Public option for healthcare

[Professor S]

Game, do you realize you just proved his point? We've asked you to provide real ideas and evidence for your opinions, and you've responded by changing the argument to one of whether or not your taking people out of context, which you just did. You criticize for us responding to sentences, when you skip vast parts of our posts and then continue to ignore the points held therein, and then ADD ideas to our posts so you have something to argue with.

I really struggled with the idea of posting this, but at this point I see no more articulate or appropriate response to this thread:

[TheGame]

I can't watch youtube at work, but I'll check when I'm at home.

And no, I didn't prove his point, I replied to the whole point of his post. As for your post, I'm trying to get away from this whole 'arguement analysis' thing that you're trying to push the thread into, so I replied to the issues you said that you are confused about.

[Professor S]

Originally Posted by TheGame

I can't watch youtube at work, but I'll check when I'm at home.

And no, I didn't prove his point, I replied to the whole point of his post. As for your post, I'm trying to get away from this whole 'arguement analysis' thing that you're trying to push the thread into, so I replied to the issues you said that you are confused about.

So if by "getting away from argument analysis" you mean reinterpreting what has been written to fit your argument, changing the argument when it fits your needs and ignoring inconvenient evidence and logical thought, then congratulations, you've succeeded... in utterly destroying what most rational people consider discourse.

You have to realize what you are avoiding is called the "Socratic method" and it is what all real public discourse is based on.

http://en.wikipedia.org/wiki/Socratic_method

I've come the the conclusion having a reasonable conversation with you on political or social issues is impossible. In future political/cultural threads, I'm simply going to ignore you.

[KillerGremlin]

Originally Posted by Professor S

2) Equity. Everyone pays, but what if one person is a marathon runner and eats only organic brocolli, and someone else loves vodka, smokes and twinkies? Is that "fair"? Will healthy eating and weightloss be made legal mandates or a fineable offense? If so, who makes those determinations and what exactly will they be? Will regular checkups become an obligation that is enforceable? Will sin taxes be added to items that are deemed a detriment to our health? This is the problem whe people make the mistake of mixing the "right" of healthare with public funding.

Originally Posted by TheGame

I don't think that is something that you should fear. We're already the most over weight country in the world as is, the most I could see happening is the doctors promoting fitness but not enforcing it. But even when you consider that, the country as-is is still horrible when it comes to health. How dare the government care about people's health!

http://www.infoplease.com/world/statistics/obesity.html

We are actually the 9th fattest country. What would be more interesting to look at is annual deaths from conditions like Diabetes and Heart Disease. You could make the case that this country suffers from a ton of deaths from weight disorders:
http://www.the-eggman.com/writings/death_stats.html
Major Cardiovasular Diseases being the number 1 cause of death and diabetes being the number 4 cause.

Again, though, these statistics would need to be weighed against other country's statistics.

I do believe a moral issue would arise (should the public have to pay for the quadruple bypass of someone who chose their lifestyle?). Besides pointing out that you neglected to rebuttal the moral premise of 'the exploitative unhealthy body' in social health care that Prof S made, I ask; how could doctors or the government enforce exercise? I ask this question not with debate in mind but simply to suggest public health care or not, the weight epidemic will continue to be an epidemic.

Edit: I do also want to clarify that it's not so much an "epidemic" as a social reaction to our lifestyles and diets. The term epidemic does not do the complicated problem that obesity is justice. Furthermore, the BMI scale used to determine obesity is flawed and that is (IMO) a factor in the inflated obesity statistics. But that really is irrelevant in this discussion...I just didn't want anyone to think I felt a particular way about the way people weigh.

[TheGame]

Percentage wise, are 9th. But look at the countries that are 1-8...

The population is 10,000 people in Nauru, 155,000 in Micronesia, 20,000 in Cook islands, 112,000 in Tonga, a whopping 1,398 in Niue, 188,000 in Samoa, 21,000 in Palau, and last but not least, 2.7 million in Kuwait.

And there's 300,000,000 (or 300 million) in the united states.

So you're right, we're not the fattest country percentage wise, but we're the home to the most fat people. And we're worse percentage wise then any compareable free western countries.

-EDIT-

I think I may as well reply to the other half of your post too. The government would not have to enforce excersize any more then private health insurance would. Since the public option would not be manditory. It'd be subject to its own premium, and not some direct tax like social security is. I don't see how a reasonable conclusion could be drawn that they would force people to stay in shape. (I could imagine them supporting it by offering some type of discount, or doing different things to help people get into shape since that'd help with the costs of the program.. but actually making it illegal to be unhealthy? Yeah right.)

As for your thoughts on BMI, I agree completly, its very out dated. Everybody is different.

[TheGame]

Originally Posted by Professor S

So if by "getting away from argument analysis" you mean reinterpreting what has been written to fit your argument, changing the argument when it fits your needs and ignoring inconvenient evidence and logical thought, then congratulations, you've succeeded... in utterly destroying what most rational people consider discourse.

You have to realize what you are avoiding is called the "Socratic method" and it is what all real public discourse is based on.

http://en.wikipedia.org/wiki/Socratic_method

I've come the the conclusion having a reasonable conversation with you on political or social issues is impossible. In future political/cultural threads, I'm simply going to ignore you.

Haha ok.. that's your choice. What I was chosing not to respond to, however, was pointles rederick that wouldn't have led to any meaningful discussion. Lets go back and look at the rest of the post that I was refering to.

Game, at this point your logic is so scattered, contradictory and absent minded to me that I can't continue. At one point you seem to agree with my points in theory but then argue against what you had previously agreed with.

My untyped responce to that would be something along the lines of "Ok and...?". I'm not argueing against something I previously agreed with, and I already disproved that when you brought up your so-called examples of this.

When we mention real problems with the current legislation, you just say they'll avoid them when the actual legislation isn't overcoming any of them.

Once again, nothing meaningful can come from this quote.. My reply to this at most would be: "'It didn't work there, so its not going to work here' is no more or less of a legit arguement then saying 'We can learn from their mistakes.'" Which I said before.

You're discussing in theory why you believe it won't work, which I haven't really challenged other then discussing in theory why it can work.

In the end, I have no idea what your ideas on the subject are, beyond being for public options "damn the torpedoes", with all arguments leading to that end regardless of leaps of reality that must be taken to get there. Public healthcare does not default GOOD. There must be real solutions and challenges overcome, not simply a unthinking movement toward an immediate goal.

Once again another thing that I addressed in the last post I made but didn't quote directly. But I'll just quote myself for the sake of not having you scroll back up again.

"Ok to clarify this, there's two ways I see private health insurance going if the public option is created.

1) Private insurance will try to compete with the public option by offering better quality at a more reasonable price.
2) Private insurance will not be able to compete with the quality that the public option offers at it's price, so it will move into being something only available to wealthy people.

If option one happens, and private insurance becomes more affordable, and they become more focused on quality and legitamate coverage.. then the health care system is fixed. Even if the public option sucks enough that private is still viable, it will force private insurance to make a change for a good to keep their base.

If option two happens, and private insurance pretty much dies and becomes something that only wealthy people will dish out the money for. Then it just proves that private insurance was broken to begin with. And I'd be the first to say good riddens.

The way I see it, if the public option isn't better then what is offered now.. or if the private companies are willing to make the changes they need to compete.. then people will not switch to it. In the end its an option.. if its not a better option then we have now, then there's no reason to switch."

In my opininon its win-win, if its relitively bad compared to what private insurance is willing to offer, it will only be for extreme cases that private inurance refuses to touch. But, if private insurance doesn't get their act together enough to compete, then it will become something bigger and private insurance will likely be pushed into something that the wealthy use only.

[Bond]

I'm going to try a new tactic, since nothing else has been effective.

Originally Posted by TheGame

In my opininon its win-win, if its relitively bad compared to what private insurance is willing to offer, it will only be for extreme cases that private inurance refuses to touch. But, if private insurance doesn't get their act together enough to compete, then it will become something bigger and private insurance will likely be pushed into something that the wealthy use only.

Who pays for the public option?

You do know that the premiums paid by citizens who choose to opt-in will not be enough to cover the entire cost of the program, correct?

Do you believe a public option would truly be deficit-neutral as President Obama claims it would be? Reference this article from the WSJ citing the CBO's (which is non-partisan) findings:

But the most damaging news came from Congressional Budget Office (CBO) Director Douglas Elmendorf, who said last week that the White House’s health-care proposals would not “reduce the trajectory of federal health spending by a significant amount.” This shattered the central claim Mr. Obama has been making: that his health-care plan controls costs. In a July 17 letter, Mr. Elmendorf added that the House’s health-care bill would result in a “net increase in the federal budget deficit of $239 billion” over 10 years. That’s likely a low-ball estimate because it assumes that Congress will increase taxes by $583 billion over the next decade.

[Professor S]

Originally Posted by TheGame

Once again another thing that I addressed in the last post I made but didn't quote directly. But I'll just quote myself for the sake of not having you scroll back up again.

"Ok to clarify this, there's two ways I see private health insurance going if the public option is created.

1) Private insurance will try to compete with the public option by offering better quality at a more reasonable price.
2) Private insurance will not be able to compete with the quality that the public option offers at it's price, so it will move into being something only available to wealthy people.

If option one happens, and private insurance becomes more affordable, and they become more focused on quality and legitamate coverage.. then the health care system is fixed. Even if the public option sucks enough that private is still viable, it will force private insurance to make a change for a good to keep their base.

If option two happens, and private insurance pretty much dies and becomes something that only wealthy people will dish out the money for. Then it just proves that private insurance was broken to begin with. And I'd be the first to say good riddens.

The way I see it, if the public option isn't better then what is offered now.. or if the private companies are willing to make the changes they need to compete.. then people will not switch to it. In the end its an option.. if its not a better option then we have now, then there's no reason to switch."

In my opininon its win-win, if its relitively bad compared to what private insurance is willing to offer, it will only be for extreme cases that private inurance refuses to touch. But, if private insurance doesn't get their act together enough to compete, then it will become something bigger and private insurance will likely be pushed into something that the wealthy use only.

Game, I already addressed the illogical nature of your points one and two multiple time in this thread. Re-posting old arguments that we've already answered does not make our responses not exist.

It's not my or Bond's fault if you refuse to see them, or answer "Haha, Ok..." and then continue with your nonsensical argument ignoring the ideas and evidence placed in front of you. You are oblivious and I think perhaps have some kind of pathological disorder.

[TheGame]

Originally Posted by Professor S

You are oblivious and I think perhaps have some kind of pathological disorder.

Nah I just think you're getting old and can't accept that ideas other then yours work. And you don't seem to understand that I'm not in direct opposition to your concepts and ideas. You refuse to acknowlege that when I have an opinion supporting the public option that you disagree with, that I'm not using that idea as a direct arguement to what you have said. You don't seem to understand that I'm the only one here being open minded, and you are the only one being completly closed minded. You don't understand that you have no basis for bashing the logic of my posts and you have yet to present a valid example that shows otherwise.

And lastly, you don't understand that this whole discussion is about different concepts and ideas about how to fix healthcare, and that its based 100% off of opinion.

So yeah, if you feel like I ignored any of your points against private insurance feel free to bring it back up. But I think I've noted very clearly the things I agree with and disagree with. For opinions and facts that I do agree with, I usually don't waste as much time touching on.

[TheGame]

Originally Posted by Bond

I'm going to try a new tactic, since nothing else has been effective.

Ok

Who pays for the public option?

You do know that the premiums paid by citizens who choose to opt-in will not be enough to cover the entire cost of the program, correct?

Initially it will not be enough to cover the costs, you're right. Tax dollars will give birth to this program.

If it becomes the standard type of healthcare for the country and private insurance is pushed into being something for the wealthy.. then it will eventually get to the point where it pays for itself. Though it will pay for itself without pushing for making a profit, and without dealing with as much upper management as private health insurance has. Which will keep the costs at a lower then average rate (in theory).

Now, if it fails to become the standard, and private health insurance companies find a way to keep their price and quality comparable.. then the public option will be pushed into a corner and would be like Prof S's "Catastrophic Care" which will only deal with cases private insurance reasonably would not want to handle. If this happens, tax dollars will continue to pay for it, but it would still address issues that people have with the healthcare system as-is.

I would not mind either result.

The biggest fear I have about the public option, however, is that the governemnt will not play fair with it and continue to push private health insurance into failure by directly making changes in laws that make it impossible for them to compete. As long as the public option remains an OPTION, its win win.

As you (and prof) mentioned earlier in the thread, loosening up regulations on private health insurance would do some good. However I don't feel that it would help without the public option playing some role in it. My problem with a "Catastrophic Care" type thing is that there's no potential for it to pay for itself whatsoever. If the public option morphs into that, we can at lest say we tried to save government money.

Do you believe a public option would truly be deficit-neutral as President Obama claims it would be? Reference this article from the WSJ citing the CBO's (which is non-partisan) findings:

That would depend completly on how sucsessfull the program is as I stated above. Of course to start, it will not be deficit-neutral. Anyone with common sense knows that it will take money to get this thing rolling. As for the projection in the article, that would be unfortunate, but I think that it would be reasonable. It doesn't specify how much per year it would be exactly, because the truth is nobody knows. But it's a safe assumption that it will start off high then lower over time... but it depends on too many factors.

[Bond]

Originally Posted by TheGame

Initially it will not be enough to cover the costs, you're right. Tax dollars will give birth to this program.

So, if one already possesses private health insurance, and wants nothing to do with a public option, is it moral to require that that person pay for the public option through mandated taxation?

If it becomes the standard type of healthcare for the country and private insurance is pushed into being something for the wealthy.. then it will eventually get to the point where it pays for itself.

How would it pay for itself if the program simply had more citizens who wish to opt-in?

Though it will pay for itself without pushing for making a profit, and without dealing with as much upper management as private health insurance has. Which will keep the costs at a lower then average rate (in theory).

Statistically speaking, workers in health care management are significantly underpaid compared to management in other fields with similar education levels (MBAs, fields such as financial companies, accounting firms, etc).

Is it not possible that the reason why health care is so expensive is because of excessive government intervention (as the graphs I originally posted eluded to)?

Now, if it fails to become the standard, and private health insurance companies find a way to keep their price and quality comparable.. then the public option will be pushed into a corner and would be like Prof S's "Catastrophic Care" which will only deal with cases private insurance reasonably would not want to handle. If this happens, tax dollars will continue to pay for it, but it would still address issues that people have with the healthcare system as-is.

Okay (I wanted to make sure to quote every single paragraph so nothing was taken "out of context").

I would not mind either result.

Okay.

The biggest fear I have about the public option, however, is that the governemnt will not play fair with it and continue to push private health insurance into failure by directly making changes in laws that make it impossible for them to compete. As long as the public option remains an OPTION, its win win.

This is the exact problem with medicare and medicaid, I hope you realize. The assumption with medicare and medicaid is that the government burdens the majority of the cost of the programs, but this is false. Rather, the majority, sixty cents on every dollar, is paid for by hospitals and health systems that must treat medicare and medicaid patients. Do you see that this is one of the reasons why insurance premiums are so high for private paying customers?

As you (and prof) mentioned earlier in the thread, loosening up regulations on private health insurance would do some good. However I don't feel that it would help without the public option playing some role in it. My problem with a "Catastrophic Care" type thing is that there's no potential for it to pay for itself whatsoever. If the public option morphs into that, we can at lest say we tried to save government money.

The theory of insurance is to save the end consumer money by pooling together similar risk exposures. This is why insurance companies are picky when choosing customers, otherwise, the theory of insurance collapses as the risk exposures are no longer similar in nature, which would in turn no longer save the end consumer money. If the public option were to accept any consumer, with varying risk exposures, the option would not operate in the traditional form of an "insurance company." Therefore, how do you propose that the option operate? How would it be able to pay out the money necessary if too many of the consumers had highly correlated risks, or were prone to have the same risk over and over again?

That would depend completly on how sucsessfull the program is as I stated above. Of course to start, it will not be deficit-neutral. Anyone with common sense knows that it will take money to get this thing rolling. As for the projection in the article, that would be unfortunate, but I think that it would be reasonable. It doesn't specify how much per year it would be exactly, because the truth is nobody knows. But it's a safe assumption that it will start off high then lower over time... but it depends on too many factors.

Okay.

[TheGame]

Originally Posted by Bond

So, if one already possesses private health insurance, and wants nothing to do with a public option, is it moral to require that that person pay for the public option through mandated taxation?

That depends on if they're satisfied with the state of their insurance. Unfortunately, this is a democracy, so the majority of the people will have a say in what tax dollars should be spent for and what it shouldn't. By people elecing Obama president they have voted for healthcare reform, by people allowing democrats to have so many seats in the house and senate they have voted for healthcare reform, and polls have shown that most people are for a public option for healthcare.

I don't want to pay for a lot of programs that I will never use, but I dont' disagree with the process that got things to this point. I believe that healthcare is a right, not a luxury. And like any rights I feel that its moral for it to be protected by the law.

How would it pay for itself if the program simply had more citizens who wish to opt-in?

Because people who opt in would have to pay a set premium to get the insurance.

Statistically speaking, workers in health care management are significantly underpaid compared to management in other fields with similar education levels (MBAs, fields such as financial companies, accounting firms, etc).

Is it not possible that the reason why health care is so expensive is because of excessive government intervention (as the graphs I originally posted eluded to)?

It is very possible. This is why I promote them going about it a different way other then making more adjustments to private healthcare itself. Making a public option sets a standard for them to try and reach, trying to manipulate private insurance directly can yield questionable results, and pin accountability for the failures of a private sector buisness on the government.

Government should support change, not enforce it on a private company.

This is the exact problem with medicare and medicaid, I hope you realize. The assumption with medicare and medicaid is that the government burdens the majority of the cost of the programs, but this is false. Rather, the majority, sixty cents on every dollar, is paid for by hospitals and health systems that must treat medicare and medicaid patients. Do you see that this is one of the reasons why insurance premiums are so high for private paying customers?

I'll be perfectly honest with you, I don't understand this question as you have worded it. Are you asking me if private insurance companies are forced to raise their prices because there are people on medicaid and medicare?

The theory of insurance is to save the end consumer money by pooling together similar risk exposures. This is why insurance companies are picky when choosing customers, otherwise, the theory of insurance collapses as the risk exposures are no longer similar in nature, which would in turn no longer save the end consumer money.

correction

The theory of insurance is to make the most money by pooling together similar risk exposures. This is why insurance companies are picky when choosing customers, otherwise, the theory of insurance collapses as the risk exposures are no longer similar in nature, which would in turn no longer making as much money.

It depends on perception. You feel like they're doing it to save the customers money, I feel like they handle it that way to turn a profit. Both things could be true for some private insurance companies. But before I give a full reply, lets go to the meat of your question:

If the public option were to accept any consumer, with varying risk exposures, the option would not operate in the traditional form of an "insurance company." Therefore, how do you propose that the option operate? How would it be able to pay out the money necessary if too many of the consumers had highly correlated risks, or were prone to have the same risk over and over again?

They could do something that most private healthcare companies don't do these days.. and that's run the company with integrity, and with the health of their customers in mind. The pricing will be reasonable, but not made with profiting in mind. And when someone who is covered actually does get sick, they won't have to worry about the public option going over their health history to find an excuse to drop care.

http://www.youtube.com/watch?v=u-hUVzcOTMo

(I can't watch youtube at work, so I can't say for 100% sure if I linked the right video.)

As for the bottom line costs for the consumers, its very much possible that private insurance companies will be able to pull off comparable prices. There's even a possiility that the public option could turn out to be the expensive option (for the monthly premium anyway). But the point of the option is to not deny people based on the state of their health, and to actually take care of people when they do become sick. Which our current insurance companies do not specialize in.

[Bond]

Originally Posted by TheGame

That depends on if they're satisfied with the state of their insurance. Unfortunately, this is a democracy, so the majority of the people will have a say in what tax dollars should be spent for and what it shouldn't. By people elecing Obama president they have voted for healthcare reform, by people allowing democrats to have so many seats in the house and senate they have voted for healthcare reform, and polls have shown that most people are for a public option for healthcare.

The United States is a republic, not a democracy. In a democracy your majority claim would be correct, not in a republic. See this distinction between republics and democracies:

Republic. That form of government in which the powers of sovereignty are vested in the people and are exercised by the people, either directly, or through representatives chosen by the people, to whome those powers are specially delegated. [NOTE: The word "people" may be either plural or singular. In a republic the group only has advisory powers; the sovereign individual is free to reject the majority group-think. USA/exception: if 100% of a jury convicts, then the individual loses sovereignty and is subject to group-think as in a democracy.]

Democracy. That form of government in which the sovereign power resides in and is exercised by the whole body of free citizens directly or indirectly through a system of representation, as distinguished from a monarchy, aristocracy, or oligarchy. [NOTE: In a pure democracy, 51% beats 49%. In other words, the minority has no rights. The minority only has those privileges granted by the dictatorship of the majority.]

I don't want to pay for a lot of programs that I will never use, but I dont' disagree with the process that got things to this point. I believe that healthcare is a right, not a luxury. And like any rights I feel that its moral for it to be protected by the law.

Healthcare being a right is your personal opinion, although it is currently not defined as a right by law. The question that arises form a belief that healthcare is a right is: where does that right begin and end? If someone is dying of terminal cancer is it their right to receive continuous and costly treatment to prolong their life by only a few months? If someone chooses to live an unhealthy lifestyle and take on extravagant risks, is it their right to receive continuous and costly care?

Because people who opt in would have to pay a set premium to get the insurance.

Correct, but if the plan were to cover all sorts of varying health risk exposures, then the premium would not be able to cover the aggregated expected loss of the risk pool. This is how insurance operates. As I said before, because this law of insurance would not hold in a public option, the option would not operate as an insurance company. Therefore, the option would have to derive money from an alternate source in addition to premiums, ie. taxing those who do not opt-in.

It is very possible. This is why I promote them going about it a different way other then making more adjustments to private healthcare itself. Making a public option sets a standard for them to try and reach, trying to manipulate private insurance directly can yield questionable results, and pin accountability for the failures of a private sector buisness on the government.

Government should support change, not enforce it on a private company.

I don't understand how a public option would be "going about it a different way" than medicare or medicaid, but I will concede this point, as I don't think it is especially pertinent.

I'll be perfectly honest with you, I don't understand this question as you have worded it. Are you asking me if private insurance companies are forced to raise their prices because there are people on medicaid and medicare?

I'm not asking you, I am telling you this is the case. Private health systems must bear the burden of sixty cents on every dollar of medicare and medicaid coverage of health consumers. Because these consumers do not pay anything into the private health system, the health system must raise the premiums on paying members to generate additional revenue. This is a fact. I have worked in a health system and know it to be true.

correction



It depends on perception. You feel like they're doing it to save the customers money, I feel like they handle it that way to turn a profit. Both things could be true for some private insurance companies. But before I give a full reply, lets go to the meat of your question:



They could do something that most private healthcare companies don't do these days.. and that's run the company with integrity, and with the health of their customers in mind. The pricing will be reasonable, but not made with profiting in mind. And when someone who is covered actually does get sick, they won't have to worry about the public option going over their health history to find an excuse to drop care.

http://www.youtube.com/watch?v=u-hUVzcOTMo

(I can't watch youtube at work, so I can't say for 100% sure if I linked the right video.)

As for the bottom line costs for the consumers, its very much possible that private insurance companies will be able to pull off comparable prices. There's even a possiility that the public option could turn out to be the expensive option (for the monthly premium anyway). But the point of the option is to not deny people based on the state of their health, and to actually take care of people when they do become sick. Which our current insurance companies do not specialize in.

As I have stated previously, risk pooling (which insurance is based upon) lowers the average premium of consumers by aggregating similar risk exposures. If insurance companies (risk pooling agents) did not lower said premiums, then no consumer would pay the premium. Rather, they would decide to not pool their risk exposure.

From your last few paragraphs, I am unclear as to how familiar you are with the concept of risk pooling and insurance? It is hard to have a proper discussion on the health insurance industry if you are no familiar with the key tenants that ground its operation.

[TheGame]

Originally Posted by Bond

Republic. That form of government in which the powers of sovereignty are vested in the people and are exercised by the people, either directly, or through representatives chosen by the people, to whome those powers are specially delegated. [NOTE: The word "people" may be either plural or singular. In a republic the group only has advisory powers; the sovereign individual is free to reject the majority group-think. USA/exception: if 100% of a jury convicts, then the individual loses sovereignty and is subject to group-think as in a democracy.]

Democracy. That form of government in which the sovereign power resides in and is exercised by the whole body of free citizens directly or indirectly through a system of representation, as distinguished from a monarchy, aristocracy, or oligarchy. [NOTE: In a pure democracy, 51% beats 49%. In other words, the minority has no rights. The minority only has those privileges granted by the dictatorship of the majority.]

Ok.

Healthcare being a right is your personal opinion, although it is currently not defined as a right by law. The question that arises form a belief that healthcare is a right is: where does that right begin and end? If someone is dying of terminal cancer is it their right to receive continuous and costly treatment to prolong their life by only a few months? If someone chooses to live an unhealthy lifestyle and take on extravagant risks, is it their right to receive continuous and costly care?

In my opinion, yes its their right.

Correct, but if the plan were to cover all sorts of varying health risk exposures, then the premium would not be able to cover the aggregated expected loss of the risk pool. This is how insurance operates. As I said before, because this law of insurance would not hold in a public option, the option would not operate as an insurance company. Therefore, the option would have to derive money from an alternate source in addition to premiums, ie. taxing those who do not opt-in.

That is purely speculation. I agree that tax dollars will be used to help create this program, and I agree that in the long run there is a possibility that it could rely on tax dollars. This is something that I've said both directly and indirectly multiple times before.

I don't understand how a public option would be "going about it a different way" than medicare or medicaid, but I will concede this point, as I don't think it is especially pertinent.

Ok.

I'm not asking you, I am telling you this is the case. Private health systems must bear the burden of sixty cents on every dollar of medicare and medicaid coverage of health consumers. Because these consumers do not pay anything into the private health system, the health system must raise the premiums on paying members to generate additional revenue. This is a fact. I have worked in a health system and know it to be true.

Ok ok, so it was rhetorical question? Understood.

As I have stated previously, risk pooling (which insurance is based upon) lowers the average premium of consumers by aggregating similar risk exposures. If insurance companies (risk pooling agents) did not lower said premiums, then no consumer would pay the premium. Rather, they would decide to not pool their risk exposure.

From your last few paragraphs, I am unclear as to how familiar you are with the concept of risk pooling and insurance? It is hard to have a proper discussion on the health insurance industry if you are no familiar with the key tenants that ground its operation.

I completly understand the concept of risk pooling and insurance. If I directly said something that conflicts with this understanding feel free to point it out directly.

[Bond]

Originally Posted by TheGame

I completly understand the concept of risk pooling and insurance. If I directly said something that conflicts with this understanding feel free to point it out directly.

Well, if you completely understand risk pooling and insurance then you are way ahead of me! I only understand the basics of how insurance companies function. They are quite complex organizations, and they fact that they are one of the most regulated industries in the world makes them even more complex to dissect and understand.

That being said, I believe the concept you are missing is that the public option would simply not be able to function as a normal insurance company. This is not speculation. It is a fact. Here is why:



Just to be clear, this is a graph I made for one of my classes last year, which demonstrates the principle of risk pooling. The specific numbers are not important for this example, but simply the principle.

As you can see, the graph converges at 500, the expected value of this risk pool. As you know, the expected value never changes, but rather the probability of that expected value, and therefore the standard deviation, does change. This graph is an example of effective risk pooling, as the expected value has a high probability, and the standard deviation is rather low (there is a low likelihood of a long tail loss).

This model only functions in this manner if those within the risk pool face similar risk exposures, which is, again, why insurance companies are so picky. If the public option will accept any type of consumer, regardless of precondition, as you say it will, then this model will cease to function properly (unless you can come up with a new way to pool risk).

Therefore, the standard deviation will rapidly increase, and in turn the probability of extreme outcomes will increase. With the probability of those extreme outcomes increased, the chance of the collective risk pool's premium being able to handle the group's losses is severely diminished.

With the assertion that the public option will not be able to operate as a normal insurance company, this now begs the question how will the public option be able to make up the extra capital that is required? I see two options: One. Charge an excessively high premium (higher than what one would find on the private market). Two. Force taxpayers to pay the rest through mandated taxation. Option one would not be politically popular, and would defeat the point of the so-called "public option." Option two would further tax citizens in excess of the required premium of citizens who chose to opt-in. Therefore, the program would cost much more, in the long run, than simply the premiums of those citizens who chose to opt-in.

In conclusion, as long as you are fine with taxpayers, who choose not to opt-in to the system, having to bear the brunt (or a significant portion) of this public option, then I have no further issue. But I do hope you find this to be an extremely disturbing prospect at best.