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Yes, it’s true...
Posted by: Bryan Pick on Wednesday, July 18, 2007

...Some people choose to go without health insurance. One of our commenters, FA, recently said,
The actual number of uninsured is far lower than universal health care supporters would have everyone think (about 20% of the population, IIRC). Of this number, this vast majority choose not to elect insurance coverage.

Why? They don’t get sick very often! Isn’t this a choice healthy people should be able to make, and doesn’t it encourage better behavior?
Regarding FA's first point, yes, the figures bandied about by Democrats about how many people "lack coverage" are often snapshots of how many people are going without insurance for an arbitrary period of time. Some people go without insurance for short periods, but are counted in statistics as if they're part of a permanent uncovered underclass. And what Democrats don't often mention is how many people go without coverage because the company they worked for was providing their insurance—another reason to go with the portability recommendation Dale made in his recent post and in the July 2005 issue of The New Libertarian (PDF, 1.1 MB), which has a few detailed essays about health care.

But on to FA's main point. When, in "progressive" company, I make the claim that some people choose to go without health insurance, and it's not a matter of "lacking access," they often return a skeptical glance. So then I say, "For example... me."

I'm healthy; I eat well, I exercise regularly, I'm fit enough to run several miles whenever the urge strikes me. I don't take many of the health risks others do. Over the last two years, my health worries have amounted to three headaches and a flu that my immune system broke in about 24 hours. So I'm not interested in buying health insurance. I have a pretty good idea of what it would cost, and I can imagine many (unlikely) scenarios in which insurance might come in handy. I understand the concept of managing "risk of ruin." Just so nobody's confused: this is called managing my own risk. Oddly, this doesn't stop other people from using me as a statistic to advocate saving me from my own choices.

And I find it ironic that the same "progressive" crowd that's trying to force me to buy health insurance—or force others to buy something for me that I don't want—also chants, "My body, my choice" when it's convenient to their orthodoxy. For that matter, many of them would also prevent me from purchasing organs to save my life.

I choose to manage my health more directly. I choose to spend my money on other things, things I expect to benefit me more than insurance coverage that is very likely a losing bet. So, to all the people who want to use me as a statistic to force people to buy things for me that I don't want: kindly mind your own business, and I'll mind my own, as I have so far done to my satisfaction.
 
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Comments
Fine with me, but please don’t come asking for money if you hit the cancer lottery or have a major car accident. You might want to consider a high deductable plan unless you’ve got a couple million in the bank to spare.

By the way, this is one of my favorite blogs. You all do a great job promoting less government interference with interesting and well thought out posts.
 
Written By: Craig
URL: http://
Fine with me, but please don’t come asking for money if you hit the cancer lottery or have a major car accident.
Deal.
 
Written By: Bryan Pick
URL: http://www.qando.net
What you have is implicit high-deductible insurance, because if, as Craig notes, you happen to slide off the road one day, somebody is going to pay for your trauma surgery, and it won’t be you.

 
Written By: Mithras
URL: http://harnly.net
Bryan said,
I’m healthy; I eat well, I exercise regularly, I’m fit enough to run several miles whenever the urge strikes me. I don’t take many of the health risks others do. Over the last two years, my health worries have amounted to three headaches and a flu that my immune system broke in about 24 hours. So I’m not interested in buying health insurance
When you strip away the bravado Bryan is a welfare cheating bum.

If he gets hurt in an accident he will be transported to the hospital and treated in a very expensive trauma unit. If he survives surgery he will spend some very expensive time in the SICU.

None of the physicians who save his life will get paid for the time effort and risk they put into saving his life. The hospital will not get a penny for the work it does to save his life.

Who gets to pay for Bryan’s care? Why the taxpayer does (that explains the welfare cheating bum part). The responsible patients who carry insurance also get to pay for Bryan’s care because via cost shifting.

Bryan also says
kindly mind your own business, and I’ll mind my own, as I have so far done to my satisfaction.
Which is a neatly illustrates his arrogance and ignorance.

He is happy to be irresponsible and spend money on things he likes while forcing the rest of us to pay for his care if he gets injured. That is some stack of arrogance.

He is ignorant of the costs of trauma care and happy to roll the dice because at some level he understands the rest of us will pay for his irresponsibility.

Pretty scummy behavior.
 
Written By: TJIT
URL: http://
Bryan,

Here is a friendly suggestion. Put on your pants, show a little responsibility, and buy health insurance for yourself.

A high deductible, catastrophic care policy should not be that expensive. Those policies also qualify as health savings accounts. These accounts provide you the ability to put pre tax money in account to be used for medical expenses or retirement.

You won’t have to worry about going personally bankrupt or bankrupting your family members if you get sick or injured. Furthermore you won’t be sponging off the taxpayers if you get sick or injured.

One other point.

Hospitals are filled with people who were perfectly healthy until the bus hit them. Most of the time there is no warning before people slide from being very healthy to being catastrophically sick.
 
Written By: TJIT
URL: http://
Fine with me, but please don’t come asking for money if you hit the cancer lottery or have a major car accident.
Deal.
Yeah right. That reminds me of my father twenty years ago. But now, closing in on his own mortality… not so much.
Which explains this…
I’m healthy; I eat well, I exercise regularly, I’m fit enough to run several miles whenever the urge strikes me.
Yeah, I take it with this, “I’m fit enough to run several miles whenever the urge strikes me.”, that you’re a twenty-something. Get back to me when you’re forty. Or fifty. Or sixty. When you’re medicine cabinet is as full as your beer fridge used to be.

Which would also confirm this,
He [Bryan] is happy to be irresponsible and spend money on things he likes while forcing the rest of us to pay for his care if he gets injured. That is some stack of arrogance.
Exactly.

You know Bryan, you make some good points. But ease back on the young and indestructible business.
Trust me… that feeling… will fade.

Especially if you want to try and convince the rest of America of your ideas on health care. Which I would be right to remind you…

Is not twenty-something.

Cheers.
 
Written By: PogueMahone
URL: http://
A country in which there was common agreement not to provide health care except in accordance with ability to pay would be interesting, to say the least.

Friday night in the emergency room would largely consist of stabilization only. Next morning, when people wake up you get that lovely question, how much care can you afford? Gee, you smashed up your leg pretty good when that drunk hit you — amputation and a 19th century prosthesis is going for $1,000. Reconstructive surgery and post-op care is about $10 K. Paid in advance, of course.

A liberal is a libertarian hit by an uninsured judgment-proof driver.

 
Written By: Francis
URL: http://
I hope your health continues.
 
Written By: VRB
URL: http://hathor-sekhmet.blogspot.com
Francis: Libertarian theory is compatible with forced insurance schemes in principle, at least in some circumstances - for actions that cause risk to others, like driving, especially.

For reference, Nozick covers it in "Anarchy, State, and Utopia". (p115)

(Also, in that notional world of yours, wouldn’t people buy insurance? And since hospitals wouldn’t be "giving away" expensive care and surgery to people who couldn’t pay, wouldn’t that mean that everyone else would pay less, as there’d be no subsidization of the uninsured going on?

And of course, let’s not forget that even in a "libertarian dreamworld" there’s still charity and endowments. Libertarians object only to the unwarranted extension of state power, not to people voluntarily doing good.)

Pogue: So? He didn’t say he wouldn’t buy insurance when he got older and less healthy (ie, when it would be a good investment).

Or that anyone in that situation shouldn’t buy insurance.

All Bryan said is that he, like many other young, healthy people who don’t need much if any health insurance choose not to buy it; explaining why people quite rationally go without health insurance.

(I’ll let TJIT’s assertions that Bryan would default rather than pay his debts go, as it’s simply unsubstantiated.)
 
Written By: Sigivald
URL: http://
Bryan you are the anti-me. NZ has nationalised healthcare and yet I choose to buy private health insurance.
 
Written By: unaha-closp
URL: http://warisforwinning.blogspot.com/
What some of you are bringing up with respect to Bryan’s personal example—that you will have to pay for him yourself—is only because liberal government policies would so mandate. If Bryan knew for certain that he could not borrow his way out of a catastrophic injury, raise money on the Internet or whatever, then he would be a fool not to buy high-deductible cat coverage—as would anyone else.

But this whole notion that we his fellow citizens must pay for him is merely a function of the Stafford Act and various state laws that mandate or coerce hospitals to provide charity care. It doesn’t have to be so, any more than flood aid is given to farmers in Louisiana or drought aid to ranchers in Nebraska. But leave that aside for a moment.

What Francis is arguing for, it seems to me, is a perverse case of moral hazard that presupposes Bryan will be more reckless with his health since he’s uninsured. The reality is, I think, that Bryan’s lack of insurance would have the opposite effect, knowing that he doesn’t have a "callable" safety net below him. In fact, moral hazard theory says that you holier-than-thou insureds complaining about the prospect of picking up the tab for Bryan are actually more likely to be reckless with your own health—meaning your insurance company, its reinsurers and the whole pool of insureds across the country are more likely to pay for your poor health decisions.

Ironic, eh?
 
Written By: FA
URL: http://
Sigvald said
(I’ll let TJIT’s assertions that Bryan would default rather than pay his debts go, as it’s simply unsubstantiated.)
I should have stipulated that my comment assumes Bryan had not set aside enough money to pay for the necessary care.

However, given that trauma care is expensive and could wrap up six figures worth of expenses very quickly it would be a better return on investment to buy insurance instead of putting six figures worth of cash reserves into a contingency fund.
 
Written By: TJIT
URL: http://
I typed out a lengthy reply and hit "Preview" only to find that Sigivald and FA had pretty much covered everything I wanted to say.

One last thing, TJIT:
I should have stipulated that my comment assumes Bryan had not set aside enough money to pay for the necessary care.

However, given that trauma care is expensive and could wrap up six figures worth of expenses very quickly it would be a better return on investment to buy insurance instead of putting six figures worth of cash reserves into a contingency fund.
Three things:

1.) It’s a very remote risk of six figures of payments. You buy earthquake insurance if you live in Tokyo, not the Sahara Desert.
2.) I went to the most expensive university in the country. A six-figure bill is just another painful monthly payment, but I’m good for it.
3.) If I really can’t afford it, I want you to know, sincerely: I won’t coerce anyone else to make up the difference. I wouldn’t rob someone, and I won’t have someone else do it for me, not if I can help it. Not even if it means serious harm to me. Is that understood?
 
Written By: Bryan Pick
URL: http://
Bryan,
Health care is not about you. It is about everyone else.

I don’t consider the health problems I have, to be catastrophic and I can’t see the systems cost coming down. It may not grow, but if I were paying out of pocket, unless there were drastic reductions in cost of insurance, services and prescriptions, those things would be prohibitive to me. The retail cost of my prescriptions are already over 25% what I earn now. What I do pay is not chump change, either? I can’t see Dale’s plan reducing the cost quickly enough, so that those who already in the system would benefit. There are some cost I don’t think any plan will affect; cost of technology, equipment and drugs. People just automatically think that technology is so special they have to pay top dollar. Pharmaceuticals don’t believe volume has an effect on price, even with generics. I’m looking for a plan that works, not some plan that is supported by some utopian ideal (either side). I wish there was some empirical data that could support some of these ideas, not if’s.
 
Written By: VRB
URL: http://hathor-sekhmet.blogspot.com
A six-figure bill is just another painful monthly payment, but I’m good for it

A six-figure bill is $100K to $999K. The number of people in the US making between $1.2 million and $12 million annually is microscopic. Bryan Pick may be in a position to self-insure, but most Americans cannot.

Skimming around the internet for a while shows that a trip to the emergency room, to get some tests and some first aid, can run around $15,000. Any kind of surgery can easily run tabs in excess of $100,000.

Median US income is about $45,000 annually.

So one emergency room visit without insurance is 3 months of gross family income for the median American family.

As I said, Saturday morning in the ER in a country which accepts the idea that people should only get such health care as they can afford would be verrry interesting.

You, Bryan, may say now that you prefer to be discharged to die of internal bleeding rather than accept surgery you can’t afford. But your fellow citizens suspect that when the time comes your desire to live will outweigh your principles.

 
Written By: Francis
URL: http://
Is that understood?
Bryan, there are those among our commenters who are, in my opinion, not capable of understanding that attitude.

I did the same thing as you in my twenties - went for years with health insurance, knowing that there were potentially catastrophic consequences. High-deductible policies were much harder to find then (that’s what I have now). I knew I might hit the bad-luck jackpot, and go into deep debt to get past it, or indeed in extreme circumstances to look at a shorter life as a consequence of my decision. But I was prepared for that.

And it’s not just in theory. My landlord of eight years picked me as his renter because we shared a libertarian mindset. Several years before that, he was without health insurance (at an age I considered him foolish), and had to have a triple heart bypass. It took every asset he had to pay for it. But pay for it he did, and then built his business back up again and lived for fifteen more years.

There’s something in the soul of many with a liberal mindset that believes no one could really take that level of responsibility for their own actions. They really consider everyone a potential child that will cry for mommy (in the form of government or imposition on family) when the really bad stuff comes along.

That inability to see the world through the eyes of someone like us is a major reason they don’t understand many things - why the soldier does his job, why the firefighter runs into a burning building, or why an old man is silent about his cancer until he dies because he does not wish to bankrupt his family or endure their pity. Just because they would not be willing to be grown up about such things, they believe no one else could do it either.

And, I might add, I consider them a disgrace to our pioneer ancestors.
 
Written By: Billy Hollis
URL: http://
Bryan wrote:
...Some people choose to go without health insurance.

As per the Census data released last year (for 2005), there were about 46.6 million uninsured. Of these, about 17.6 million have household incomes of $50,000+ a year (another 15 million have 25,000+ a year).

http://www.census.gov/prod/2006pubs/p60-231.pdf
 
Written By: ABC
URL: http://
Bryan,

It is painfully obvious you have no appreciation for the actual risk you are taking. If you drive you are at risk of substantial trauma. This is not the same situation as taking out earthquake insurance in the Sahara.
If I really can’t afford it, I want you to know, sincerely: I won’t coerce anyone else to make up the difference. I wouldn’t rob someone, and I won’t have someone else do it for me, not if I can help it.
That is the problem chances are you won’t be able to help it.

You have zero understanding of what will happen if you end up in a trauma unit. You are liable to show up in the trauma unit unconscious and incredible amounts of money will be spent before you even wake up.

Furthermore, If your family members show up they may be asked to take financial responsibility for you treatment. If they agree to out of concern for you your irresponsibility has sandbagged them with an incredible expense and possible bankruptcy.
Not even if it means serious harm to me. Is that understood?
Easy statement to make when you are sitting in a comfortable chair at your desk.

A compound fracture and the possibility of bleeding out from abdominal trauma is highly likely to make you remember your Not even if it means serious harm to me. statement with considerable regret and embarrassment. At that point you will be kicking yourself in the butt over your incredible stupidity and bravado.

Furthermore, you statements show you have not even considered the fact that Many trauma patients end up DEAD. Last time I checked the income producing potential of a dead body is highly limited and it can’t pay off six figures worth of debt.

Additionally, you have not considered the fact that even if you survive whatever bus happens to hit you (trauma, cancer, stroke, neurological disease, etc)may make it impossible for you to earn a living even if you survive it.

Your inexperience, ignorance, and lack of exposure has you whistling past the graveyard while taking incredible financial risks.
 
Written By: TJIT
URL: http://
As per the Census data released last year (for 2005), there were about 46.6 million uninsured.
Well not exactly:
However, the Census Bureau report “Income, Poverty, and Health Insurance Coverage in the United States: 2005,” puts the initial number of uninsured people living in the country at 46.577 million.

A closer look at that report reveals the Census data include 9.487 million people who are “not a citizen.” Subtracting the 10 million non-Americans, the number of uninsured Americans falls to roughly 37 million.

[...]

But according to the same Census report, there are 8.3 million uninsured people who make between $50,000 and $74,999 per year and 8.74 million who make more than $75,000 a year. That’s roughly 17 million people who ought to be able to “afford” health insurance because they make substantially more than the median household income of $46,326.
So we may be talking 20 million at most of that group who may not be able to afford insurance, and even some of them may only be temporarily without insurance because they’re between jobs.
 
Written By: McQ
URL: http://www.qando.net/blog
Why, in this conversation, is Health Insurance synonymous with Health Care? When I get sick, I need affordable health care, NOT affordable insurance. It seems to me that doctors, medical establishments, lawyers, and insurance providers all work hand in hand to convince the consumer that having insurance is the end-game.
I suppose I’m totally naive to think there is such a thing as Affordable CARE. Is not health insurance simply a corporation willing to make a wager on your well-being?
I feel like a simpleton even asking that question, but I feel completely distrustful of the insurance industry and, truly, insurers don’t help to heal a sick person. Are there ways to bring down the cost of Health Care - regardless of the cost of Health Insurance?
Are we getting ripped off?
Silly me...Asked and answered...
 
Written By: BWIII
URL: http://
Thanks McQ, I had looked around a little to find if illegals were counted in the uninsured, but could not find anything. Your cite addresses non-citizens, however, but if they are here legally, and working towards citizenship, then I think they should be counted.
Anyways, link saved.
 
Written By: ABC
URL: http://
"A six-figure bill is just another painful monthly payment, but I’m good for it"

Not if some car accident, mugging, stroke, etc. leaves you disabled and unable to pursue your profession, or if there are ongoing medical expenses.

" Just because they would not be willing to be grown up about such things, they believe no one else could do it either."

I also believe, because experience has taught me so, that talk is cheap.
 
Written By: timactual
URL: http://
It is painfully obvious you have no appreciation for the actual risk you are taking. If you drive you are at risk of substantial trauma.
It’s also painfully obvious that you haven’t read your car insurance policy. Moreover, if the accident is the fault of another driver, guess whose insurance pays for Bryan’s bills?

Moral preening is best accompanied by a modicum of knowledge about the subject you’re addressing.
 
Written By: MichaelW
URL: http://asecondhandconjecture.com
MichaelW,
It’s also painfully obvious that you haven’t read your car insurance policy. Moreover, if the accident is the fault of another driver, guess whose insurance pays for Bryan’s bills?
I used auto accidents because that is probably the single biggest exposure to trauma people have.

If Bryan as a pedestrian gets hit by an uninsured driver (uninsured drivers are not rare) who do you think pays for his bills then?

There are numerous other ways to get badly injured and in these cases if you don’t have health insurance you and a lot of innocent bystanders are royally screwed.
 
Written By: TJIT
URL: http://
I choose to manage my health more directly. I choose to spend my money on other things, things I expect to benefit me more than insurance coverage that is very likely a losing bet. — Bryan
All the warnings and castigations in these comments notwithstanding, it is very likely a losing bet that a guy in his 20s will recoup in necessary or desired benefits what he pays in in premiums — even if he’s not taking great care of himself. Mother Nature is very fond and forgiving of people in their 20s. I just about never cracked a deductible of any of the various employer-paid policies I had in that sunny bygone age.

This is why health insurance policies range all the way down to not really all that expensive for 20-somethings. Not that I would specifically urge a young uninsured person to buy one, since that is undeniably a personal choice — the harrowing exigencies and hugely inflated costs of our government-mucked health care system notwithstanding. It shouldn’t be the way it is, and even though it is the way it is, respecting the right of people to handle their own affairs is still the thing to do.
 
Written By: Linda Morgan
URL: http://
I think if less people had insurance, health costs would come down.

Hospitals do not want to go out of business. If people can not afford their services, they can either go out of business or lower their prices. As long as there are deep pockets for some - i.e. insurance companies and government programs - there will be high prices for all.

The biggest cost of all health care these days is not the actual care. It is paying people to do the necessary paperwork required by law for insurance and government health care programs. And medical malpractice insurance against people who demand not care but perfection - surgery without scars, and babies without birth defects, as examples. Litigation against drug companies when there is no scientific agreement of causality of death of certain drug users, raises prices.

Mandating insurance for everyone will not make these problems go away.

That said, people who blow off hospital bills because no one can legally make them pay irritate the goshdarnheck out of me.
 
Written By: Adraine
URL: http://
Billy Hollis,
It is not that I can’t see your point of view, as I said to Bryan, I don’t think the health care I want is about you. I would have like to have been so fortunate to make the kind of choices you make or be as lucky as you and I don’t think I am a defective human being for not being so. I don’t wish you ill and I have had people in my family who have lived to their ninties without any severe medical problems. Just didn’t get passed down to me.

I am one of those people who make an average income, pay out the nose for health care and I don’t like someone like you assuming they know how I use health care or that I don’t want to take responsibility for it. I like living, so I do the best I can with what I have. I not saying that I have been personally attacked, but why the generalization of what you think some people will do because they do not have your set of ideals.
 
Written By: VRB
URL: http://hathor-sekhmet.blogspot.com
VRB, nothing in my comments should be construed to be critical of someone who chooses to buy insurance. I have it now, and if I had been flush in my twenties, I would have had it then. As I said, my real-life example was someone who was at an age that indicated sufficient risk that he should not have been without insurance.

So I’m not saying there’s a thing wrong with the attitude that recommends that people have health insurance.

I’m saying that, once someone else has told you that they have made their own choice, if you consider them an adult, you accept that choice and refrain from assuming they would welch on their obligations if a bad situation arose. I offered a real-life of someone who didn’t.

The attitude of "oh, you say that now, but you don’t really mean it, so I get to continue to try and boss you around so that you toe whatever line I think is appropriate" is not, in my opinion, consistent with a libertarian philosophy. Perhaps a better way of putting it is that busybodies are seldom libertarian.

I don’t know whether you personally fall into that category or not. If you don’t, then all you have to do is accept that sometimes people make different judgements than you would make, and that they are prepared to take responsiblity if those judgements are wrong. That is what freedom is all about.

 
Written By: Billy Hollis
URL: http://
Hmm. I wonder if I was this arrogant back when I was in my twenties… Probably.
If I really can’t afford it, I want you to know, sincerely: I won’t coerce anyone else to make up the difference. I wouldn’t rob someone, and I won’t have someone else do it for me, not if I can help it. Not even if it means serious harm to me. Is that understood?
Oh yeah. I understand completely.
I understand that you are twenty-something and bulletproof. I understand this well, for I used to be twenty-something and bulletproof.
Though I may be full of something, my tanks are beginning to run low on piss and wind. And so I understand quite a few more things now.

Not even if it means serious harm to me.

I’ve heard this many times.
I’ve heard this throughout my childhood. My father, a one-time staunch libertarian, always said he’d “rather be shot”. Now – with his health failing and his meager savings starting to dwindle, I haven’t heard “I’d rather be shot” in years.
I’ve heard this many times throughout my twenties. That attitude was almost communal among my contemporaries. My friend Paul; bulletproof – check, piss – check, vinegar – check, spent his last few months on this planet in a hospital bed hooked up to half a dozen machines. His desire to hold on to life was inspiring. He was 28.
Pity for Paul.
And pity for the taxpayer. For the taxpayer had to eventually pick up some of that bill, even though Paul – at one time – was “good for it”.

The point is, of course, that you may be ultra-confident now, Bryan, but when faced with certain realities, your attitude may suddenly turn. And you would be wise to consider that now.
And of course certain realities do not necessarily need to be fatal.
A six-figure bill is just another painful monthly payment, but I’m good for it.
Gods forbid, you may be struck down with a debilitating illness leaving you alive but unable to be “good for it”. Or perhaps you may go bankrupt, or any number of other possibilities that might leave you unable to be “good for it”.

I obviously don’t know you Bryan. You may actually be that one guy that gives illness or death a tidy shrug. Or you may have a prosperous family to help support in such undesirables. However, most people are not in that way.

Truth is, that we as a society do simply turn away from the sickly indigent. We do not say, “Oh well, buddy. It was all about personal choice and responsibility. Shoulda’ Coudla’ Woulda’. Sux to be you.” Though perhaps we should.

But if one wants to argue for greater personal responsibility and choice, perhaps one should tone down the “I’m young, I’m healthy, and I’m good for it.” Even though that may be true.
I’m no fan of state run health care, but a serious overhaul of the health care system in this country is widely desired. And one shouldn’t be so dismissive as to write it off to personal choice and responsibility with carefree attitude. Such bravado may cause that argument to fall on deaf ears.
That may not be the “point” of Bryan’s post, but it’s my point.


One quick side note. There are many valid arguments against having to pay for another’s health due to their own risky behavior. You know the one; paying for another’s cancer treatment although he was the one that smoked all his life, not you.
I’m pretty much in that camp. But I will say, that my paternal grandfather drank whiskey most of his life, smoked cigars and such, died on the dance floor at age 96. My maternal grandmother, on the other hand, never touched so much as a glass of wine, she was diagnosed with Alzheimer’s at age 62. (strangely enough, after she was diagnosed, she began drinking lots of wine. I guess she said “f*ck it”, or she simply forgot that she didn’t drink.)

Life isn’t fair.

Cheers.
 
Written By: PogueMahone
URL: http://
Truth is, that we as a society do simply turn away from the sickly indigent. We do not say, “Oh well, buddy. It was all about personal choice and responsibility. Shoulda’ Coudla’ Woulda’. Sux to be you.” Though perhaps we should.
Yeah... That should read,
Truth is, that we as a society do not simply turn away from the sickly indigent. We do not say, “Oh well, buddy. It was all about personal choice and responsibility. Shoulda’ Coudla’ Woulda’. Sux to be you.” Though perhaps we should.
I hate it when that happens. ;)
 
Written By: PogueMahone
URL: http://
The point is, of course, that you may be ultra-confident now, Bryan, but when faced with certain realities, your attitude may suddenly turn. And you would be wise to consider that now.

...and therefore stick it to the taxpayers. After all, Bryan, your potential turn of attitude in the future entitles you to it!

If you aren’t convinced, then that’s probably because you’re twentysomething [pats Bryan on the head] and you don’t know what’s best. Ha! Kids! I’ll supply you with anecdotes until you believe me!
 
Written By: Wulf
URL: http://www.atlasblogged.com
Wulf,
Your sarcasm is incredibly misplaced. Because that’s not what I’m saying.

In fact, I’m saying just the opposite. That people like Bryan who may be confident and cavalier with predictions on their health, never know what’s around the corner and it would be wise to purchase some insurance. Even if you are young and fit.

LEST THE TAXPAYER FOOT THE BILL.

It’s just smart business. You may not want to purchase insurance on your home because it is highly unlikely that it will burn down taking everything you have, but we do know that houses sometimes burn down.

Also, when trying to turn people away from the idea of a state run health care system, it is not wise to do so while thumping your chest. That will likely, and as we have seen here, garner an undesirable response.

Yeah,… you’re young and fit… Most of us were at one time.
Then we come to learn of certain realities.
 
Written By: PogueMahone
URL: http://
If Bryan as a pedestrian gets hit by an uninsured driver (uninsured drivers are not rare) who do you think pays for his bills then?
So, Bryan must buy insurance because someone else — who is breaking the law by not having car insurance — might injure him? How is the financial responsibility for this anyone’s but the driver’s? And if society pays for this, how is it Bryan’s fault?

What I’m gathering from those attacking Bryan on this issue is that you all feel he should be forced to carry insurance, on the chance that he might be severely injured and not be able to afford treatment. Is that a fair characterization? If not, set us all straight.

Let me ask this: should everyone be required to carry an umbrella liability policy, just in case they injure someone? These policies are pretty cheap, so it’s not as great a financial hardship as you might imagine.
 
Written By: Steverino
URL: http://steverino.journalspace.com/
Pogue -
The point is, of course, that you may be ultra-confident now, Bryan, but when faced with certain realities, your attitude may suddenly turn. And you would be wise to consider that now.
I am considering it now. I know that I may come to regret my decision. But that’s true of many precautions for remote risks to me.

I don’t consider myself bulletproof, but I am in rather good health now, and I have a good record of bouncing back from things that knock out other people my age — nothing like cancer, but you get my point. Maybe I’m lucky, maybe I’ve played my cards right, or maybe I’m just like lots of other very young people, but them’s the facts. I’m not arrogant—I know that some illnesses may hit even a person as seemingly healthy as I am, and that accidents happen. I do. One of my friends died instantly in an auto collision shortly after high school.

But the risks to me are quite low. It’s not chest-thumping to say that my good health and low risk profile makes buying health insurance a bad bet, and that’s my rationale for not buying it. People can decide not to buy health insurance for plenty of reasons, but when people act skeptical when I say it’s sometimes a matter of choice, that’s the reason I give them for my personal decision: I consider it a very likely losing bet. All the anecdotes in the world don’t change the reality Linda Morgan discussed: it’s very unlikely that an early twenty-something is going to recup’ his premiums. Even the risk of ruin is very low. As I age, when I decide that it’s become a good bet, I may join the ranks of those with coverage.

And many people who are young, healthy, financially secure or some combination of those may be perfectly rational in recognizing that buying insurance isn’t a good bet. I respect others’ freedom to come to that decision themselves.

But if and when something terrible happens and I regret my decision, I won’t coerce others (or let anyone else do it for me, if I can help it). Yeah, talk is cheap—as you, timactual, and Francis have pointed out—but I’m not exactly in a rush to prove my point. So how am I supposed to respond? How do I communicate to you my sincerity to not change my mind about coercing people just because I regret my personal decisions?

A six-figure bill is just another painful monthly payment, but I’m good for it.
Gods forbid, you may be struck down with a debilitating illness leaving you alive but unable to be “good for it”. Or perhaps you may go bankrupt, or any number of other possibilities that might leave you unable to be “good for it”.
... which is why I followed up by saying what I’d do if I really can’t afford it. So I could have clarified things by saying, "If I get back on my feet, I’m good for it." Given.

See, if someone saves my life now, I have plenty of time to pay them back. Billy Hollis gave us the example of his landlord, who was much older than I am now, making good on a triple bypass.

There are some events that might obliterate everyone’s ability/willingness to take care of me, so that nobody’s good for it, but they’re remote enough that I can accept the possibility of having to let go at that point. That’s life; that’s risk. I don’t laugh in the face of those possibilities, mind you. I don’t know why anyone would get that impression from what I’ve written so far. As far as I’m concerned, it’s cold calculation.
Truth is, that we as a society do simply turn away from the sickly indigent. We do not say, “Oh well, buddy. It was all about personal choice and responsibility. Shoulda’ Coudla’ Woulda’. Sux to be you.” Though perhaps we should.
You don’t have to turn away from the sickly. Family, friends, church, charity, social clubs, and creditors betting on your good health: society isn’t heartless or cruel simply because folk respect a person’s freedom to make his own choices.

"We as a society" ? our government. And perhaps the government should turn away, so that it doesn’t rob someone out of the goodness of its heart.
But if one wants to argue for greater personal responsibility and choice, perhaps one should tone down the “I’m young, I’m healthy, and I’m good for it.” Even though that may be true.
I’m no fan of state run health care, but a serious overhaul of the health care system in this country is widely desired. And one shouldn’t be so dismissive as to write it off to personal choice and responsibility with carefree attitude. Such bravado may cause that argument to fall on deaf ears.
That may not be the “point” of Bryan’s post, but it’s my point.
[...]
Also, when trying to turn people away from the idea of a state run health care system, it is not wise to do so while thumping your chest. That will likely, and as we have seen here, garner an undesirable response.
I’ll keep that in mind, but I only wanted to explain my own reason for not buying insurance, to show that it can be a rational choice in addition to being a free choice that people ought to respect anyway.
One quick side note. There are many valid arguments against having to pay for another’s health due to their own risky behavior. You know the one; paying for another’s cancer treatment although he was the one that smoked all his life, not you.
Or a million other risks, some obvious and some not. So, how do you believe we should respond to these many valid arguments?
-=-=-=-=-=-=-=-
Francis -
A six-figure bill is just another painful monthly payment, but I’m good for it
A six-figure bill is $100K to $999K. The number of people in the US making between $1.2 million and $12 million annually is microscopic. Bryan Pick may be in a position to self-insure, but most Americans cannot.

Skimming around the internet for a while shows that a trip to the emergency room, to get some tests and some first aid, can run around $15,000. Any kind of surgery can easily run tabs in excess of $100,000.
I wasn’t saying that I’d pay off a six-figure bill in one month. A monthly payment, like that for loans, credit debt, or a mortgage. At my age, if I can be nursed back to functioning, I have lots of time to repay anyone who bets on my life.
 
Written By: Bryan Pick
URL: http://www.qando.net
" How is the financial responsibility for this anyone’s but the driver’s? And if society pays for this, how is it Bryan’s fault"

Noone is saying the responsibility is not the driver’s. The point is that although it is the driver’s responsibility, he/she may be unable for one reason or another to fulfill that responsibility. Noone is saying anything about fault.

"How do I communicate to you my sincerity to not change my mind about coercing people just because I regret my personal decisions?"

You already have. It is not that I disbelieve your sincerity at this point in time. It is, rather, that people do tend to change their minds when they see the grim reaper looking at them with a grin on its face.

"Billy Hollis gave us the example of his landlord, who was much older than I am now, making good on a triple bypass."

And I am sure there is plenty of anecdotal evidence to the contrary, also.
 
Written By: timactual
URL: http://
Noone is saying the responsibility is not the driver’s. The point is that although it is the driver’s responsibility, he/she may be unable for one reason or another to fulfill that responsibility. Noone is saying anything about fault.
You missed the point there, tim. Bryan was berated because he wasn’t insured, and if something happened to him, his medical care would be a burden on society. The implication was that in this scenario, Bryan was somehow wrong for not carrying insurance.

If an uninsured driver causes damage that he can’t pay for, why is it Bryan’s responsibility to insure himself? Why is Bryan looked down upon for not having insurance in this instance?



By the way, whoever said a trip to the ER can run $15,000 is a bit off. A year ago, I went — uninsured — to the ER. (It was early on a Sunday morning, neither my doctor nor any of the urgent care clinics were open.) Turns out, I had bursitis. The visit, including the knee brace, cost about $700. Since I was paying cash, the hospital waived about $300 in charges.

This past January, I was in the ER again, this time with insurance. The doc thought I might have had a TIA, and ordered the following tests (over and above blood work):

CT scan
Chest X-ray
Ultrasound imaging of the heart
Ultrasound imaging of the carotid artery
MRI
MRIA

All this and an overnight stay in a hospital room came to less than $13,000, including all the doctors’ bills. My point is that unless you’re getting a battery of tests, an ER visit isn’t quite the nightmare that’s being painted. Now, something requiring surgery would be more.


I’m going to ask my question again: should everyone be required to carry umbrella liability policies? Most drivers only insure to the legal minimum, which isn’t going to cover a severe injury. If people who refuse to carry medical insurance are doing a bad thing because they might become burdens to society, then are underinsured drivers also doing a bad thing, because they might cause more damage than they can pay for?
 
Written By: steverino
URL: http://steverino.journalspace.com/
I feel sort of dumb here, Steve, for not being sure whether you’re in earnest about the question you’re asking. But here’s the obvious answer: No, no one should be required — at least not by government — to buy an umbrella liability policy, just as no one should be required by government to buy health insurance.
 
Written By: Linda Morgan
URL: http://
steverino,

For libertarian philosophy to work libertarians must put on some pants and take responsibility for themselves.

At the end of the day a person should be responsible for their expenses. Absent insurance covering major medical disasters an individual has little chance of paying their bills if they have a medical incident.

I’m not advocating mandatory insurance. I am advocating that people consider the risks to themselves and others when they don’t carry insurance.

If you don’t have insurance and end up in an ER you are taking money from the those who provide your care. It is no different then nationalized healthcare requirement that health care providers work under government terms not their own.

There are policy solutions that can help this situation without requiring massive government intervention. One of them is discussed here

Death, Taxes, & EMTALA
Uninsured patients. Uncompensated care. Uncompensated emergency care. These are potent buzzwords sure to get the attention of physicians, hospital administrators, and anyone who keeps an eye on the hurricane force winds surrounding medical care. I don’t pretend to have any firm solutions to these problems, but certainly have a few ideas that might get us started down the right path to fixing them.
The best way to prevent more government intervention in the healthcare system is for more people to show responsibility for themselves.
 
Written By: TJIT
URL: http://
Attitudes towards health insurance are a mess and it causes a lot of problem.

Insurance was designed to cover major events that an individual could not pay for without insurance. If everyone carried a major medical policy with a big deductible the medical system as a whole would be more solvent and healthy.

Furthermore, insurance is a game of odds. For it to function you need a lot of people who are not likely to need the insurance enrolled. This keeps the rates affordable for them, covers them in case of a medical catastrophe, and provides an adequate pool of money to cover the medical expenses of those who need to use the insurance.

Actuarially insurance can’t work if healthy 20 and 30 year olds don’t buy insurance but the 40 year old + folks who are more likely to use insurance do.

I think the technical term is a moral hazard.
 
Written By: TJIT
URL: http://
I feel sort of dumb here, Steve, for not being sure whether you’re in earnest about the question you’re asking. But here’s the obvious answer: No, no one should be required — at least not by government — to buy an umbrella liability policy, just as no one should be required by government to buy health insurance.
For libertarian philosophy to work libertarians must put on some pants and take responsibility for themselves.

At the end of the day a person should be responsible for their expenses. Absent insurance covering major medical disasters an individual has little chance of paying their bills if they have a medical incident.

I’m not advocating mandatory insurance. I am advocating that people consider the risks to themselves and others when they don’t carry insurance.
My question was quite sincere, and my point is as follows:

1. Folks here are lecturing Bryan because he doesn’t have insurance, and he may not be aware of the risks he’s taking. Fair enough.

2. One of the arguments made here is that Bryan might have a catastrophe befall him, and even if that catastrophe is the fault of someone else, Bryan must take financial responsibility. I’m less inclined to accept that argument.

3. Any of those lecturing Bryan for not covering his risk is about as likely to cause injury to another person, and that injury might extend beyond his ability to pay for the damages he causes.

4. If you injure somene beyond your ability to pay for the damages, then you are in effect hurting society in the very same way that Bryan is by not buying health insurance.

TJIT, if you believe that all libertarians must "put on some pants and take responsibility for themselves", don’t you think that part of that entails making sure you can pay for damages you cause to someone else? Or do you think that everything should be "no fault": I cover myself, no matter who really caused the damage?

If you are all going to lecture Bryan for not insuring his health properly, then you all should be lectured for not carrying enough liability insurance to protect those whom you might injure. Sauce for the goose, and all.

My own view is that no one should be forced to purchase health insurance, nor should anyone be forced to purchase general liability insurance. But you can’t argue that refusing medical insurance poses a risk to others without acknowledging that refusing general liability (and/or taking very low liability on your car insurance) poses the same risk to others.

 
Written By: Steverino
URL: http://steverino.journalspace.com/
". One of the arguments made here is that Bryan might have a catastrophe befall him, and even if that catastrophe is the fault of someone else, Bryan must take financial responsibility. I’m less inclined to accept that argument."

So who do you think is going to pay?


" don’t you think that part of that entails making sure you can pay for damages you cause to someone else?"

You are aware, I hope, that auto insurance and homeowners insurance does just that?
 
Written By: timactual
URL: http://
Steverino said
TJIT, if you believe that all libertarians must "put on some pants and take responsibility for themselves", don’t you think that part of that entails making sure you can pay for damages you cause to someone else? Or do you think that everything should be "no fault": I cover myself, no matter who really caused the damage?
Life is hard, and unfortunately there are lots of people that don’t carry insurance to pay for the damage they do to others. The options are

1. Take responsibility for you and your families well being and have financial mechanisms (insurance or something else) in place to deal with the financial damage you might suffer.

2. Trust that everyone else is going to have financial mechanisms in place to deal with the damage they might cause you. The downside to this option is that the wellbeing of you and your family is left in the hands of complete strangers.

Option one is the one I try to follow. Your welcome to try option two if you want.
If you are all going to lecture Bryan for not insuring his health properly, then you all should be lectured for not carrying enough liability insurance to protect those whom you might injure. Sauce for the goose, and all.
The discussion involved health insurance not other types of insurance. Since you brought up other types of insurance I will address it.

Right, wrong or indifferent this is the situation.

If you have assets and no insurance the attorneys for the people you damage will take your assets to pay for the damage you did to someone else. This is an effective way of erasing years of your personal hard work. So those that have accumulated assets have a need for insurance to protect their assets.

If you have no assets that can be taken a sense of responsibility is the only reason to carry those types of insurance. Many people carry insurance in this situation out of respect for their fellow citizens and a desire to be responsible for their actions even though it provides no real benefit to themselves. On the other hand many don’t.

Again, sorry, it is not fair, but the moral hazard of the situation is tilted against those who take personal responsibility for their financial well being.

I have pointed out that the only person who has a vested interest in seeing that an individuals financial house is in order and able to survive medical / property / or automobile accidents is that individual. For some reason this appears to have caused you a great deal of heartburn.
 
Written By: TJIT
URL: http://

 
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