Tuesday, June 04, 2013

Probability and morality in healthcare reform

This morning Democracy in America has a great post on Obamacare, highlighting the folly (in European eyes) of approaching healthcare as an insurance problem.

An insurance premium is basically calculated by multiplying the payout in case an event takes place by the probability that the event takes place. Crucially, and obviously, the payout is conditional on having purchased  protection. If a flood takes away my house I will be reimbursed only if I have purchased flood insurance, otherwise I will sleep outdoor. If I damage my car I will be paid to repair it only if I have insurance, otherwise I'll walk.

Healthcare (in America, where it is treated insurance-like) is different: emergency care is not withheld subject of having insurance. Despite Europeans believing that uninsured Americans are left dying in the streets, emergency care has to be administered, everything on top is not, but the basics are offered. Afterwards a patient is billed and if uninsured he/she will pay the potentially large sum up to his/her abilities which could include personal bankruptcy. Awful but better than death.

This is the fundamental difference, I am saved even if I have not paid. In finance the difference between buying an option or the underlying is that in the first case the capital is protected, hence the upfront premium. This applies also to standard insurance as well (where instead of capital we have the thing we want to protect, i.e. a car, a house, etc.) but not to health insurance. When it comes to health in America, the capital (our life) is protected anyway irrespective of our having health insurance.

The article points out that as Obamacare stands, the incentive/penalty for young, healthy people is not enough to push them towards buying insurance (and thus contributing to the overall expense) and a bigger carrot/stick is needed. Of course the ultimate stick would be saying, if you do not have health insurance you will not be treated at all, you will be left dying. Morally impossible one has to admit.

Monday, April 22, 2013

Ah, the irony ...

The same people who were up in arms against the government trampling individual freedoms when it came to gun control, do not seem to mind in the case of the trial of the Boston bomber. 

Tuesday, January 29, 2013

It won't add anything ....

... to the unsolvable debate. But this is one of the most interesting and well put things I have read on the subject of gun control. An interesting excerpt:

Mr Garrison and his ilk among CSOPA seem gripped by two common fallacies. The first is the belief that county sheriffs can violate federal laws that they happen to disagree with, and can deny federal officers the right to enforce federal law in their counties. This is simply hogwash. It is true that as a local law officer Mr Garrison will not be required to enforce federal laws, but neither can he violate them just because he happens to believe they are unconstitutional. As for keeping federal officers out, well, the South has tried that a couple of times before. It did not end well.
The second is a misguided notion that the second amendment is the best and surest constitutional protection against tyranny. As Conor Friedersdorf sagely noted, the Bill of Rights offers much more effective and less costly checks on government power. There is the fourth amendment, which protects against unreasonable search and seizure; the fifth amendment, which guarantees due process; the sixth amendment, which establishes fair trials; and so on. When these rights were hollowed out during the war on terror—by acts of Congress, the courts and even through executive orders—where was the outrage from those who see tyranny in every gun law?
The second amendment has a lizard-brain appeal: it is sexier to imagine yourself a lone soldier for justice defending your loved ones against an oppressive, tyrannical government than it is to imagine yourself protesting warrantless wiretapping. Mr Garrison approvingly cites a letter written by another sheriff, which states: "We must not allow, nor shall we tolerate, the actions of criminals, no matter how heinous the crimes, to prompt politicians to enact laws that will infringe upon the liberties of responsible citizens who have broken no laws." Stirring words, and entirely unobjectionable. I wonder if he had the same response to the Patriot Act.

The only thing one can add are the immortal words of the Onion.