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Comment by wyager | Hacker News Reader

> The fact insulin isn't a few dollars or free is beyond disheartening

90-95% of type diabetics have type 2 diabetes. Of those, around 95% can completely eliminate insulin dependency by straightforward dietary modifications. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104272/

Under what moral framework should these people (around 90% of diabetics) receive insulin at others’ expense? I can see at least a first-order argument for having everyone else pay for obligate insulin dependents’ medication, but I struggle to see an argument for foisting the cost of an entirely preventable dependency on everyone else.

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I feel like that's the same thing as arguing that your taxes shouldn't go towards public schooling since any one of those parents could have chosen not to have a child.

If that argument strikes you as problematic, it might be because society is better when it's generally well educated and healthy.

I should get a $100k rebate at retirement for not having kids.

That "rebate" is called those other well educated and well functioning kids working to keep the world running when you retire.

The median HN user having kids is a net positive social externality. You shouldn’t be rewarded for not gifting that externality.

Educating children has a positive externality. Eating diabetes-inducing food does not.

Why should I have to contribute to Social Security for people who didn't bother to save for retirement? /s

What is sarcastic about that? Why should I pay for the retirement of people who neglected to save for it?

Social security is a savings plan. You don't get social security if you don't work, and it's in proportion to how much you earn. This is, in fact, the point of social security. It came about as a response to old people dying in the streets. It exists for people who either through bad luck or lack of financial education couldn't save enough.

The idea is that if you worked through your life, then shit hits the fan, you shouldn't be knocked down below your contribution to society as measured by your level of success under capitalism.

Because not everyone is able to or can?

Lots of couples are infertile. Should they be able to conscript anyone off the street to have a baby for them?

You really shouldn't, that's the entire point.

Let them eat cake!

Most type 2 diabetics have the opportunity to improve their health now and eliminate insulin dependency and continuously choose not to do so. At least SS has the argument that it’s too late for people who failed to save to change their behavior.

Can you clarify where that 95% figure came from? From your link:

> Forty percent (31/78) of CCI participants who began the study with insulin prescriptions … eliminated the medication

Not op, but it's not unreasonable. There was a nejm study where 800 calorie diet reversed t2d in 11/12? Patients?

More recent studies by nhs show ~25% success rate but I bet it's due to compliance. The nejm study (iirc) had strict monitoring, which is impossible at the ~300 patient level

I think society has largely given up on the concept of a not awful diet being a reasonable thing to ask of people.

Society continues to push back on any regulations on addictive junk food and loading down budget food with excessive amounts of added salt and sugar - so yea, the company's freedom to make a buck exploiting addiction trumps your freedom to live a healthy and happy life.

We're not talking about being fat, but eating suger to the point you neet to start taking medication to keep the suger in your blood from ripping your veins apart. At some point there's some personal responsibility. It takes more than a little suger added to your food to do that.

I can only see a first-order argument in saying "I will not pay for anyone else."

There's a second-order argument of the form "We will all be better off if we invest in healthcare. Society is not zero-sum."

There's difference between investing out of your own volition and being forced to by threat of violence.

That's fine as long as you are willing to forgo the benefits of the things that other people have collectively paid for.

If you want to opt out of taxation you should surely also be morally obliged to opt out of using roads, internet, mobile telephones, clean water, sewerage, police, fire brigades, etc.

I know that it is possible to opt out of fire services in rural US but most of the rest might put a bit of a crimp in your lifestyle.

Not just police, but general societal protection - the fact that you can exploit people for your own profit and not get beaten up when they come back for vengeance is one of the benefits of being in a society. I personally didn't find the depiction of Caeser's Legion in fallout to be the most desirable and free society to live in, but to each their own - maybe you image you'll end up as Caeser (but you won't).

I'm more than okay with paying for these things; in fact, I already pay for majority of them.

> We will all be better off if we invest in healthcare.

Enabling unhealthy diets is not “investing in healthcare”.

Great. Restrict the handouts to Type-1 diabetics. They certainly didn't get the disease by choice.

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