[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?

[antisthenes]

I can ask you the same thing, but in reverse. What is your strong opinion on believing that people should have no responsibility for the obesity, when we know it is caused mostly by over-eating?

Why do you presume people are completely hopeless at controlling what they put in their stomach?

How many experts did you consult with to form your opinion?

[jlebar]

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

[antisthenes]

I'll gladly read that in a textual format. Podcasts tend to be long-winded with a lot of useless fluff.

If you have a link to one of his papers, I'll gladly peruse it.

[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.