Insurance market for football evaporating, causing major threat for NFL | Hacker News Reader

Insurance market for football evaporating, causing major threat for NFL

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74 pointsOsiris3064 comments

Insurance is useful to spread the cost for things that are:

- Rare, but predictable in a statistical sense, ie x% of people will claim for y amount, and actuarial tables say so.

- Expensive to compensate. This is why we need to spread the risk.

- Where's it's hard to separate risk levels of different people. If not you get adverse selection, where the average cost discourages the safer people, leaving the less safe.

With the recent revelations about brain damage from tackle football, the actuaries will rightly decide that their old tables are systematically biased. More people will be allowed to claim that initially believed from the old evidence. Furthermore, you can't just up the premium to compensate, you don't know how bad it might get. There was that one study of old NFL players' brain that concluded all of them (!) had damage to their brains. You also don't have any idea what the courts will award, so you really have no clue how much to ask for.

You also have to ask whether general health insurance will start asking people whether they play football. (I'm not familiar with the US system). Much like smoking, it might turn out to be a predictable high risk group, so that people in it will have to pay prohibitively more for coverage, or not get covered at all.

So if all the youth players can't get insurance, you have to wonder what will happen to the professional game.

Perhaps there's some major rule change necessary. I'm not sure how I'd change it to be similar but safer, something about the game seems to require tackling to be football.

We'd play flag football in school, where one wore a belt with flags on it attached with velcro. "Tackling" meant ripping off one of the flags. This should be coupled with fining a player for knocking others down.

You can still get injured with this, but the odds of head injury should go way down.

Whether this version of the game would hold the interest of fans would remain to be seen.

Or one team could be given swords and the other tridents, and give the fans what they really want :-)

I remember learning a long time ago that Barry Sanders started out with flag football, which is why he became such an amazing running back. If you can evade flag-tacklers, actual tacklers are gonna have an even worse time getting you (on average).

Despite the more technical nature of sport it would bring, you’re right in your final analysis–this is our modern day gladiatorial contest, we want hits.

I was a bit astonished at first because my brain read "Bernie Sanders"

Flag football sounds pretty unwatchable to me.

For the simple reason that, no matter how few, enough athletes are paid way too much money, and gain substantial celebrity for having, what amounts to, professionalized fun.

Why should I slog my life away in a salt mine, when they get a free ride, VIP status, attractive spouses of their choice, and worldwide recognition and adulation?

Stay in school, kids. It’s just like work, so get used to it now. Not so fast! Maybe you can hitchike your way to fame and fortune, by playing kickball or dodgeball or freeze tag or hide and go seek! Millions of dollars and desireable sexual partners (inclusive of any gender!) can be yours, if you choose goofing off for a living!

But hey, maybe millennials want a kinder, gentler, baby soft world.

I doubt it. The truth is, there’s a motive from upper eschelon and high command to eliminate football. It has nothing to do with what people want.

>It has nothing to do with what people want.

Gladiators

There's much less of an active opposition to the other professional sports and entertainment industries, including many with all the same attributes you just listed. The opposition is primarily to how much more dangerous tackle football is to the athletes than other sports, especially to the brain.

Try watching football's close relative rugby (popular in much of the world), or hockey (popular in the northeastern US and Canada among other places), baseball (still popular nationwide even if not as much as football), basketball (ditto), or professional wrestling (more entertainment than actual sport but still athletic).

Depending on your particular preferences, those are all pretty fun... And don't tell hockey fans that you think their athletes' body checks and damaged teeth are a baby sport...

Some of those sports have significant physical danger too, but based on the evidence available to date, American tackle football is currently the most dangerous major sport played.

What does this post have to do with flag football? It mentions it in the first sentence then it's just a generic post against professional sports.

Why would flag football be in any way different?

Does rugby have the same problems?

Is it a problem that the helmet etc allow harder tackles? Much like boxing gloves allow harder punches?

There are studies that show that the hard helmets in American football are actually less protective than the old leather helmets. The hard plastic transmits the forces better in a fast impulse, the exact opposite of what you want. They have been designed to prevent a skull getting crushed but that isn’t a problem in football. Bad engineering and bad science perpetuated and now the hard helmet is such a macho symbol of the nfl they will never change it.

The big difference is that rugby players actively protect their head as part of their play, whereas american football players have a perceived notion that the helmet is providing all of the support. I wouldn't be surprised if there are studies out there that show that Rugby players have less issues.

I have to think you’ll still get quite a number of blows to the head over the course of a rugby career though. Maybe not worse than football but possibly still enough to reliably cause brain damage

Rugby is becoming more and more aware of this issue, with high-profile players forced into early retirement because of repeated concussions.

It is too early to know what will be the long-term effect of those concussions on their health, but at least they're still alive, as opposed to the 2 young French players who died this season after being hit while playing (there are probably others, but living in France I've heard the most about those 2).

Having been forced into retirement from Rugby several years ago, following a couple of wrist injuries, I still miss playing a lot. However, I don't think that I would be comfortable with the health risks that today's Rugby presents.

> Where's it's hard to separate risk levels of different people. If not you get adverse selection, where the average cost discourages the safer people, leaving the less safe.

I don't think this is necessary at all. You need insurers and the insured to have a similar understanding of their risk level. If you can accurately price it, it should be cheap for lower risk people and more expensive for riskier people.

This doesn't achieve social goals in the context of health insurance, but that shows more about how insurance isn't a great model for healthcare, rather than limitations of what insurance markets can work.

So the football industry now has to pay for their externalities. That's progress.

Now if only we could get the fossil fuel and agricultural industries to do same.

What surprises me about this is the throwaway remark suggesting soccer and hockey should be lumped in with American football. As I understand it, they are not close to being in the same category for brain injury. What's the justification for that remark?

Correct. I believe the dangers with American football is the use of the helmets in particular. It allows for tackles that normally would not be possible without the attackee injuring themselves. Refer to Rugby or Australian Football for comparisons.

Hmm yes American football is worse than the others but this overall problem makes me really concerned for rugby. Head injury issues and the subsequent legal exposure is only starting to become an issue taken seriously in the sport. Frankly, the sport doesn't have the money that the American football system has to be able to survive an onslaught of legal cases.

There have been a number of cases of former NHL players with CTE. I'm not sure it's as many as in the NFL, but it has less focus so possibly underreported.

ISTR many of those afflicted NHL players had been goons/enforcers, so much of their CTE could be attributed to fisticuffs. Sure, that's one of the most entertaining parts of hockey, but it's not integral to the game in any sense. In fact non-pro hockey doesn't have that at all. (If you get in a serious fight in a high school game you might get arrested, and rightly so.) It seems that the NHL could fund some studies to figure out whether this is the case. TPTB probably want to get rid of fighting anyway to attract the "cuddlier" millennial fan. (cf. NFL's offensive explosion this year due to their new "no touching the QB" rules. I'm not complaining; my team drafted the Mahomes.) If NHL had studies that blamed fighting for all their CTE, they would have an argument to present to their more "traditional" fans while changing the rules to attract the new younger fanbase they desire.

> What's the justification for that remark?

A desperate false equivalence to defend the right to exist of a brutal sport that doesn't belong to a modern compassionate world.

Well soccer have head play and hockey has a lot of full contact. While probably not in the same league - we should probably monitor.

The implications of banning headers in soccer would be quite interesting, but it also seems entirely possible, as in the game wouldn’t suddenly be completely different.

After all, handling the ball (referring to both arms and hands) is already banned and banning the head would just neatly slot in there and could use the same rules. (I.e. just add “or head” to this sentence in the rules of the game “Handling the ball involves a deliberate act of a player making contact with the ball with his hand or arm.”).

(If you ban headers for health reasons you should, however, probably also ban the goalkeeper from doing headers, even though the goalkeeper is allowed to handle the ball under certain circumstances.)

I do not know what other rule changes would be necessary, but, as I said, I wouldn’t expect the game to be radically different and unrecognisable. (Are there implications for corners and free kicks would be my main question. I could imagine that those are suddenly worth less if headers are disallowed, since in those situations the defenders have time to get in place and space and – as a direct consequence – time are consequently tight. Always having to get the ball to the ground or at least on a level where you can kick it somehow will slow the game down, giving defenders more time to react.) But I also know that soccer (associations, clubs, fans) can be very conservative …

Repetitive blows to the head cause brain damage, doesn’t matter if it’s a header in soccer or a fist fight or body check in ice hockey or a tackle in football or punches in boxing. The brain is still get knocked around.

Soccer does have a problem with not treating conscussions seriously where there is the occasional clash of heads. Headers are subconcussive, and it seems the evidence is not clear what the health impact is of that.

Even if headers turn out not to be harmful, many of those clashes of heads are caused by two players going for a header at the same time, so there's still reason to ban them.

The clash of heads issue will likely be solved by having independent medics judge fitness to continue rather than club physios. The problem is people continuing to play after the first concussion. Clash of heads is quite rare, maybe one concussion every 5-10 games, so I doubt headers will be banned unless there is conclusive evidence that the subconcussive impacts of the headers themselves are harmful.

Even if the evidence is not crystal clear that impacts to the head cause brain damage, I think it’s worth erring on the side of caution when trying to figure out if knocking your brain around against the skull damages it, even if it doesn’t cause a concussion.

Why anyone would want to mess with the brain is beyond me.

Soccer has headers and the occasional accidental clash of heads. The youth organizations have mostly all banned headers up to a certain age. To be honest, I'd be fine if they banned headers in the game completely if it became an issue. Even then, the ball is lighter than it used to be, so it's a difficult thing to track if headers are still an issue. Technology and rule changes could almost fix it completely. But not sure how they're going to do that for gridiron football and still retain the essence of the game.

First let me start by saying that the research on brain injuries and sports is very new and at times has shown fairly bad protocols in the studies, so basically anything you read on the subject requires more specialist context than I have.

That said, in reading about this for the last decade or so when it became a top news item, its become apparent that most brain injury news stories don't report on them very well and lump 2 drastically different kinds of brain injury into the same bucket. Concussions and CTE. The former is caused by a single traumatic event that can leave the brain damaged after it. The latter is probably a repetitive injury, lots of small events that add up to brain damage.

Gridiron football has the opportunity for both. Big shots on open field runners frequently lead to concussions, but for CTE the most dangerous position may be offensive linemen who infrequently take those high speed impacts that get so much coverage. Instead on every play they are taking repeated small blows to the head.

This is how soccer gets lumped in. There is at least circumstantial evidence that the arial game in soccer and potentially even header practice can lead to CTE at fairly high incidence rates. Given the lack of studies its unclear what the level of danger is.

Hockey on the other hand has the opposite danger. Repeated small head hits are rarer than in football but the incidence of traumatic concussion causing hits is similar if not higher.

American football is the first sport to have major studies around brain injury and those are fairly early days. As the other sports have more studies, and as the studies get more data, I suspect we will find that all contact sports put you at risk of brain injury and that football and rugby have higher incidence of CTE than the others. But thats just guess work right now.

For soccer it’s trivial to remove the aerial aspect from the youth game, in fact they’ve already done it. No headers, no throw ins, etc. Doing so doesn’t do much to change the game at a youth level.

Football on the other hand... it’s pretty much impossible to take the CTE risk away without ending up with another sport (rugby, Aussie rules, whatever).

IMO the long term viability of US football is not good.

I would bet also that an effective soccer helmet is at least feasible.

Hockey seems to have serious brain injury problem, deaths and concussion lawsuits but not enough epidemiological data. There is slowly growing body of literature that points to similar problem as American football. Maybe the brain autopsies from dead players will turn the tables there as well.

This has certainly been the case with NHL “enforcers” who’s job is to have bare knuckle fistfights on the ice. Granted it’s been a while since I followed hockey so I’m not sure if that’s still a thing.

Unless you're interested in the finer details, the article is very long.

Basically, the NFL should be fine, but even they may be self-insuring head trauma nowadays.

For youth and school contact football programs, they are in jeopardy. Insurers are increasing premiums and/or requesting waivers for all neurological injuries. Some schools are already folding their teams. Probably with no end in sight. Where will the next generation of players come from?

As a non-American, this is something that confuses me about American culture. I see a lot of statements along the lines of "I should be able to do X if it only harms me" but people also sue for X causing them damage.

If you play football then surely you accept certain risks onto yourself?

You're right about the cognitive dissonance going on. Americans want the right to do whatever they want, but won't accept responsibility for their choices.

Yes, but lawyers don't make as much money that way.

Yes, and that principle is embedded in common law. For example, if you park near a baseball field and a flyball breaks your car window, you likely will have no recourse to sue anyone.

Same would be true of something like football, but things change when you have an organization making money off of it that has known and may have known of the dangers for a long time and has made a concerted effort to hide the dangers.

I think the long term dangers of football are still not widely known or acknowledged.

Until roughly a decade ago, the risks of football were under-disclosed. This includes nefarious actions such as the NFL buying their way into medical journals to refute claims that football leads to brain injuries. Arguably, the 2015-16 rookie class is the first that had consequences laid out to them from Freshman in HS forward. (I believe the 2009 AFCCG is the NFL line of demarcation.) Additionally there is the question of ability to consent and duty of care for a minor playing HS football.

In direct response to your question, yes, there is an ability to do dangerous things in the NFL/football, but the NFL had previously withheld/ actively withheld information about the risks from the players. This is different than the ability to knowingly consent to the danger.

That answer might be fine for the NFL (and maybe even for college teams), but for high school and younger football players, it seem absurd to say "Well they accepted the risks"

For good reason, we don't give children the full scope of authority to assume personal risks that we allow to adults.

100% agreed. If you take a risk and it doesn't pay off, you shouldn't be able to sue other people for your own decisions or mistakes.

Played an extreme sport (like skydiving or winggliding or snowboarding or mountain climbing or anything else) and got injured? Tough, you decided to do that, and you and your family should stop something looking for someone to blame/sue because of it.

Same goes for any other hobby, whether it's fishing or caving or climbing the outside of buildings for Instagram photos. You took a risk, and if it didn't pay off, tough luck. You made that decision.

And this especially goes for anything illegal. Oh sure, there are exceptions for legal activities if some party did do something wrong that caused it to become more dangerous than expected (like say, telling kids to play American football without padding and helmets on ice) then maybe there may be a case that someone is to 'blame'. But if you break the law and get injured doing so, well tough luck. You did something illegal and it worked out horribly, what you'd expect?

For instance, I distinctly recall cases of burglars suing because they got injured robbing some property or trespassing. That's ridiculous, and the whole idea should be immediately tossed out with 'well if you didn't break into a property you weren't supposed to be in, you wouldn't have got injured'.

People should take responsibility for their own mistakes and decisions, and accept that sometimes things don't work out well and that it's merely part of life.

Taking on a known extreme risk isn't the same as taking on an unknown risk that exists due to the negligence of others.

...surely you accept certain risks...

TFA is largely about insurance for youth leagues. Children aren't capable of assessing and accepting certain risks. That's why we don't let them drive automobiles on the highway.

Where will the next generation of players come from?

I'm actually perfectly okay with a sport going extinct and becoming some weird historical artifact because the world got wise to how very harmful it is to the participants in an irreversible and serious manner.

robots or VR football

NFL should guarantee lifetime health coverage for anyone who plays one NFL regular season game. If that craters salaries, so be it.

That doesn't account for damages.

They should do this, though as the article demonstrates good luck finding a carrier to buy it from

The NFL doesn't need a carrier. They can self insure and contract with a health insurer to just do the claims administration.

Surely in terms of brain injury American football is comparable to professional boxing? If so, that sport seems to be doing right.

Boxing is the canonical example of a sport in decline. It went from most popular sport in America to a minor sport today.

Minor in what sense? It’s still one of the largest in terms of industry revenue and viewership.

Pro boxing can continue as a profitable spectacle without requiring lots of "developmental" amateur participation. For decades, most boxers have been drawn from relatively disadvantaged populations (recent immigrants, minorities, etc.) who are less likely to have access to the sort of legal representation required to address CTE liability. Who would they sue anyway? Most boxing gyms are dumps that barely keep the lights on.

It's interesting to imagine football going that way. The college game would probably have to disappear. (which it should do anyway because institutions of learning should not concentrate most of their energies on frivolous contests between indentured servants) High school teams might be replaced by AAU teams run by shady coaches who could never be sued. I'm not sure where they would play, however. A football field is a big investment that is always going to be attached to some deep pockets. It's not clear that football could survive in the same way that boxing survives.

From public health perspective do not underestimate the importance of gladiatorial sports in channeling society-wide aggressive impulses

I'd like to see some data on that.

Why is this on HN?

Because it's interesting to the HN users; I know I found it interesting a few days ago when I read it.

HN isn't just about tech, startups, and the ilk. :)

The solution seems clear: prohibit tackling in football or change the rules to discourage it (for example no heavy helmets)

IE just shutdown the sport. I personally have no personal opinion on that. But tackling is pretty baked into the game.

Other tackling games like rugby - do they have similar stats? I'm not familiar with the numbers but I do know lots of concussions happen in rugby too, although probably a bit less than NFL

I don't see UFC being "shut down" with the safety rules they have added since their beginning, so I'd say it's adaptable

Rugby doesn't have as many issues it seems

Not clear to me how much that has to do with lack of collected data on the issue. Head trauma is a big and growing concern within rugby, with some high-profile casualties. It is possible that we're just a few years later than American Football to raise this concern.

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