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Comment by bjl | Hacker News Reader

> How do you justify the healthy paying for the unhealthy?

Because we live in a society, and in a society people help one another.

I absolutely agree that people should help one another. In fact, it's inherently built in to a lot of people. I'm not arguing against that.

I'm arguing against being forced to help others who I have no relationship with, live in far off places, hold different health standards than me, etc.

Believe me, if a family member of close friend needed help with medical expenses, I'd be the first to volunteer.

But what about the millions of people with poor family/friends? Are they supposed to just roll over and die if they get sick?

And don't say 'but charity', we already know charity is massively insufficient.

No, absolutely not.

You're assuming that if the government didn't mandate health insurance, nobody would step in to help those people, which I don't believe is true. Lots of different groups – religious, businesses, municipalities, etc. – could fill that role. Individuals could even give directly to strangers in need through something like https://donorsee.com/.

>You're assuming that if the government didn't mandate health insurance, nobody would step in to help those people

No, the assumption is that if government mandated dollars stopped coming in, voluntary contributions wouldn't make up the difference. And that seems pretty obvious to anyone who pays attention to the political dialogue. Look at the Republicans who believe Obamacare is too costly. Their sole goal is to have less of their own dollars subsidize the sick.

That's also assuming the costs would stay the same, which they wouldn't if government stopped intervening. With lower costs, more people could afford to pay for healthcare out-of-pocket, which would reduce the amount of voluntary money necessary to cover those who truly need it.

>which they wouldn't if government stopped intervening.

That's a very strong assumption, and I see no reason to believe its true.

Look at health care costs pre- and post-1965. They began increasing in 1965 with the passage of Medicare and Medicaid, and have continued to increase as more and more government regulations have been added since.

Have you ever considered that your beliefs are utopian in nature? That if we give over everything to the market things won't just solve themselves?

Besides healthcare costs are lower in countries where the government intervenes more than ours does disproving the point.

I try to keep an open mind. I don't believe things will just solve themselves, nor do I think the market is the perfect solution. I do believe, however, that it's a better solution than government intervention, and we haven't found a superior solution.

Also, source for your second assertion?

>Also, source for your second assertion?

It's well established, just google it.

The US has the highest healthcare costs in the OECD on an aggregate basis, on a per capita basis, and on a share of GDP basis.

The OECD publishes copious statistics on healthcare expenditures, access, quality, and outcomes: http://www.oecd.org/health/health-data.htm

So are you in favor of a law so they can't discriminate on who they help? As if you are, it's an optional tax played for by people who aren't fully aware of the need. And if you aren't, better not tell anyone about your differences, you might die if the coke distributor knows you drink Pepsi or if the church knows you're gay.

No, in fact, the ability for these institutions to choose who they help is key. A business being able to choose to help only its own workers makes it possible to even help them in the first place. If they had to help anyone, it wouldn't be feasible. Same for a church or any institution. Being able to discriminate is important; it's not a dirty word.

Now before you go and doomsay about all sorts of discrimination happening based on race, gender, sexuality, etc., I'd argue that lots of institutions wouldn't discriminate on those factors. Case in point: most of the major tech companies. And if one did, would you really want to be associated with them and/or have them paying for your healthcare?

>Case in point: most of the major tech companies.

The ones that have recently faced age discrimination suits, criticism for the lack of diversity in their employees, and a whole range of reports of terrible conditions in their manufacturing plants? For some bizarre reason, I'm sceptical.

>And if one did, would you really want to be associated with them and/or have them paying for your healthcare

When compared to dying or living with severe health problems, absolutely. This entire thing is about unexpected healthcare costs, I may not have the ability to shop around for the most ethical choice.

No, the myriad that say "we care deeply about diversity and inclusivity" in their job posts. The ones that come out against banning travelers from Muslim-majority countries. The ones that care about climate change and the effects it has on people of this planet.

So adding a line to your job postings and sending out press releases is a better indicator than their actual acts? As you're probably talking about the same companies as me.

I understand what you're saying with "the ability to discriminate is important," but free discrimination has led to the trampling of human rights repeatedly in history.

Here is a good reason to think that people would help others less even when everybody is in agreement:

https://www.youtube.com/watch?v=mwzBJF5Q7Vw#t=3m29s

This is Dan Ariely describing "The public goods game" and the instability of 'cheating'. Cheating in scare quotes because the conclusion stands -- in fact is enhanced -- even when the 'defect' choice is regarded as a choice that members of society are free to take (in fact that is the case he discusses).

> I'm arguing against being forced to help others who I have no relationship with, live in far off places, hold different health standards than me, etc.

How is that any difference from defense, law enforcement, fire protection, or property rights standards?

This idea, which lies behind a lot of American libertarianism, says that theft (as taxation is construed here) outranks most or all other moral values, but does not explain why.

Instead, it hopes dogmatically that other moral values will be met as a side effect of following this one.

Not just theft, but aggression of any sort, including the most serious offenses such as rape and murder. Is there not a more fundamental moral value that we can all agree on?

Equating theft with rape and murder is just one of the reasons rational people ignore right-libertarianism.

Stealing a mans food can be just as lethal as stabbing him.

> forced to help others

It's good to know that you're against your tax money being used for the most expensive military in the world.

Absolutely.

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