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Comment by clarky07 | Hacker News Reader

Just because the system is broken, doesn't mean we need socialism, and it doesn't mean that a software developer should support anything in particular. I personally, won't support anything that makes me pay for your health insurance. I pay plenty for mine, I have no desire to pay for yours. We can work to fix the broken system, but keeping everything the same and then taxing us more to have the government foot the bill WILL NOT FIX THE PROBLEM. The government getting involved isn't the solution.

Just think, emergency rooms that function with the efficiency of the DMV. Woo Hoo

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Again, why the downvote? The problems in our system are far bigger than Obamacare can solve. Read these anecdotal comments lower in the thread - http://news.ycombinator.com/item?id=4465802 - http://news.ycombinator.com/item?id=4466161

note that obamacare isn't socialism by any stretch of the imagination, and that isn't good for those that want socialism. it also isn't good for people who want free-market. it's the worst of both worlds.

that being said...

I never remotely suggested that our current system is good, or working as it should. I think it sucks. I also take note of how bad a job our government does at running...pretty much anything they try to run (possible exception to NASA). I also note the stories from countries that have socialism. Everyone loves it because it pays for the doctor when they have a something minor or chronic. Then I see the stories of the people dying on waiting lists because they can't get the procedure done in time when it would have been done in America. Due to this, I've come to the perfectly reasonable conclusion that I don't want either our system or socialism. There is another option, and that is to actually fix some of the major problems in our system.

It's hard to take comments like this seriously when the private American health care system has worse outcomes and more than double the cost of numerous socialized systems.

You can blindly chant "government isn't the solution" all you want, but it doesn't change the fact that it undeniably is the solution in a large number of countries with functional health systems.

Functional does not in any way mean better. I do not want to wait on a list for my health care. As I noted in another comment - http://news.ycombinator.com/item?id=4466161 - this doesn't just have to be "current shitty system" versus "socialism". I never said that the current system is great. All I said is that I'd rather have it than socialism. So many things we can fix easily about our system without going to socialism. And Obamacare is the worst of all worlds. Halfway socialism while still keeping insurance companies. Please tell me how that makes sense.

"I personally, won't support anything that makes me pay for your health insurance."

Um, that's kinda the point of any kind of insurance.

> "I personally, won't support anything that makes me pay for your health insurance."

> Um, that's kinda the point of any kind of insurance.

No, the point of insurance is not to buy into or share the risk of others, but to amortize one's own risk over time. An insurance policy can have a single applicant and still function as it should -- the issuer is betting that the applicant won't suffer a loss, the applicant is betting that he will. An actuary sets the rate based on his best guess about the possibility of a claim.

This thesis is proven by the classic alternative to buying insurance -- self-insurance, a scheme in which an individual sets aside his own cushion against loss, or "self-insures" -- accepts risk using his own resources.

Many states will accept an alternative to otherwise mandatory car insurance -- a personal bond against claims. The advantage to the individual is that the bond can earn money as an investment while it stands as proof of personal responsibility.

So the idea that insurance means joining a pool of insured individuals may be true in many cases, but it isn't a requirement for insurance to function. And it certainly isn't "the point".

  the issuer is betting that the applicant won't suffer a
  loss, the applicant is betting that he will. An actuary
  sets the rate based on his best guess about the
  possibility of a claim.

Emphatically: no! The issuer is betting that in the entire group of clients the total loss will be smaller than the rates they set. Almost nobody can ever financially deal with the greatest risk health insurance insures against. Health insurance is almost never about amortizing your own risk. It is about insuring against risks you couldn't possibly deal with otherwise. Almost nobody can pay for a long stay on the IC after an accident, with months of rehabilitation afterwards. When you need the insurance, it's the money of the other clients, that with hindsight never needed the insurance, that pays for your costs.

Of course obligatory health insurance is pure socialism (not in the pure 'political movement' sense of the word, but in the 'common usage' sense of the word, meaning forced sharing of a population's resources for a specific greater good) and thank God for it. I'll take my Western European social democracy over your government any day. I gladly pay taxes to have it this way.

> When you need the insurance, it's the money of the other clients, that with hindsight never needed the insurance, that pays for your costs.

This is the normal approach, but it's a coincidence -- the insurance system doesn't collapse if it's not the model. Insurance can equally be a case of one policy, one client, all depending on what's being insured -- see below.

> Emphatically: no! The issuer is betting that in the entire group of clients the total loss will be smaller than the rates they set.

My point is that system works with one client the same way as with 10,000. It's a matter of accurately assessing the risk of a claim. Insurance doesn't suddenly stop working because there are few clients or only one client.

Multiple clients is the usual case, but it's not required for the system to work. Large insurance houses will very happily write a policy that only applies to one person:

http://voices.yahoo.com/bizarre-insurance-policies-famous-ce...

A quote: "America Ferrera is the newest addition to the list of stars who have some of their body parts insured. Famous for her role as Betty Suarez in the top-rating ABC sitcom "Ugly Betty", Ferrera has had her smile insured for 10 million dollars by Lloyds of London."

One person, one smile, one client, one policy.

No, Lloyds of London have huge numbers of clients. There is not one person / group of people who will personally lose a huge amount of money if that pays out. The money will come from someone else's car insurance not paying out.

No, the point of insurance is not to buy into or share the risk of others

Yes, that is exactly the point of insurance. Everything you wrote is wrong, sorry.

The model where there are many clients and one policy is the norm, but that doesn't mean the system requires it. If insurers went to the trouble of making it work, you could have individual policies written up for each and every client, and sell the risk to subscribers (as is done with mortgages). Example:

http://voices.yahoo.com/bizarre-insurance-policies-famous-ce...

One person, one smile, one client, one policy.

> Everything you wrote is wrong, sorry.

It's generally thought good form to offer some evidence for your position, as I have for mine.

You're right, my statement was too broad, but I submit that it is still correct for health insurance, when the goal is (I hope) to get affordable health care for everyone. The difference is that if vehicle insurance for your tank is unobtainable to prohibitively expensive, you can choose not to drive that tank. You have no choice in getting type 1 diabetes, or appendicitis, or an MRSA-infected bug bite.

> You're right, my statement was too broad, but I submit that it is still correct for health insurance ...

It's correct because the present system is set up that way. But this doesn't mean it must be that way, or that insurance requires a large pool of clients with the same policy and coverage. That's a coincidence.

From the standpoint of a large publicly-held corporation, many clients with identical policies, or many clients each with unique personal policies, work internally exactly the same way -- it's all about actuaries assessing risk and setting rates.

> I submit that it is still correct for health insurance, when the goal is (I hope) to get affordable health care for everyone.

Regardless of the business model, if health costs cannot be controlled, insurers will refuse to write the policies. This outcome doesn't depend on the assumptions behind the program -- whether there is a large program with many identically covered clients, or a program in which each client has a unique policy and the capital pool is the corporation's stockholders rather than the policy holders.

In both cases, some circumstances are unworkable. It remains to be seen whether health costs can be meaningfully regulated, in order to make a mandatory health insurance requirement politically acceptable. I sincerely hope so, but I don't control health care costs.

> It's correct because the present system is set up that way. But this doesn't mean it must be that way, or that insurance requires a large pool of clients with the same policy and coverage. That's a coincidence.

No, it is not.

> From the standpoint of a large publicly-held corporation, many clients with identical policies, or many clients each with unique personal policies, work internally exactly the same way -- it's all about actuaries assessing risk and setting rates.

The economy exists to serve people, not the other way round. The only acceptable system is one that allows people with chronic illnesses to get coverage like everyone else, and for an affordable price. The only effective way to prevent commercial insurers to refuse coverage to such people is to not allow them to issue personal policies.

>> It's correct because the present system is set up that way. But this doesn't mean it must be that way, or that insurance requires a large pool of clients with the same policy and coverage. That's a coincidence.

> No, it is not.

It is a coincidence, and many insurance companies write policies that apply to only one person. They can do this because a large pool of people, all with the same policy, is not essential for the system to work. Example:

http://voices.yahoo.com/bizarre-insurance-policies-famous-ce...

One person, one smile, one client, one policy.

> The economy exists to serve people, not the other way round.

Please, to discuss that topic, start a new thread. It has precisely nothing to do with present topic, which is how insurance companies work.

Then please, for the sake of the public good, do the following:

  Don't drive on the roads.
  Do put out your own fires if you house catches fire.
  Do hire private police for your security.
  Don't use public transportation.
  Don't use the Internet (including HN).
  Don't use, or have your children use public schooling.
  Do pay completely, without subsidy or federal grant, for all your higher education.
  Pay for a septic tank if available, or do not use public sewers.
  Don't drink water from city water.
  Better yet, don't drink water at all: EPA endorses cleaner environmental health.
  Don't eat food unless you grew it: All food is inspected by FDA.

Better yet, just go buy a boat and live in the ocean. And don't come back.

Then you can be free from "EVIL SOCIALISM".

You're right. Clearly because I don't want socialism it means I want 100% anarchy and no government whatsoever. That doesn't follow at all. You also added several things in there that the government doesn't provide, so I'm just really confused by this comment.

(side note I could probably get by without almost everything on this list except for food and roads. I'm disregarding internet, as the gov't doesn't provide that).

Don't drive on the roads. -do want roads, those the gov't should provide

Do put out your own fires if you house catches fire. - i have a sprinkler system installed so it's unlikely I'll need them. I suspect I could get private insurance to cover this though in a free-market. pay small money into pool (just like taxes) and we can all have firemen without your government. Also, if you don't live in a city, it is very possible that there are no firefighters who will come to your house.

Do hire private police for your security. - Police are nice for keeping things relatively civil, but most of the time they are minutes away when you have a few seconds of need. They come and do paperwork about the thing that happened to you that they couldn't stop.

Don't use public transportation. - i don't

Don't use the Internet (including HN). - since when did the gov't start providing me internet? I should really stop paying charter to provide it for me.

Don't use, or have your children use public schooling. - i think our public schools are pathetic, and I'm seriously considering home schooling.

Do pay completely, without subsidy or federal grant, for all your higher education. - i did. I probably helped pay for yours though with my taxes too.

Pay for a septic tank if available, or do not use public sewers. - no problem. will do.

Don't drink water from city water. - city water mostly sucks. I have to filter it anyways, I might as well filter water from a well.

Better yet, don't drink water at all: EPA endorses cleaner environmental health. - I could do with less from the EPA.

Don't eat food unless you grew it: All food is inspected by FDA. - I could also do with less FDA. Turns out Kroger has a vested interest in not poisoning me. It's likely I'll start going to Publix if they do.

> Turns out Kroger has a vested interest in not poisoning me.

Are you sue? Last time I checked, Kroger had a vested interest in getting your money. If you get cancer in 10 years and your children get born with deformities it doesn't matter for them. They've already got your money and good luck proving it was them doing it and not WalMart.

> I suspect I could get private insurance to cover this though in a free-market.

Make sure to also buy "bring you back from the dead" insurance you might need that too.

> Don't drive on the roads. -do want roads, those the gov't should provide

Why? What's your justification? There are actually private highways and roads in this country and make good money off of people driving on them. They are expensive but usually well maintained. Why roads and not say a rescue squad?

> I could do with less from the EPA.

You make your own lead and pesticide testing kits? Are you going around to every grocery store and test every single product for bio , chemical and radiological safety?

> Police are nice for keeping things relatively civil?

So no police then. Alright. So when you abolish them let me know so my local militia friends can come and raid your house.

"Do put out your own fires if you house catches fire. - i have a sprinkler system installed so it's unlikely I'll need them."

Haha. Sorry. As a Firefighter, you're very wrong. It'll definitely help, no doubt. But most commercial buildings today have sprinkler systems, and they burn.

"I suspect I could get private insurance to cover this though in a free-market. pay small money into pool (just like taxes) and we can all have firemen without your government."

Plenty of places do this. And it's an unregulated market. With sometimes horrific consequences. Grant's Pass, Oregon, for one, with three fire companies. Make sure you do your research - you don't want to get the company that has an engines with insuffient GPM capacity, or doesn't have sufficient tenders/tankers if you don't live in a hydranted community. Make sure their firefighters are all accredited (there is both an art and a science to it). Make sure they have SCBA so they can go inside your burning building (or your neighbors, who might cause a risk to yours). These are things you think should be obvious, but are not.

"Also, if you don't live in a city, it is very possible that there are no firefighters who will come to your house."

Most such areas also have a volunteer firefighter presence.

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