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Comment by kenhwang | Hacker News Reader

There's a choice component to health. Sure, you can lose the genetic or environmental lottery and just be unhealthy.

Or you can choose to be unhealthy. Smoking, drinking, drugs, poor diet, lack of exercise. These are by far the biggest contributors to healthcare cost and they cost absolutely nothing to prevent. Many people just don't take responsibility for their health, and many others in the US don't like the idea of subsidizing other people's healthcare for preventable or self-inflicted health complications.

edit: I actually do have access to one of the best single payer systems in the world due to dual citizenship. Single-payer is far from the perfect silver bullet everyone likes to sell it as.

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I think what you're getting at is that in the US, people have a financial incentive to be healthier due to the cost of health care.

How is that working out? Does the average American eat healthier, do more exercise, consumer fewer drinks, or do fewer drugs?

I actually don't think it's working out. People in general are awful at risk assessment. But, Americans like their choice, even if it means the majority of them will make poor ones.

It's also a downward spiral. The more people are responsible for their own well being, the more they're opposed to "handouts". So those who do take of themselves and do responsibly manage risks I've noticed are the ones more opposed to socialized medicine.

Hm, this is a good point. US provably has the greatest incentive to live healthy due to having the provably highest health care costs. That is a rational and reasonable argument. Yet you get downvoted for it which is interesting. I think you make a good point though.

> many others in the US don't like the idea of subsidizing other people's healthcare for preventable or self-inflicted health complications.

Who cares really?

It costs a bit more to care for people in dollars and cents, but it fosters a better society, which everyone benefits from.

Another case of people wanting to be freeriders.

Apparently enough people care enough. Otherwise this wouldn't be such a contentious debate topic.

Right but it reduces your cost as well, which is why it's so strange. It's cutting off your nose to spite the face.

It doesn't seem to be working. U.S. has obesity epidemic and shorter life expectancy than most countries with socialized healthcare.

This system throws caring-but-unlucky people under the bus.

And even people who really care about their health still have to endure this absolutely bizarre implementation (how can you have an efficient market where prices are secrets or fiction?)

In the USA there are plenty of perfectly normal, educated people, taking care of themselves, eating right, jogging every morning and doing the "right thing" entire life who get literally financially destroyed, savings wiped out, and go bankrupt because of "complicated" illness that is perfectly solvable but "costs a lot" due to the state of medicine in this country.

Why "educated" people in this country still keep voting in the same crooks (dems & reps) is beyond me.

This election cycle is going to be the same thing - this crook or that crook. Pick one that will do less damage. There is no difference anymore. This two party system BS has to go.

But there is a solution to that. Anything that can be easily identified as being the result of someone's own choices they are on the hook for and/or can get insurance for. Yes, these things would have to be enumerated, with some things debated and others refined, but insurance companies didn't seem to have any trouble enumerating what they will or will not cover and this isn't any different. Most if not all of the issues with implementing a system like this will be things that have been done before.

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