Comment by Rule35 | Hacker News Reader

Comment by Rule35 | Hacker News Reader

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> In the case of organs there's an inherently limited supply, since people have to donate voluntarily and all sorts of other conditions have to be met.

Yes, and charity spending on one person necessarily takes away from spending on another too. To support someone whose choice of behavior impacted them means you can't support someone who was injured entirely through 'acts of god'.

> It's not as if we're throwing away livers rather than give them to alcoholics.

No, but but they do go to the back of the line. Especially if they still drink.

> I'm sure you must be aware that we do treat all kinds of obesity-related conditions – and at great expense.

Sure. But thankfully we prioritize them to below children with heart defects, and non-obese adults with the same conditions.

> Are you in favor of conditionally refusing treatment to HIV patients depending on the manner in which they contracted the virus?

No more than I am for prioritizing treatment downward for everyone whose injuries were self-inflicted. That's only fair for the people whose were not.

I don't think you've really answered the last question. At the moment, in the US, how you contracted HIV makes no difference to your access to treatment. Do you think this should change or not?

As to the rest, you're obviously aware that in general, obese adults are not deprioritized for treatment as compared to non-obese adults.

> I don't think you've really answered the last question

That's pretty much a textbook example of sealioning. Why are you so anxious?

> HIV

Are they asking for charity? If not then their circumstances shouldn't be relevant, just their ability to pay.

> you're obviously aware that in general, obese adults are not deprioritized for treatment as compared to non-obese adults.

They are. If you're up for a contested treatment (a rare organ, a diagnostic machine that's always in use) you're given a score that represents your health and ability to benefit. Obesity isn't a total black mark but it absolutely is considered. However, we don't consider why you're fat, fat is just a health risk and we recognize that and don't waste effort where it won't be rewarded.

It seems you agree, then, that there is no ethical dilemma in insurers paying for HIV treatment regardless of whether the patient acted irresponsibly. But it would be easier to understand your answer if you’d just say whether or not you think that access to HIV treatment in the US should be more restrictive than it is at present.

We already covered the special case of contested treatments. It’s obviously irrelevant here as we are just talking about access to drugs for HIV patients, not access to an inherently limited resource. Either you pay for Truvda or you don’t. There’s no queue.

Similarly, if you are obese, no generally available treatment that could be of medical benefit to you will be denied merely because it’s expensive and you’re obese.

> Similarly, if you are obese, no generally available treatment that could be of medical benefit to you will be denied merely because it’s expensive and you’re obese.

Nope. There's a limit to everyone's insurance, beyond which they will not pay for more treatment. You won't get told that you're too fat but your treatments will cost more and consequently you'll get less of them. Your insurance contract is for a sum of money, not a specific set of life-saving actions.

But generally that limit is much higher than what you've paid so your expensive treatments take money from the pool.

> there is no ethical dilemma in insurers paying for HIV treatment regardless of whether the patient acted irresponsibly.

As long as their fees cover the payments. But if they're costing more than they're paying as a class, meaning that all other users are compensating them, then yes - dilemma.

> It’s obviously irrelevant here as we are just talking about access to drugs for HIV patients, not access to an inherently limited resource. Either you pay for Truvda or you don’t. There’s no queue.

Paying out of your own pocket, 100% fine regardless.

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