[MontgomeryPy]

In speaking with my republican father in law on his opposition to universal healthcare, it dawned on me that he views it as a sort of zero sum game. If he has healthcare today, and then universal healthcare offers it to folks that don't have it today, it is a loss for him.

[wredcoll]

Something I've run into in similar situations is the "moral necessity of punishment", sort of a reverse just-world fallacy.

"There are people not good enough for health care and helping them would violate this natural order".

[kasey_junk]

It’s absolutely the case that public health coverage will benefit some people who make bad health decisions at the cost to some of those who make good decisions (or the decisions themselves must be made by a central authority).

That doesn’t make it the wrong policy decision. Lots of systems we happily manage with similar dynamics. But I don’t think denying that basic fact is the right path forward. The moral hazard is real and worth acknowledging.

[AngryData]

Ironically the people who make bad health decisions are often benefiting the medical system by dieing more often around retirement age rather than going on to live 20+ years past retirement with age-related healthcare problems that cost WAY more than any other health conditions they could encounter when they are younger.

Smokers for example have more lung disease and cancer which cost money to treat, but usually not until they are in their 60s so they still spend their entire life paying into the system, but then they die soon after, saving on age related healthcare costs. And that is on top of smoking disqualifying someone from many treatments and surgeries, making smokers a net-win for healthcare costs to society.

Being really fat also seems to have similar effects, although the the finances are much closer so perhaps the second order effects from being fat cancel them out. But on paper they are still a bit cheaper than the average person.

Many people will argue against it because it "feels wrong" and they think unhealthy people should be punished (for example with higher insurance fees) and don't want to admit that unhealthy people are subsidizing their own healthcare, doubly so if you add in the sin taxes they have been paying their whole life that often result in more state income than their entire life-time medical costs add up to. But there has been numerous studies across the decades in Europe and the US showing how much cheaper unhealthy people that die earlier are to care for compared to the 90 year old granny walking everyday and risking broken hips and taking 30 different medications a day.

[const_cast]

The problem is we're already doing that, just worse.

Insurance is just risk-pooling. The most effective risk-pooling requires a bigger pool. That's why we have big insurance companies and bigger companies offer better employer healthcare plans.

Well, the biggest pool is the entire US population. So, we should just do that.

We already have socialized medicine. If my coworker smokes, I pay for that. If we're going to do socialized medicine, we should do it right.

[wredcoll]

What moral hazard? Is there someone out there smoking 16 packs a day on the basis that their lung cancer will be treated for free??

I think bad health is usually its own punishment.

[fnordpiglet]

This is going to be the ultimate issue if we do achieve some sort of post scarcity world where human labor is redundant. The idea that it’s not someone’s fault their indenture is unnecessary let alone a moral failing deserving of punishment is foreign to a lot of American thinking. The puritanical labor is godly mentality combined with the long term warping of anti Soviet propaganda is going to lead to some serious wide spread suffering that would take what should be the greatest achievement of man kind and turn it into a scourge.