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Comment by arcticbull | Hacker News Reader

A high deductible plan would bankrupt the average person if they ever needed to draw on it. The average American can't come up with $500 let alone $5000 so for them the high-deductible plan (the only only the could afford) is as good as nothing at all. You're still going to be relying on medicaid.

It's not a real health insurance plan because it doesn't cover the realities of every-day life. You're leveraging (literal) survivorship bias in defense of this plan. You could make the same exact case if you didn't have health coverage at all, and nothing happened to you (that it was a good fit for you and it was both simple and lived up to its promises).

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What if Stronico could afford $5000 in an emergency, and could also afford to pay for the much smaller incidental treatments not covered?

It is clearly false for you to claim Stronico didn’t have insurance.

If something serious had happened they would have paid the $5000 and the rest would have been covered by their plan.

I agree that this might not work for the average American, but that’s the only valid part of your claim.

To your point I was speaking of the average American and not necessarily the poster themselves. Their plan worked just as well as not having insurance because they didn't need to draw on it.

This is misleading.

Their plan would also have worked had they needed to draw on it.

The fact that they didn’t need to draw on it has no bearing on whether their plan would have worked for them.

Again, not for the average American.

Firstly there in fact are no average Americans.

If you want to use a statistical model to say how many people it would or would not work for, by all means do so, but otherwise this is just an empty definition.

Secondly, you actually argued that it only didn’t work for him because he didn’t make a claim. That has nothing to do with the average American and is simply a false statement.

I agree that it wouldn’t work for everyone. But it would clearly work for many people, including him.

If you want to argue about the average American, then you need numbers and facts, otherwise it’s just an empty opinion.

By your reasoning is there any circumstance where a high deductible plan, albeit paired with an HSA, could ever work for anyone, at any time? Because it worked quite nicely for me for quite some time.

Yes, if we allowed people that could not pay for treatment to die? That's the rub, right? If 999 out 1000 people in your insurance make the right decision, but one person gets... emergent liver failure by Hep C or needs a lung transplant, then the system only works if it is ruthless and the cost for treatment is not socialized (Medicaid).

"The average American can't come up with $500"

>The lowest-income households in the U.S. on average spend $412 annually on lottery tickets[1]

>In the U.S., people living below the poverty level and people having lower levels of educational attainment have higher rates of cigarette smoking than the general population[2]

>Among smoking households, the mean quarterly expenditure on cigarettes in constant 2015 dollars was US$458[3]

[1]https://www.bloomberg.com/news/articles/2018-09-12/the-poore...

[2]https://www.cdc.gov/tobacco/disparities/low-ses/index.htm

[3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009464/

I think the meaning here is that the average American finds themselves unable to execute on the fact that they have the means to save an emergency fund and are instead too focused on the short-term dopamine hits that they can get immediately.

Being able to come up with a dollar a day isn't the same as being able to come up with a year's worth of lump sum at once.

Being poor changes how you think about money. Every time you save a few dollars, something happens - an unexpectedly high electricity bill, an unexpected doctor visit, losing your phone - and that minute bit of savings goes out the door. It's easy to get into the thought pattern that you might as well spend on something fun while you've got it.

As for cigarettes, being as addictive than heroin will do that to ya.

Does not saving prevent those events from happening? How are those events handled without savings? How would giving them more money resolve this problem?

> Does not saving prevent those events from happening?

That's not the point. Of course it doesn't - but that unexpected $35 copay for the urgent care visit would've wiped you out, whether you'd bought the $1 lottery ticket or not. At least you had a little burst of "man, if I won, I'd..."

We know from studies that poverty dramatically changes short-term vs. long-term decision making.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641572/

> How are those events handled without savings?

Be hungry the week after, pawn a possession, payday loan.

> How would giving them more money resolve this problem?

How would having money solve money problems? That's really the question?

>How would having money solve money problems? That's really the question?

I have shown that they do have $500 to cover an emergency but they have chosen to spend it on lottery tickets and tobacco products. You claim that this is due to being poor and how they have poor impulse control and that makes them unable to save the money and instead the immediately spend it. If I give them another $500 why wouldn't they just spent that on more lottery tickets and tobacco products?

> I have shown that they do have $500 to cover an emergency

You have not. You've shown that after a year of not buying lottery tickets they might have that $500, with the caveat of the fact that we know that's not really how that works - any savings gets wiped out by the next unexpected bill long before that.

> If I give them another $500 why wouldn't they just spent that too?

Where was that suggested? That's a silly approach to the problem.

Far more comprehensive solutions are necessary. Better housing policy, living wage, national healthcare, better regulation (or banning) of payday loans, guaranteed access to banking services, etc.

>You have not. You've shown that after a year of not buying lottery tickets they might have that $500, with the caveat of the fact that we know that's not really how that works - any savings gets wiped out by the next unexpected bill long before that.

I don't see how this math works. Lets say my total annual income is $5000 to keep the math easy. My spending looks like this:

get $5000 paycheck (for the sake of ease of math)

spend $3000 on rent

spend $500 on lottery tickets

spend $1000 on food

spend $500 on tobacco

Now I have a $500 bill that I don't have the money for.

Conversely I could:

get $5000 paycheck

spend $3000 on rent

spend $1000 on food

Now I have a $500 bill that I can cover because I did not buy all those lottery tickets.

You continue to pretend poverty doesn't have one key fact: There are always more bills to pay.

Your car breaks down. You get a parking ticket. Your kid gets sick. You get evicted and some of your stuff gets ruined by the rainstorm because the landlord put it on the lawn.

Exactly. Car-job-house, lose one and the other two quickly fall. You're one bill away from homelessness. As a Markov chain, ultimately everyone in poverty crashes at some point or another.

>There are always more bills to pay.

If saving money causes more bills to appear as you suggest the solutions seems to be to give the poor less money so they will have less bills.

> If saving money causes more bills to appear

Sigh. I'm not sure if this is a comprehension issue or if you're deliberately misrepresenting what I'm saying.

Saving doesn't cause bills to appear. The bills are already there. They've likely been piling up for years, and continue to do so.

If you're $20k in debt, and it keeps growing, and every time you've tried to save up a few dollars to pay it down you've had to spend the couple bucks you managed to accrue on yet another critical bill you can't put off any longer, it starts to feel pointless to save.

> you suggest the solutions seems to be to give the poor less money

What?

I laid out specific, systemic interventions that are necessary, none of which require giving the poor less money.

>The bills are already there. They've likely been piling up for years, and continue to do so.

>If you're $20k in debt, and it keeps growing, and every time you've tried to save up a few dollars to pay it down you've had to spend the couple bucks you managed to accrue on yet another critical bill you can't put off any longer, it starts to feel pointless to save.

If they have so much debt buying so many lottery tickets? Seems like a bad idea. What if they never bought lottery tickets to begin with? Who keeps extending them credit when they clearly never pay any bills?

Do you extend this same logic to firms like Amazon? Amazon spends virtually every dollar they make, does that mean they are poor? Should the government step in a give them money because of how poor they are?

I don't see why, "You have to stop buying lottery tickets" is a non-starter when talking about Americas poor. First stop buying lottery tickets, then we can talk about money problems you may have.

> Who keeps extending them credit when they clearly never pay any bills?

Predatory lenders, utilities and hospitals that may not be legally permitted to deny service but can still attempt to collect, etc. They're certainly not getting a 2% cash-back credit line from Chase.

They're also not never paying bills. They're juggling them, so the latest and most critical get paid. Squeaky wheel gets the grease - you'll probably pay to get your car out of impound before you'll pay your kid's school lunch debt.

> Do you extend this same logic to firms like Amazon? Amazon spends virtually every dollar they make, does that mean they are poor?

My "I'm being argued with in bad faith" senses are beginning to tingle.

> I don't see why, "You have to stop buying lottery tickets" is a non-starter when talking about Americas poor.

Again, systemic solutions are required here.

Add "get rid of lotteries" to my systemic fixes list, if you like.

Couldn't come up with that amount of money all at once. Lottery tickets and smoking add up to $2.38 per day.

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