Mother, mother, mother - there's too many of you crying.

[Adder]

Originally Posted by LessinSF

Fine, but cN we stop calling publicly funded healthcare "insurance?"

None of our health insurance is insurance.

[Tyrone Slothrop]

Originally Posted by Adder

None of our health insurance is insurance.

?

[Tyrone Slothrop]

[Adder]

Originally Posted by Tyrone Slothrop

?

There's an insurance component - against the smaller probabilities of big problems - but most of what your doing is pre-paying and cost sharing.

[ferrets_bueller]

I'm having difficulty separating fiction from reality these days; if you don't suffer from this I suggest that you may not be paying close enough attention to reality.

Has Kelly been named Hand of the Mad King?

Was it Daenerys or Ivanka that said "Don't judge me by my father's actions."?

Was it Vladimir who starts wars to stir nationalist fervor, in order to divert attention from domestic failures? Or, as we will hear on the talkingheads tonight, is it Mad King Donald? See below:

http://www.nbcnews.com/news/north-ko...option-n788396

[Tyrone Slothrop]

Originally Posted by Adder

There's an insurance component - against the smaller probabilities of big problems - but most of what [you're] doing is pre-paying and cost sharing.

Not following your distinction about cost sharing or how you get to "most" (which is more nuanced than your previous categorical statement). I guess my view is that most of the reason that people want what we call health insurance is because of the insurance component -- people are afraid of the ruinous and otherwise prohibitive costs of treating big problems.

[Adder]

Originally Posted by Tyrone Slothrop

Not following your distinction about cost sharing or how you get to "most" (which is more nuanced than your previous categorical statement). I guess my view is that most of the reason that people want what we call health insurance is because of the insurance component -- people are afraid of the ruinous and otherwise prohibitive costs of treating big problems.

It think there is actually pretty good evidence that you're wrong. Perhaps you saw a post not that long ago from Tyler Cowen on how much people value their Medicaid coverage. The answer was not very much and certainly less than it costs. Which isn't surprising because people are terrible at evaluating risks and probability (like, it's an inherent weakness in human cognition). It's very hard to tell if you're going to get cancer or have a heart attack, much less have any sense of what it will cost you.

Meanwhile, it's pretty obvious that if you're planning to have a baby, what you're looking for from your insurance is to get everyone else who's in the same risk pool to chip in for the cost. No one ever puts it that way, but that is indeed what happens.

As to all the rest, the preventative, diagnostic and mundane, none of that is "risk" you're seeking to lay off. You're signing up for insurance for that stuff primarily to take advantage of group purchasing power and enhance the predictability of what you will need to pay.

And what other insurance do you buy that you're virtually certain to make regular, sustained claims against and where making claims that exceed your premiums isn't at all unusual?

[sebastian_dangerfield]

Originally Posted by LessinSF

Fine, but cN we stop calling publicly funded healthcare "insurance?" Covering pre-existing conditions does not insure against risk acciddnt. "Insuring" against known losses is illegal and a moral hazard. Call it what it is.

Even health insurance as it is now is not actual "insurance." It's a TPA for your health care.

[Tyrone Slothrop]

AON, this is fun.

[sebastian_dangerfield]

Originally Posted by ThurgreedMarshall

This is absolutely hilarious.

TM

Actually, it's pretty factual. There are more Ds in the country than Rs.

And the measuring stick for stupid fancied today is "votes against policies that would entitle him to more." The Rs who want more entitlements and then vote against people who'd give them those things are indeed stupid. And numerous. But the Rs who vote against their own benefits because they believe the entitlement state is too large, or put fiscal concerns above their own interest, are not stupid.

I'm also not so sure a person who votes based on who will give him more in govt benefits is smart. He's certainly rational, at least in the short term. But such Pavlovian voting ("I vote for he who butters my bread") is often more craven and short-sighted than intelligent.

I struggle to differentiate between he who votes only to avoid taxes and he who votes only to get more from the govt. Both are simply voting short term personal interests. The logic employed is essentially the same.

[Tyrone Slothrop]

Originally Posted by Adder

It think there is actually pretty good evidence that you're wrong. Perhaps you saw a post not that long ago from Tyler Cowen on how much people value their Medicaid coverage. The answer was not very much and certainly less than it costs. Which isn't surprising because people are terrible at evaluating risks and probability (like, it's an inherent weakness in human cognition). It's very hard to tell if you're going to get cancer or have a heart attack, much less have any sense of what it will cost you.

Meanwhile, it's pretty obvious that if you're planning to have a baby, what you're looking for from your insurance is to get everyone else who's in the same risk pool to chip in for the cost. No one ever puts it that way, but that is indeed what happens.

I did see that post, which was by Alex, not Tyler. I have a couple of issues with it, which may or may not have been anticipated by the underlying article. One, the implications of the Oregon study have been addressed quite a bit elsewhere but do not seem to slow anyone down from claiming that it shows that Medicaid does not improve physical health, silly as that sounds. Two, people who get Medicaid definitionally do not have as much money as other people. Asking them how much they would pay for Medicaid, given that they don't have funds, almost certainly tells you more that it sucks to be poor than about the value of health insurance more generally.

I think you can set child birth aside because it is planned. From my experience, admittedly more with people with higher incomes than Medicaid recipients, the scary thing about healthcare costs is the prospect of getting cleaned out or not being able to pay at all for care. While people may be poor at accurately estimating the likelihood of low-probability events, they are also are scared by them, often more than they rationally should be, and they are averse to many kinds of risks.

As to all the rest, the preventative, diagnostic and mundane, none of that is "risk" you're seeking to lay off. You're signing up for insurance for that stuff primarily to take advantage of group purchasing power and enhance the predictability of what you will need to pay.

I understand that. I just think that while use of those benefits is greatest by incidence, it is the part of healthcare coverage that most people value less because paying out of pocket for these things is just not that scary. (From a systemic perspective, you get better outcomes if you incent people to take get some sorts of this care, so it also reduces long-run costs quite apart from group purchasing power.

And what other insurance do you buy that you're virtually certain to make regular, sustained claims against and where making claims that exceed your premiums isn't at all unusual?

In part, this is just another way of saying that the distribution of healthcare expenses is more evenly distributed than the distribution of other things against which you can insure, like car accidents.

But of course you are right that there is an element of cost-sharing and -management in what we call health insurance. I didn't say it wasn't there. I just said that's not what's most important to people about it (and thus that you are wrong in saying it's not insurance). But when Sebby is done stp-ing, he can tell me why I'm wrong.

[Tyrone Slothrop]

Originally Posted by sebastian_dangerfield

Actually, it's pretty factual. There are more Ds in the country than Rs.

At parties, I bet you tell people that there are more stupid women and men, and then when you elicit the requisite offense, you get to say, actually it's pretty factual - there are more women than men. Ha!

[ThurgreedMarshall]

Originally Posted by sebastian_dangerfield

Actually, it's pretty factual. There are more Ds in the country than Rs.

And the measuring stick for stupid fancied today is "votes against policies that would entitle him to more." The Rs who want more entitlements and then vote against people who'd give them those things are indeed stupid. And numerous. But the Rs who vote against their own benefits because they believe the entitlement state is too large, or put fiscal concerns above their own interest, are not stupid.

I'm also not so sure a person who votes based on who will give him more in govt benefits is smart. He's certainly rational, at least in the short term. But such Pavlovian voting ("I vote for he who butters my bread") is often more craven and short-sighted than intelligent.

I struggle to differentiate between he who votes only to avoid taxes and he who votes only to get more from the govt. Both are simply voting short term personal interests. The logic employed is essentially the same.

Your analysis is limited by your stunted worldview.

TM

[Greedy,Greedy,Greedy]

Originally Posted by sebastian_dangerfield

Actually, it's pretty factual. There are more Ds in the country than Rs.

And the measuring stick for stupid fancied today is "votes against policies that would entitle him to more." The Rs who want more entitlements and then vote against people who'd give them those things are indeed stupid. And numerous. But the Rs who vote against their own benefits because they believe the entitlement state is too large, or put fiscal concerns above their own interest, are not stupid.

I'm also not so sure a person who votes based on who will give him more in govt benefits is smart. He's certainly rational, at least in the short term. But such Pavlovian voting ("I vote for he who butters my bread") is often more craven and short-sighted than intelligent.

I struggle to differentiate between he who votes only to avoid taxes and he who votes only to get more from the govt. Both are simply voting short term personal interests. The logic employed is essentially the same.

Whatever the pros or cons of your position, it is pretty clear the Republicans put more of their morons in elected positions, and elect more of them to higher positions.

[sebastian_dangerfield]

Originally Posted by Tyrone Slothrop

At parties, I bet you tell people that there are more stupid women and men, and then when you elicit the requisite offense, you get to say, actually it's pretty factual - there are more women than men. Ha!

If equal percentages of men and women are stupid, which is a pretty fair assumption, this wouldn't be a statement without some heft.

I mean, if one must go back of the envelope, as is unfortunately required in these things.