ACA Repeal/Replace: Progressives Face Moral Dilemma

[Bob Butler 54]

Kinser

I perceive insurance programs as a risk sharing proposition.  I’ve paid a lot of money into home insurance.  I’ve never had the sort of disaster that has called for use of the policies.  If one is a gambler, one might think it cost effective to not buy the insurance.  Insurance companies are out to make a profit.  The odds they give you aren’t particularly advantageous.  On average, being uninsured is a financial win.

Except in a disaster, where it isn’t.  It seems prudent for me to share the burden, so those who have been lucky help out those who haven’t been.

For the healthy and wealthy, poor or no health coverage can similarly seem attractive.  One can convince one’s self that there is such a thing as a free lunch, and roll the dice.  I wouldn’t consider that prudent, but some are willing to live on the edge.

If one isn’t healthy and wealthy, the odds are much different.  Being uncovered is not by any means a good gamble.  If someone still young enough to think himself immortal wants to roll dice, I have no great desire to prevent him.  However, when the healthy and wealthy want to set up schemes to force those who are not healthy and wealthy to roll dice against absurd odds for deadly stakes, I get very dubious.

There is a lot to be said for letting the states trial and error a bunch of different schemes.  However, in the process they are going to force lots of impossible dice rolls with deadly stakes.  I am doubtful about that.  If past schemes have not been ideal, neither are many of the possible future schemes.

I have mixed feelings about letting the states each set their own policies.  Too many lives would be put at risk.  However, I’m not going to throw extreme partisan style hissy fits if it is attempted.

I feel more firm that health care should not be optimized for the benefit of the healthy and wealthy.  One should start with a goal of providing everyone coverage, and look for some way to share the burden reasonably.  Anyone moving in the opposite direction is moving in the wrong direction.

And, no, I don’t want to nitpick your experiences in Florida.  I’ve just have had very different experiences in Massachusetts.  Both your own feelings and Florida’s culture wish to avoid sharing the burden.  Both myself and Massachusetts culture lean the other way.  I don’t see much point in nitpicking details.