Health care: three simple questions for conservatives / libertarians

[Mr Spinkles]

Please give a simple, yes or no answer:

1. Should health insurance companies be allowed to discriminate against people who have medical conditions by refusing to cover them, i.e. denying coverage based on "pre-existing conditions"?

2. If your answer is "no", then do you acknowledge that the financial incentive for most healthy people would be to forgo health insurance until they develop a medical condition, and this would be unsustainable?

3. If your answer is "yes", then would a tax break for having health insurance be a reasonable incentive to avoid this problem?

Thanks in advance.

 

[Revoltingest]

1. Should health insurance companies be allowed to discriminate against people who have medical conditions by refusing to cover them, i.e. denying coverage based on "pre-existing conditions"?

Yes

3. If your answer is "yes", then would a tax break for having health insurance be a reasonable incentive to avoid this problem?

Yes.
It would be reasonable, but I prefer to eliminate all personal deductions.

 

[YmirGF]

1. Should health insurance companies be allowed to discriminate against people who have medical conditions by refusing to cover them, i.e. denying coverage based on "pre-existing conditions"?

Yes, though a pre-existing condition should not disqualify individuals from getting ANY healthcare.

3. If your answer is "yes", then would a tax break for having health insurance be a reasonable incentive to avoid this problem?

Not in my view, no. IF the government mandates that all people must have insurance in order for the system to remain viable it would be counter productive to give money back to those who caused the biggest drain on the system. At best, I suppose you could use the model from driver's insurance where you get a small discount for a clean driving record.

 

[Magic Man]

Not in my view, no. IF the government mandates that all people must have insurance in order for the system to remain viable it would be counter productive to give money back to those who caused the biggest drain on the system. At best, I suppose you could use the model from driver's insurance where you get a small discount for a clean driving record.

I could be wrong, and Mr. Spinkles will clarify, but it sounded to me like he was posing the questions as if the ACA didn't exist.

 

[Mr Spinkles]

1. Should health insurance companies be allowed to discriminate against people who have medical conditions by refusing to cover them, i.e. denying coverage based on "pre-existing conditions"?

Yes

Health care that discriminates against the sick. Nice. At least you're honest.

 

[Revoltingest]

Health care that discriminates against the sick. Nice. At least you're honest.

The fact that someone is sick does not obligate me to provide them with medical services.
Were you asking questions just to generate fodder for criticizing the resondents?

 

[Iti oj]

The fact that someone is sick does not obligate me to provide them with medical services.
Were you asking questions just to generate fodder for criticizing the resondents?

Nor does the aca

 

[Revoltingest]

Nor does the aca

The admin publicly proclaimed that different classes (the young) will subsidize others (us fogies).
So I'd say you're wrong.
But doesn't it seem potentially disingenuous to ask questions of libertarians, receive predictable answers, & then launch into snark?
Next time Mr Spinkles gets a spanking, it won't be from Mystic....it'll be from a less skilled groundskeeper.
Now, before you mention it, I don't mean that I'm less skilled at groundskeeping than Mystic, but I'm a newbie to the spanking world.

 

[Mr Spinkles]

Yes, though a pre-existing condition should not disqualify individuals from getting ANY healthcare.

Of course. We wouldn't want people with medical conditions to get NO healthcare, we just want to make sure they don't get MUCH healthcare.

Anyway, thanks for the straight answer.

Not in my view, no. IF the government mandates that all people must have insurance in order for the system to remain viable it would be counter productive to give money back to those who caused the biggest drain on the system. At best, I suppose you could use the model from driver's insurance where you get a small discount for a clean driving record.

I could be wrong, and Mr. Spinkles will clarify, but it sounded to me like he was posing the questions as if the ACA didn't exist.

Right. I would say a few things in response to YmirGF:

1. First, again, thanks for the straight answer.

2. What if there is no other "mandate", besides the tax break? Then is it reasonable, in your view?

3. In the case of the ACA, the "mandate" IS a tax break. Getting health insurance is "mandatory" for most people IF they want a tax break. It's not illegal for individuals to forgo health insurance under the ACA.

4. It's interesting that you compare a driving record to a health record. There are actually incentives that many employers and health insurers are adding to American insurance plans now for making healthy choices -- getting your blood pressure checked, signing up for a weight loss program if you are overweight, etc. (Tangentially, this has happened over the past couple of years thanks to the ACA, but let's not pursue that.) But do you really think we should compare other aspects of a health record, such as being diagnosed with a brain tumor, or giving birth to a child with a genetic disorder, to a driving record? You could find out you have a brain tumor tomorrow. So could I. Wouldn't it be smart if we pooled our resources together and agreed, ahead of time, that whichever one of us is unlucky enough to have that diagnosis, that pooled fund will help him cover his expenses?

 

[esmith]

Please give a simple, yes or no answer:

1. Should health insurance companies be allowed to discriminate against people who have medical conditions by refusing to cover them, i.e. denying coverage based on "pre-existing conditions"?
Depends on how you qualify the term discriminate. Do you think that automobile insurance policies discriminate?

2. If your answer is "no", then do you acknowledge that the financial incentive for most healthy people would be to forgo health insurance until they develop a medical condition, and this would be unsustainable?

3. If your answer is "yes", then would a tax break for having health insurance be a reasonable incentive to avoid this problem?

Thanks in advance.

Depends on how you qualify the term discriminate. Do you think that automobile insurance policies discriminate?
Do I think that those that lead an unhealthy lifestyle; for example: smoke, are overweight, use drugs, use alcohol excessively, work in a high risk environment(not necessarily unhealthy per-se), and a myriad of other possible situations including not having annual health check-ups as rmentioned previously should pay the same as those that do not have the same lifestyle? Then the answer is I think ones cost should be based on a risk based scale. Should those with pre-existing conditions pay more than those without pre-existing conditions. I say maybe, depending on the situation. Let say your per-existing condition is a result of your lifestyle, then you should pay more. However, if it is based on conditions that were beyond ones control, then no. I would be willing to assist those under those conditions with slightly higher premiums for myself.

 

[Mr Spinkles]

The fact that someone is sick does not obligate me to provide them with medical services.

Agreed. But even animals as low as vampire bats are intelligent enough to understand that reciprocal altruism, though not obligatory, is a smart contract for all parties involved to sign.

Were you asking questions just to generate fodder for criticizing the resondents?

No, that happened all on its own. I did not expect anyone to answer "yes" to the first question, honestly.

 

[Revoltingest]

Agreed. But even animals as low as vampire bats are intelligent enough to understand that reciprocal altruism, though not obligatory, is a smart contract for all parties involved to sign.
No, that happened all on its own. I did not expect anyone to answer "yes" to the first question, honestly.

Then you've much to learn about libertarians. We dislike coercion. To impose taxes (eg, 'insurance fees', fines) to pay for the health care of others involves coercion. If I'd answered otherwise, I wouldn't be a libertarian. Sure, sure, you hear about these "libertarian socialists", but they're just posers who want big government to provide us with security. You're free to look to bats as a model for how you'd construct society, but you should note that they do as they please, without government enforcing their altruism.

 

[esmith]

No, that happened all on its own. I did not expect anyone to answer "yes" to the first question, honestly.

How about a qualified maybe, as per my response?

 

[Mr Spinkles]

Depends on how you qualify the term discriminate. Do you think that automobile insurance policies discriminate?
Do I think that those that lead an unhealthy lifestyle; for example: smoke, are overweight, use drugs, use alcohol excessively, work in a high risk environment(not necessarily unhealthy per-se), and a myriad of other possible situations including not having annual health check-ups as mentioned previously should pay the same as those that do not have the same lifestyle? Then the answer is I think ones cost should be based on a risk based scale. Should those with pee-existing conditions pay more than those without per-existing conditions. I say maybe, depending on the situation. Let say your per-existing condition is a result of your lifestyle, then you should pay more. However, if it is based on conditions that were beyond ones control, then no. I would be willing to assist those under those conditions with slightly higher premiums for myself.

Thanks for clarifying that. For the record, I have no problem with there being incentives, including forms of "discrimination", to encourage healthy lifestyle choices.

That's not what we're talking about.

I'm asking if insurance companies should be allowed to refuse to sell coverage to people with pre-existing medical conditions. That doesn't mean those people won't pay more. To simplify the discussion, let's assume we are only talking about medical conditions which have nothing to do with a person's lifestyle choices -- e.g., being paralyzed because you were hit by a drunk driver, or being born with a genetic disorder, or finding out tomorrow that you have a tumor.

 

[Akivah]

Please give a simple, yes or no answer:

Complex questions can't be accurately answered with a single word. Especially questions with run-on langauge and conclusions stated within the question.

1. Should health insurance companies be allowed to discriminate against people who have medical conditions by refusing to cover them, i.e. denying coverage based on "pre-existing conditions"?

What is insurance? It is a form of risk management to hedge against the risk of a contingent loss. To equitably cover the contingent risks, the parties that incur greater risks are obligated to pay more for their increased risk than a lesser risk party. Thus, people with existing medical conditions are more likely to have immediate and higher medical costs than people with no existing medical conditions. Theoretically, a person that incurs medical costs in excess of funds of the entire population wouldn't be able to be covered by the insurance entity. To answer your direct question, a company should be able to charge higher premiums for less healthy people to cover their increased risk. This economic reality is not "discrimination". I don't think anyone should be 'refused' coverage, but the insurer should be allowed to have different premium rates to cover higher risk people.

2. If your answer is "no", then do you acknowledge that the financial incentive for most healthy people would be to forgo health insurance until they develop a medical condition, and this would be unsustainable?

We shouldn't factor personal responsibilty out of the equation. If a person forgoes medical treatment because of how they think their premiums might change, that is their fallacy and their right. The government shouldn't force people to get health care.

3. If your answer is "yes", then would a tax break for having health insurance be a reasonable incentive to avoid this problem?

A tax break isn't reasonable because it doesn't address the underlying issue. If an insurance entity is incurring rising costs that aren't being covered by its existing premiums, then it should have the right to increase their premiums. On the other hand, if their premiums collected exceed their costs (and reasonable profits), then their premiums should be decreased.

A tax break is just an unrelated amount that the government gives to the general public. At best, the size of a tax break should be related to the amount of medical care costs needed. But most likely, a tax break will simply be related to a person's gross income. Also, comparing to existing tax breaks as a guide, the size of a tax break received will be far less than the actual expenses incurred. Rendering a tax break of dubious incentive to persuading someone to get medical care. For example, in 2012 the US gov't gave a tax deduction of $3700 per dependent (a $555 tax credit at 15%). Does anyone think $555 covers the expenses of a child for a whole year? Does this incentive persuade the average person to have kids?

 

[Mr Spinkles]

Then you've much to learn about libertarians. We dislike coercion. To impose taxes (eg, 'insurance fees', fines) to pay for the health care of others involves coercion. If I'd answered otherwise, I wouldn't be a libertarian. Sure, sure, you hear about these "libertarian socialists", but they're just posers who want big government to provide us with security. You're free to look to bats as a model for how you'd construct society, but you should note that they do as they please, without government enforcing their altruism.

They don't need a system (such as government) which coordinates the reciprocal altruism of many bats because the resource they are sharing does not transcend an individual bat. One bat can provide and dispense the food needed by another bat. One human cannot, in general, fund or dispense the brain surgery needed by another human.

 

[Mr Spinkles]

Complex questions can't be accurately answered with a single word.

True but as written, they aren't very complex questions.

What is insurance? It is a form of risk management to hedge against the risk of a contingent loss. To equitably cover the contingent risks, the parties that incur greater risks are obligated to pay more for their increased risk than a lesser risk party. Thus, people with existing medical conditions are more likely to have immediate and higher medical costs than people with no existing medical conditions. Theoretically, a person that incurs medical costs in excess of funds of the entire population wouldn't be able to be covered by the insurance entity. To answer your direct question, a company should be able to charge higher premiums for less healthy people to cover their increased risk. This economic realtity is not "discrimination". I don't think anyone should be 'refused' coverage, but the insurer should be allowed to have different premium rates to cover higher risk people.

Emphasis added. While I appreciate the rest of your comments, that part actually answers the question that was asked. Thank you.

We shouldn't factor personal responsibilty out of the equation. If a person forgoes medical treatment because of how they think their premiums might change, that is their fallacy and their right. The government shouldn't force people to get health care.

I agree, we shouldn't factor personal responsibility out of the equation. However, respectfully, you did not answer the question, which was: if insurers cannot refuse to cover the sick (as you said above), then do you acknowledge that the financial incentive for most healthy people would be to forgo health insurance until they develop a medical condition, and this would be unsustainable?

Until you answer whether you acknowledge this financial incentive exists, or not, responding to your other comments would be getting ahead of ourselves.

 

[Revoltingest]

They don't need a system (such as government) which coordinates the reciprocal altruism of many bats because the resource they are sharing does not transcend an individual bat. One bat can provide and dispense the food needed by another bat. One human cannot, in general, fund or dispense the brain surgery needed by another human.

I don't argue against your desire to have gov provided benefits thru income redistribution.
Tis only that I don't share it.

 

[Akivah]

if insurers cannot refuse to cover the sick (as you said above), then do you acknowledge that the financial incentive for most healthy people would be to forgo health insurance until they develop a medical condition, and this would be unsustainable?

I don't like when you add conclusions to your questions. It's almost like you are answering your own questions.

Most people don't go to the doctors until they feel something is wrong.

I don't think most people would forgo health insurance, anymore than they would forgo car insurance until they get into an accident. I think they would go for the cheapest insurance they could find.

 

[dust1n]

We dislike coercion. To impose taxes (eg, 'insurance fees', fines) to pay for the health care of others involves coercion.

Yeah, coercion is bad... unless it involved operating a monetary system on a national level, having a military to protect us from baddies, and maintaining an order of private property (which mine as well be called "publicly enforced private property"). That's the good type of coercion.