[beefield]

There is also this thing called game theory and prisoner's dilemma which pretty much guarantees that the silicon valley version is limited to "make me feel good doing my part" instead of being an actual solution to universal health care.

My initial thought was that someone had tried to reinvent insurance, but this is not even that. Just charity destined to fail being a proper solution.

[michaelmior]

Could you explain more why you think the probability of failure is so high?

[beefield]

First we have to define the problem we want to solve before we can discuss whether a potential solution to the problem is likely to succeed or not.

If our problem is "I want to feel good by helping someone to cover their health care costs", Watsi and other charity solutions obviously are viable solutions. (Note that state sponsored health care is also a good solution for this problem, with the downside that somebody else tells you how much you need to pay). So Watsi is a better solution to this problem than state sponsored health care only in the limited case where you have no interest on the outcome of the health care, but only your own feelgood and want to have precise control how much you want to spend to feel good. (If someone senses contempt here to charity givers, the sense is not unfounded)

Second potential problem we are discussing here would be "I want some more people get health care." Of course, here as well, Watsi and other charity programs obviously are a solution to the problem in question.

Third problem might be something in the lines of "I want every member of the society to have access to decent health care so that first, when I drive past hospital, I do not have to look beggars begging money to get their health problems addressed and second, when I get sick, I do not need to worry whether there was some small print in my insurance contract I did not understand"

The third problem is the one where charity based solutions are doomed to failure. There is simply no scenario where I am motivated to pay. One scenario is where there are enough people to pay to solve this without me, so so I can save my money to more important things and enjoy health care benefits. Other scenario is that there are not enough people to pay the beggars out of the street, and my money is not going to change that, so again, I am better spending my money somewhere else. Only path out is that all of us that want to solve the problem and get benefit from the problem [1] solving somehow coerce each other to pay for the solution. I.e. state sponsored health care. Or individual mandate & community rating & subsidies (obamacare).

[1] Note here that everyone gets benefit so everyone must be coerced. If you let people out who claim they enjoy looking beggars, the system collapses again, because obviously I say that I enjoy immensely looking beggars and actually you should pay me if you deprive my enjoyment of looking beggars if you otherwise get the system working without my money. And the ones who actually do enjoy looking beggars, let's just say I am a bad person and more than happy coercing them paying real money to get rid of beggars.

[michaelmior]

You seem to be implying that people are only motivated to help because they don't want the guilt of seeing people in need. While this may be true for some, it's awfully pessimistic.

[beefield]

I did also imply that people are willing to help because they want to feel themselves good about helping.

Yes, I am a cynical bastard. But I think i is safer to design important institutions in society assuming bad about people instead of assuming good about them.

[michaelmior]

While I don't share your cynicism (acknowledging that naivete can be an equal or greater problem) I think it's true that ideally we should design systems that don't rely on altruistic behaviour.