An interesting conversation about health care reform

[cartman94501]

I had a chat with a colleague who falls squarely into the "America is awesome, I started out poor and became upper middle class, so anyone can do it" camp. He also proudly watches Fox News though he's not apparently unintelligent.

Anyway, he says he supports reforming health care so that it's not tied to your job, but he opposes mandatory coverage

Comments

[lexica510]

I had a discussion with my dad once after I was no longer covered by his health insurance. "You are carrying major med or catastrophic, right?" he asked. "Because if something happens to you, I will bankrupt myself if that's what it takes to pay for your care."

So whatever choice your colleague might or might not have made about his own actions, he has no control over other people's actions, and his family might well have decided "we'd rather go bankrupt than let our son die and know that we might have been able to save his life."

[cartman94501]

By "bankrupt oneself" do you mean (a) file for protection from creditors under the bankruptcy laws or (b) liquidate and spend down all assets? If the former, it's not as easy as it once was, and if (b), what if that's still not enough. Treatment for leukemia can easily exceed $1 million, and few Americans have that much in any form.

Do you agree that if we make sure insurers can't cherry pick by choosing only healthy people with no pee-existing conditions, we have to make sure that people can't game the system by opting out of coverage until they become I'll?

[lexica510]

Oh, I'm moderately radical on that subject: insurers should not be able to exclude anybody, and nobody should be able to opt out. The whole point of a risk pool is having lots of people with varying levels of risk. We don't let people opt out of paying the taxes that fund the Fire Department, even if those people live in completely non-flammable buildings made entirely of stone. Your personal risk of fire is low? How nice for you. Now pay your taxes so the community as a whole is protected.

"I like paying taxes. With them I buy civilization." - Justice Oliver Wendell Holmes

And by "bankrupt myself" I believe he meant that he would liquidate and spend down all assets and go into as much debt as he could manage to obtain without concern for whether he would later be able to pay it off. His point was not that this would be sufficient to pay for my care, his point was that he would deplete his savings and effectively destroy his future and his retirement if that would give a chance of helping me.

[cartman94501]

I agree wholeheartedly, and I don't think it's radical at all. We've allowed the far right to frame the debate for far too long. Even Canadians who vote Tory support national health. Re-privatizing health care finance (health care provision is private) is simply not on the mainstream agenda in Canada.

Your father's devotion is admirable, but it still leaves open the question of what would happen if his assets and the maximum amount he could possibly borrow were still not enough.

[webmacher]

I just read a really interesting book called Stumbling into Happiness which basically talks about how bad we are at predicting how we will react to events in our lives - we think we'll be happy if we buy XYZ, we'll want to kill ourselves if we go blind - and by extension, how we make poor decisions as a result.

Making decisions based on your feelings of invulnerability at age 22 seems related to that somehow.

That said, I think I can predict with a fair degree of certainty that if my daughter decides to go without health insurance at 22, and then needs expensive medical treatment I will 1) do what I need to do to get her treatment, including going bankrupt 2) be pissed off as hell at her for her selfishness and short-sightedness.

[cartman94501]

I read that book too and liked it a lot. Your response to the hypothetical sounds reasonable, but what if you couldn't get your hands on enough money to treat her and she would therefore die? Would you spend all you could just to assure yourself that you'd literally done all you could, or would you spend zero since no amount you could spend would be enough? Obviously, we rarely know at the beginning of an illness exactly how much it will cost to cure it, so the point is rather moot, but if I could know in advance that my maximum ability to gather cash would give me $x, and the cost of my child not dying would be $3x, bankrupting myself would be pouring money down a rathole for nothing, and I'd opt not to do so and to spend $0 (or just the amount necessary for palliative care).