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Comment by refurb | Hacker News Reader

That's how it works in Canada. You keep the malpractice insurance rates low by limiting payouts.[1]

[1]In 1978, the Canadian Supreme Court limited damages for pain and suffering. Adjusted for inflation, the cap now is just over $300,000. The United States has no federal cap on damages, though a few states, including Florida, have imposed them.

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"Pain and suffering" is only one class of damages, though. What about the cost of medical procedures and lost wages?

How do you have lost wages in countries with unlimited sick leave. Medical procedures are covered for the most part by public insurance

Unlimited sick leave? If you are permanently disabled in Canada a company will keep paying your wages until you die? That sounds implausible, but even if it's true you could presumably expect some appreciation in your wages that you will not get if you can never work again.

Not 100% how it works in canada, but in Germany, you start off on the employer's program, then a combination of state and employer programs, then after some point (I think 18 months of non-work?) you get switched off the employer's program and onto the state's pension system, which carries some set of other consequences. I do believe pay decreases as well but not sure how much.

Either way it seems pretty clear how you could have lost wages.

So you get five year worth of money for lifetime impairment? Sounds fair.

I guess that's what disability insurance is for? You also get a pretty good safety net in Canada in terms of health insurance coverage and disability payments.

Long term disability insurance is crazy expensive in the USA.

My wife got multiple quotes around $15,000 a year for a perfectly healthy 28 year old woman. It excluded back issues because she went to a chiropractor a few times. This was for like 60% income replacement too.

I would guess that there's a serious adverse selection problem in personal disability insurance.

The strange thing is long term disability insurance for a group plan is really cheap. My work provides it as an option and I only pay $300/year or so for the premiums, work doesn't pay any percent of the premiums.

Adverse selection is a huge problem in insurance. And disability fraud is especially bad (like billions of dollars in CA every year).

As a result, insurance companies don't want to play in that space, since their average margin is only like 6% anyway. States backstop the insurance companies, to make sure they continue to offer the product.

In many cases if it weren't for the medical sciences, we'd already be dead or die from the ailment a physician or surgeon were trying to fix. I think people lose sight of that. If you have any doubt about making it through some event, buy your own insurance. If you can't find someone to insure you, it's likely it's too risky a behavior and you should question your acceptance of it as a solution to your problem.

I would rather society as a whole take on responsibility for caring for the permanently disabled, than try and place that entirely on the individual who disabled them (or on an insurance company that'll just fight it all the way).

We do take care of them, there is the SS Disability, the only problem is it is never enough $ to live the lifestyle they had prior

It is never enough money to live (full stop)

"I would rather society as a whole pay for thing I want".

- Every socialist

Society isn't an entity that can be assigned responsibility; it's simply the existence of communication, cooperation and trade between individuals.

The alternative in most parts of the US seems to be you don't get the surgery at all, because you can't afford the jacked up costs (of which some sizable portion goes towards expensive malpractice insurance).

I'd argue malpractice insurance is kept low in Canada is through most MDs having the same insurance (CMPA), and only settling when fighting in court would be a guaranteed loss or set a problematic precedent.

As well, in Ontario, the government pays most of the insurance premiums:

http://www.health.gov.on.ca/en/pro/programs/ohip/mlp/announc...

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