[Holybeds]

Where I live you know the cost before you go to the doctor since you will only pay a symbolic sum of 30 USD even if the visit ends up with something like a life long cancer treatment. If you need medicine you will pay at most 120 USD per year regardless of the costs.

The idea that your access to healthcare should be linked to your own or your parents financial is crazy.

[miketery]

I agree in principal to an extent - however economics need to be tied to the end product somewhat. Otherwise many people would opt for $100k healthcare cost (at the expense of the public) to extend their life for a few more months, this is not reasonable. Resources are finite - therefore we need appropriate allocation.

In the end I agree that a basic safety net is necessary and serves a greater good - providing things like normal checkups, preventative services, and acute trauma care is reasonable. However $200k for a second heart surgery for someone who hasn't taken heed of earlier exercise or diet advice by a practitioner should not be supported.

[jlebar]

Serious question: Do you live a perfect life? Do you exercise daily? Do you never eat processed meat (linked to cancer)? Do you never drink soda (linked to metabolic syndrome)? Do you not smoke? Do you not drink any alcohol (linked to cancer)? Do you live close to your work so as to minimize the time spent in a car (car accidents are a major cause of preventable death)? Are you not overweight, even a little? And so on.

Do you think that someone who follows all but one of those rules still deserves healthcare? All but two? What's the moral difference between someone who smokes and someone who hasn't taken heed of diet/exercise advice after getting heart surgery? Where do you draw the line?

It's easy to say, "I don't want to pay for the healthcare of some hypothetical 'slob'". But make it real, consider what this actually means, and I think it's not something most of us want.

None of us is perfect. I'm sure that even olympic athletes occasionally eat bacon. Let he who is without sin cast the first stone, right?

[antisthenes]

> Do you think that someone who follows all but one of those rules still deserves healthcare? All but two? What's the moral difference between someone who smokes and someone who hasn't taken heed of diet/exercise advice after getting heart surgery?

Yes. Yes.

Moral difference no idea, but neither one should expect to have society foot the entire bill for their bad habits.

> Where do you draw the line?

Probably around morbid obesity that's unrelated to genetic/chronic issues.

> Let he who is without sin cast the first stone, right?

By setting an unreasonable standard and saying no one under it has the ability to cast judgment is extremely anti-intellectual. If 2 people were telling you about health habits and one of them was an olympic athlete (who occasionally ate bacon), and the other was a random overweight person from the street, whose advice would you give more weight to?

[jlebar]

> Probably around morbid obesity that's unrelated to genetic/chronic issues.

The jury is still very much out on how common this is, isn't it? Who is going to make the decision of whether I am "at fault" for my obesity?

Also how many people actually choose to be morbidly obese? Like, suppose I am genetically predisposed to like "unhealthy foods" (scare quotes because we don't really know what that means). Does that excuse my obesity as genetically caused? How are you going to tell the difference between someone who "selfishly likes" unhealthy foods and someone who can't help themselves? More to the point, is there a difference?

> By setting an unreasonable standard and saying no one under it has the ability to cast judgment is extremely anti-intellectual. If 2 people were telling you about health habits and one of them was an olympic athlete (who occasionally ate bacon), and the other was a random overweight person from the street, whose advice would you give more weight to?

In the face of this claim that my argument is anti-intellectual, I think I get to be pedantic and say that this counter-argument is a straw-person and equivocates.

I am saying that I don't think an Olympic athelete should pass moral judgement on other people. But of course an expert can pass intellectual judgment on ideas (e.g. "candy is healthy").

I can't believe I'm here as an athiest defending Jesus, but there you go. :)

[antisthenes]

> Also how many people actually choose to be morbidly obese? Like, suppose I am genetically predisposed to like "unhealthy foods" (scare quotes because we don't really know what that means). Does that excuse my obesity as genetically caused? How are you going to tell the difference between someone who "selfishly likes" unhealthy foods and someone who can't help themselves? More to the point, is there a difference?

I'm sorry but this is insane. Are we just abolishing any notion of personal responsibility whatsoever? I can't and won't argue from that first principle so we're going to have to disagree here fundamentally.

What if I can't help myself but grope women? What if I'm genetically predisposed to violence? Or kleptomania? Those things also impose a heavy cost on society, but if I just can't help myself, am I really at fault?

> How are you going to tell the difference between someone who "selfishly likes" unhealthy foods and someone who can't help themselves? More to the point, is there a difference?

Of course there's a difference. If your willpower is not sufficient to correct your obesity, then you should take other, more radical steps that do. And if you don't, then you're just selfishly externalizing your problems to society.

> But of course an expert can pass intellectual judgment on ideas (e.g. "candy is healthy")

Good, at least we can agree on something. So to answer the first part of your post, you should ask an expert on obesity. I'm not one, so if their judgment differs from mine, I'll stand corrected. But until then, I'll be of the opinion that most obesity cases are not genetic.

[jlebar]

> you should ask an expert on obesity. I'm not one, so if their judgment differs from mine, I'll stand corrected. But until then, I'll be of the opinion that most obesity cases are not genetic.

You're saying you have no expertise in this, haven't spent any time reading the literature or consulting with experts, but you nonetheless are going to continue having a strong opinion on this question? What is the basis for this opinion on a question of fact? Hopefully it's not than the fact that fat people are icky and so must be morally at fault for their failings?

[jlebar]

From one of the world's foremost experts on the brain: https://www.wnycstudios.org/story/revising-fault-line

[Nasrudith]

The whole point against it is that there are precedents being set regardless of what you think is 'right' it will start to apply to other things in the model that you agree with far less - especially when they go off of assumptions that turn out to be objectively wrong.

It is essentially a bill of rights thing - either you support universal rights for everyone or you support them being taken away whenever convenient a.k.a. no rights at all for anyone.

Just go back as shallowly historically speaking as AIDS in the 80s. "Only gays and drug users get AIDS so why should we pay to help those degenerates?" sounds downright satirically stupid but that was essentially a real viewpoint and sadly still is really. Judging the 'guilt' of patients is a very dangerous thing for a society to do and doesn't help the underlying health problem at all.

[philwelch]

If you ask the public to subsidize your personal expenses, the public inherently has the right to set reasonable limits on that subsidy. If you want to be free from those limits, it's your responsibility to pay your own way.

[miketery]

No I don't live a perfect life, I try to do better when afforded the opportunity - but that's besides the point. You're right - I over extended the scope with my initial statement. An in no way do I think the individual without sin is the one who should be making the call either.

However, I think if we gather a pool of public funds there needs to be a priority system or some feedback loop or liability included (back to finite resources being at stake).

Those things like sugar may come with a tax so that respective procedures are funded by it. Likewise for driving, insurance is required. For diet and exercise, maybe you can get an income tax credit for following certain things.

Not perfect, but I think we can get better then a simple pool that's support for everything and anything.

[Holybeds]

> However $200k for a second heart surgery for someone who hasn't taken heed of earlier exercise or diet advice by a practitioner should not be supported.

I disagree that failing to adhere to a certain diet should be punishable by death.

[AnthonyMouse]

> Where I live you know the cost before you go to the doctor since you will only pay a symbolic sum of 30 USD even if the visit ends up with something like a life long cancer treatment. If you need medicine you will pay at most 120 USD per year regardless of the costs.

Then the problem is you have no pricing mechanism for determining how much the provider should actually be paid. If you offer less than what people value the service at, you'll get shortages (or, in this context, waiting lists and less life-saving medical R&D). If you offer too much, you're overpaying (see also US government contractors).

Governments in Europe apparently solve the "paying too much" problem by systematically underpaying, but that doesn't work if everybody does it. The US can't subsidize your medical R&D if they're doing the same thing.

> The idea that your access to healthcare should be linked to your own or your parents financial is crazy.

I've never understood why people have this idea about healthcare but not even more immediate necessities like food and housing. It's not as if the solution you're proposing is even analogous to the solutions we use for the poor there (i.e. free clinics akin to homeless shelters and soup kitchens). If the problem is that free clinics are poorly funded, why isn't the solution to fund them better rather than nationalizing the entire healthcare system?

[Holybeds]

> I've never understood why people have this idea about healthcare but not even more immediate necessities like food and housing.

Hmm but I have the same view for food and housing. Where I live if your mother doesn't have allow money to buy proper food the government will contribute (both for food and housing).

[AnthonyMouse]

The difference is that the government doesn't take over all farms, restaurants and grocery stores and require you to get your food from them even for everyone who can afford it themselves.

[Holybeds]

Hmm but the government also doesn't take over the medical facilities where I live? Most medical facilities here are normal private companies (some privately owned, some publicly listed etc).

So what do you mean?

[conanbatt]

With the difference that a long-cancer treatment might cost hundreds of thousands of dollars in the US and simply bankrupt the hospital.

Its easier to eat up cost if its a lot lower and has caps. The US has no apetite for those level of restrictions.

[Holybeds]

Not sure if you are joking but the hospitals are paid by the government for the provided services (via tax money). Obviously a life long cancer treatment will cost much more than 30 USD.

[conanbatt]

If the government has a final say, then it has to restrict supply to keep costs down. It cant say yes to everything.

[Holybeds]

Doctors are expected to give the proper amount of care so they do that. Doctors doesn't care about what this will eventually cost for the government. The doctors work for private companies so the have no incentive to limit the care. They also have no big incentive to provide more care than needed.

Anyone can go to a doctor to get an appropriate level of treatment. If you want more than that, to the degree that you want to waste your own money, then of course you can do that by paying for it out of your own pocket.

It's funny that we are having this discussion. This is a solved problem in large parts or the world and the only reason it's an issue in the US is due to people being crazy.

[conanbatt]

I don't think its a solved problem at all. Healthcare costs are an issue in terms of spending per capita in the whole world. And the "whole world" depends in great amounts on the pharma and medical research that is developed in the U.S., and exported for very little in return. Furthermore, countries have varying levels of care based on the countries budget.

When the rich people in europe get sick, they go to the U.S..