and got great treatment in the system in Alberta Canada and I watched my mother get great treatment in the Canadian system in three different provinces until her death at 99. You trot out lies with no personal experience and spread bullshit with no personal experience.
          I provided some factual numbers and all you have is stupid stories.
          The Canuck system isn’t perfect but you seem to be an idiot with your tales of slave doctors and nurses. I know my surgeon certainly would laugh at your nonsensical claims of slavery. I ski with several doctors and surgeons and again they would regard you as an idiot with your slavery claims.

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          • “I ski with several doctors and surgeons and again they would regard you as an idiot with your slavery claims.”
            Well that explains why you (and family) got favored, on time treatment. Gee if the rest of us were only allowed to know medical personnel on such an intimate level….

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          • Those in the clique always defend the clique. I’m used to it, socialists love their special privileges and are always willing to sh*t on anyone who points them out.

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          • Nice mouth hotel …. u eat with that cesspool?
            Re BFL’s comment of why I got favoured treatment … not true one ER doc didn’t know of my surgery until more than 2 years after it happened and the other has been retired for over a decade and I met him 9 months after the surgery. I got in a bit early because I was scheduled for Feb and someone didn’t want to spend xmas in the hospital so on Dec 20th I got a phone call asking if I would be interested in a Dec 23rd opening and I jumped at it.
            Again your comments about getting on time treatment are just sad and nonsensical. Especially when you have a serious illness. Elective surgery can have long wait times.
            I give up … your minds are made up and you don’t want to be confused by the facts.
            Hotel learn to communicate like an adult. Name calling is not becoming.

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      • ” They seem to be fighting tooth-and-nail for freedom from healthcare, even though it is the number one reason for household bankruptcy. Why would they not want every citizen, regardless of wealth, to stay healthy for as long as possible?”

        Many Americans cherish the right to choose.

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  5. A free health care is a hallmark of socialism. Been there, survived that care. A single payer system, you are assigned a doctor. Our doctor was called (only behind his back) as Dr. Mengele. But hospitals – including surgery – were quite good.

    There is something emotional about healthcare. It is free in socialism, therefore it must be a basic human right. Michael Crichton has a story about a breakthrough in DNA manipulation. The discoverers wonder how to make money from it. Cures for genetic diseases? Everybody will demand it cheap or free. We must come with an application that is attractive but not essential for anybody. Then we can charge anything we want. Ah – a Jurassic Park.

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    • Here in the U.K. our supposedly ‘free’ healthcare in the NHS (national health service) is only ‘free’ at the point of delivery. We just don’t get a bill as we leave the GP’s surgery or the hospital. It’s all paid for out of General taxation.

      Gradually over the last few years, the NHS is being privatised. Already private health care providers are being used by NHS patients with the bill picked up by the taxpayer. GPs are all running their practices as businesses under contract to the NHS where they get paid per treatment and per head.

      The biggest problem facing the NHS (as it is in most Western countries) is the aging population and the lack of money to provide the necessary services to the elderly. Waiting times for hospital beds is just one of the many issues as elderly patients ‘bed block’ when they can’t be discharged to either go home to their own home or to a nursing or care home. Local taxes for social care costs are the biggest increase this year.

      It was a socialist government that brought in the NHS but they never envisaged it coping with a population over 60 million people, living longer and with the level of demand there is today. And that’s without things like health tourists (foreigners getting free treatment while in the country) cosmetic procedures, such as breast implants, and infertility treatments as having a child has become a human right.

      It’s a mess and no politician is ever going to grasp the nettle and deal with it. We will probably end up with a semi private, insurance based system because it will collapse without any fundamental changes.

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      • As with any “free” health care system, it does help solve the one issue of cost, that by extension of waiting times for critical procedures, the ethics are excused when patients die waiting in queue.

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        • We do have the infamous ‘Liverpool Pathway’ an end of life ‘care’ program which has become notorious since the media highlighted it. Basically nil by mouth. No food or water. Reports of people being starved or more often dehydrated to the point of death, it has become known as way to ‘assist’ elderly people to die.

          It is a very emotive issue. My own grandfather had a major heart attack, aged 95, and the consultant did discuss putting him on the pathway, which my Uncles refused. By that time he didn’t want to eat anyway and only had his mouth moistened from time to time. He was perfectly lucid and waited to see everyone before dying a week or so after admission. Could he have been kept alive for longer? Who knows?

          In the same way, DNR (Do Not Resuscitate) can be written on a hospital patient’s notes without explanation to relatives and even without the patient’s knowledge. When my father was in hospital I always made sure to read his notes to see if there was anything I needed to ask questions about.

          Giving morphine is another one that creates confusion over it’s use as a painkiller and because it is known to hasten death. There are always difficulties surrounding medical judgements versus peoples’ natural tendencies to want to hold on to life and their loved ones as long as possible. Which is why euthanasia is unlikely to ever become legal in the U.K., unlike in other countries.

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  6. The Obamacare re-existing conditions loophole is the most equivalent. And most economically absurd. So, you are already sick (Ty2 diabetes from obesity being the most common) and the rest of us pay for it? Affordable Care Act, NOT.

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  7. Suppose you were an idiot, and suppose you were a member of Congress;
    but I repeat myself.
    ” [Mark Twain]

    Actually, many of these people want a National Health Agency (like the VA) for people other than themselves. They can’t get there in one step. So Plan B is to destroy insurance, while keeping the word. Notice, also, that ObamaCare is forcing consolidation of the health industry, and doctors and others are becoming paid employees. You need to have been going to, or involved in, health issues to see this happening.
    Eventually, medical providers will service Congress, the rich, the poor, and everyone else.

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    • That last bit seems not to convey what I want. There will be at least 4 distinct ways of getting medical care. Here, I try again:
      Congress will get great medical care, paid for by taxes.
      The Rich have the cash to pay for the best.
      The Poor will have a government system; generally better than they have now.
      Everyone Else that had decent care will have access to downgraded medical service.

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      • Actually what will happen is those in government, elected/appointed/hired, will get Cadillac healthcare and work diligently in secret to insure they keep it for life. Everyone else will get sh*t.

        Liked by 1 person

        • Scott Adams says it best:
          1. Congress asks lobbyists to write a bill that is good for the healthcare industry and bad for the American public.
          2. The bill fails because Congress is neither credible nor functional. But the public doesn’t care too much about the failed bill because it wasn’t for their benefit anyway.
          3. Repeat.
          With our current system (a Republic), that’s as good as we can do in 2017. The politicians need money to stay in office, and this is how they earn it – by selling out their constituencies

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  8. Willis, Like many of my age group (and yours) I take pills for high blood-pressure, so it’s kept under control. Now, when I fly I’m expected to pay for trip insurance and one of the questions they ask is: ‘Do you suffer from high blood pressure?’. I like to answer, ‘No’, I have it under control. But the Insurance won’t wear this so I have to answer, ‘Yes’, and pay the higher premium.

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  9. No problem. GEICO just has to charge his state’s auto insurance exchange “in excess of $100K” and it’s done. Taxpayers will cover it.

    Next problem…

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  10. In the UK we have ‘National Health Insurance’. Only it isn’t insurance. It’s a government Social Service, funded by a tax.

    Really, every nation has to decide whether health services are to be a private matter, settled either by insurance or by direct payment, or a social service, funded by taxes. If it is really to be private, then you should expect insurance companies to try to cut their costs and refuse to insure people with expensive health problems.

    It seems to me that, as civilisation evolves and human life gets better and better (see Julian Simon) that services which once were the prerogative of the very rich become available to the middle classes, then the poor, and finally become a low-cost or ‘free’ service, funded by taxation. This has happened for roads, water provision, education and I expect it will happen for health services.

    The US seems to be going through this change at the moment. I think that, as modern medicine gets better and better, you will be faced with larger and larger numbers of people who could be kept alive if a service was available to them, and as they die because of a lack of finance you will find it harder and harder to maintain that health is a matter for private provision.

    Just my tu’penny worth…

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    • > If it is really to be private, then you should expect > insurance companies to try to cut their costs and refuse to insure people with > expensive health problems.

      no, they won’t refuse to insure people with expensive health problems, they will be happy to insure them, they will just charge enough to make money on the deal

      > The US seems to be going through this change at the moment. I think that, as > modern medicine gets better and better, you will be faced with larger and > larger numbers of people who could be kept alive if a service was available to > them, and as they die because of a lack of finance you will find it harder and > harder to maintain that health is a matter for private provision.

      where does the money come from? No matter how much you tax, there will always be ways to spend more money on health care.

      As modern medicine gets better and better, it should also be getting cheaper to cover the majority of people’s needs. Things that used to be really hard and labor intensive become routine and automated.

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      • Eye surgury is the perfect example of “As modern medicine gets better and better, it should also be getting cheaper to cover the majority of people’s needs. Things that used to be really hard and labor intensive become routine and automated.”
        https://www.lasikplus.com/lasik-affordable-250_quiz?encSource=12154&utm_medium=Paid-Search&utm_source=Google&utm_campaign=Cincinnati&_vsrefdom=ppc&mkwid=soGCfheem_dc%7ccrid%7c106197288974%7cmt%7ce%7ckw%7clasik

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      • I have simple answers for all your issues.

        …no, they won’t refuse to insure people with expensive health problems, they will be happy to insure them, they will just charge enough to make money on the deal….

        Perhaps you didn’t read Mr Eschenbach’s little story too closely? In it, a person has a car with an expensive repair problem. The insurers refuse to insure, because, in order to make money on the deal, they would need to charge more than the repair costs for the first premium, and the car owner would be better off getting it fixed ‘privately’.

        The same applies, of course, to medical conditions. In fact it;s worse, because mechanical repairs are easier to cost, so less contingency money is required.

        …where does the money come from? No matter how much you tax, there will always be ways to spend more money on health care….

        Here you really need to read Julian Simon’s definitive books on the subject of the improvement of ther human condition. It really is true that, for each generation, we have a better life and things are cheaper. Water provision, transport and education, the three examples I gave earlier, have all moved from being hugely costly and available only to a few, to being cheap commodities available at low cost to all. Health care will go the same way – indeed, it already has. Hip replacements, for instance, are now quite cheap in many places – see https://www.medigo.com/blog/medigo-guides/hip-replacement-cost-guide/ for instance.

        I suspect that the US is maintaining the cost of heath care at a rather high level, and that if it were moved to a government service it could drop considerably. But that is, of course, a decision for the citizens of the United States to make…

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  11. BFL poses an excellent question:

    But just how much is an extra year worth, $1million, $100 million

    I’d say (but that’s probably neither PC nor ethical) that an extra year of Albert Einstein or Leonhard Euler is worth more than an extra year for the chronic methamphetamine addict.

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  12. And, there is still no free lunch, whether in health care insurance or automobile insurance or, God forbid, burial insurance. There were the “potter’s field” where the non funded corpse was laid to rest, with or without a pine coffin. For auto insurance, there are people driving around and getting into “accidents” while impaired, physically, emotionally or chemically. That is why the rest of us pay for un-insured motorist insurance. With health care we also have health care paid for by the collective “we” called: county health insurance and the always open Emergency Room care. Primary care and immunizations are to be had through the county, and Federal Government legislation says the ER has to accept everyone regardless of insurance. The collective “we” also pays these bills.

    To me the issue is lack of accountability. Entitlement is perceived as legitimate for all sorts of past grievances providing a rationale for not taking responsibility for one’s own behavior. Driving impaired. Cigarette smoking. Suicide. We have eased into this situation from rhetoric by community leaders, politicians, guilt association activists and an otherwise wealthy nation circumstance. We “should” be able to do such and such, it is the “right thing to do”. So, charity, which began at home, then followed by religious organizations has now become the province of government and the collective “we”. “We” have made such choices. It is hardly surprising that there is “gaming of the system” for fun and profit. Otherwise, people’s poor choices would fall upon themselves.

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  13. For some of us, pre-existing conditions are a both a big deal and not a big deal.

    On the one hand, the insurance companies need to turn a profit in return for selling their product. Even in the old days before the Clintons politicized smoking, the typical smoker only cut around 11 years off their lifespan in the actuarial tables. There was an insurance premium for smokers, but it was a small and affordable one due to the size of the pool.

    On the other hand, it is the responsibility of parents and individuals to play the game with the insurance companies on pre-existing conditions. Handicappers do get covered, at varying levels of foot dragging depending on who you do business with, but they do get covered without government intervention or “help.”

    It’s something you have to pay attention to, keeping up with the paperwork and making sure all the bases are covered so that in turn you can continue coverage without help from Uncle. We all spend a lot of time making sure our family members are taken care of. I view it as the cost of doing business similar with keeping up a will.

    While I would love to do it all out of my pocket, that is not the world I live in. So I keep the pressure on the politicians to move as much power, control and money from their control to mine as humanly possible over the years.

    Progress as always, is highly variable. Sometimes I lose massively like with O’BamaCare. Sometimes I win small victories. The only thing I do know is that every single time the feds got themselves involved in a one size fits all solution, I lose another chunk of liberty, another chunk of the ability to care for my family in the way I choose to do so.

    My experience is that pre-existing conditions is an excuse rather than a real concern, as nobody ever asked me or people like me what we actually want or need. Had they done so, my response would be to simply get the H#$% out of my life and leave me and my family alone. It is hard enough to do what we do. It is much more difficult without your “help” – insert obligatory comment about what the Road to Hell is paved with here. Cheers –

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    • My experience is that pre-existing conditions is an excuse rather than a real concern, as nobody ever asked me or people like me what we actually want or need. Had they done so, my response would be to simply get the H#$% out of my life and leave me and my family alone. It is hard enough to do what we do. It is much more difficult without your “help” – insert obligatory comment about what the Road to Hell is paved with here. Cheers –

      As Ronald Reagan said in his Farewell Address, “As government expands, liberty contracts.” That’s the basis of the principles I adduce in the aforementioned essay, so forgive me for plugging it again:

      https://walkingcreekworld.wordpress.com/2017/01/09/the-principles-of-freedom-and-medical-care/

      “How to make free choice and free markets work in the increasingly complex world of contemporary healthcare.”

      /Mr Lynn

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  14. My Ferrari-type experience (to continue the analogy). When I was in my 20s studying in Switzerland I needed to have accident insurance. Not being a Swiss Citizen, I didn’t have to have health insurance (my wife and I were self-insured for whatever), however I did purchase Swiss Accident Insurance which covered any accidents requiring medical treatment. The policy worked provided I was not competing in some event. Such events were organized motorcycle races, ski races, etc. Since I didn’t compete, but did ski, and occasionally rode a motorcycle, the accident insurance was reasonable. Hr. Brennwald, my Zurich Insurance agent was happy to take money from the American for both renters insurance and accident insurance. Long story short, while skiing in Andermatt I had a serious fall requiring reconstruction of my left ankle joint. Out of pocket = zero $$ or ChF. The accident insurance more than paid for itself.

    Most young people would purchase accident insurance rather than comprehensive medical insurance as they see themselves more or less bullet proof wrt health problems. Should the insurance companies sell accident insurance to the young, with a low premium adder which provided for catastrophic health coverage, that would be easier to market. One could conceive of the adder working as a whole “health” policy forward premium provided the catastrophic coverage wasn’t used, allowing the insurance company to take money for a reserve so that when the “young” person wasn’t so young anymore and needed full health coverage a buffer was already established. This reserve would follow the customer from insurer to insurer. The reserve doesn’t belong to the insurance company – much like a portable 401k or IRA.

    In the not too distant future I expect that genomics will make treatment of many currently difficult illnesses less problematic than they currently are. One of the biggest problems is that the medical profession uses statistics to cover for their poor understanding of the actual processes within the body. We are starting to see that by peanut buttering the treatments of certain types of diseases, patients were being lost that could have been saved with a focussed treatment based on their genomic signature. Understanding how things work is necessary to getting to the root cause. Treating root causes is vastly different than treating symptoms.

    I know people who want to live as long as possible and I know others who just want to go gracefully into that dark night. It should always be an individual’s right to chose.

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  15. The requirement for auto insurance is often used to justify government intrusion into what many believe are personal choices that should be left to individuals. In most states the mandatory part of auto insurance is for personal liability in case of damage to another person’s property. It protects other people from your actions. Collision coverage isn’t mandatory unless you’ve borrowed to purchase the car, in which case the insurance protects the lender.

    It can be argued that mandatory health insurance protects society from spending public money on the health care of someone who chooses not to insure and then relies on public sympathy to pay for their cancer treatments.

    But why not just make catastrophic (with very high deductibles) mandatory? That effectively caps society’s liability to care for someone who chooses to go without full coverage. And then make coverage for pre-existing conditions dependent on continuity of either full or catastrophic coverage after a certain age? Seems to me changes of this type would both protect society from the cost of caring for those who choose to go without health insurance and restore personal accountability for decisions about whether and what type of coverage to buy.

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  16. “It’s discrimination because you are refusing to sell me insurance on the basis of a pre-existing condition!“ he says, and folds his arms in triumph.

    He must be a cheap bugger; the truly rich would say “it’s just money” and go buy another one.
    If you can afford the risk, it’s always less expensive to be self-insured.

    This is such an obvious case with collision insurance — order matters, first put the bullet in the gun, then pull the trigger.

    It could be a textbook example of conditional probability, and after all, insurance is based on statistics. What is the probability of having a collision? What is the probability of having a collision, given that you already have one? What is the probability of having a collision given that you are male? What is the probability of having a collision given that you are 16? What is the probability of having a collision given that you drive an expensive car? There are legitimate reasons for insurance companies to charge different rates. Arguments against this (“discrimination”) are based on some sort of morality/fairness idea.

    Insurance is like a casino. The house makes a profit by taking some percent of the odds. Many people put into the pot, and one takes it home. If you adjust the odds according to some idea of fairness, what you are really doing is having one group subsidize another, or having the government subsidize them.

    On the other hand, the insurance company might have a full staff of lawyers looking for ways to game the system from their end…

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  17. Yes, we get it, you will defend your socialistic system. You got no choice, clearly, since Canadians that do come to America for needed healthcare, and with the slow death of Obamacare that will continue and you can’t stop them. That is what really pisses you off, they refuse to submit to your sh*t. Oh, and met 3 more Canadians in Pittsburgh for cancer treatment they were refused in Canada. Suck on that.

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