Hacker News Reader

Comment by TheBlight | Hacker News Reader

The idea of knowing you're going to get dementia sometime in the next decade is interesting. But I don't think it's straight-forward as to whether or not knowing is a good idea.

It's also a little amusing to take the idea to its logical extreme: What if it becomes a societal norm to know? Would public venues allow soon-to-be dementia patients line cutting priority etc? Think amusement parks, transit reservations, hotel booking, bars, movie theaters -- all of it. There could be a whole industry built overnight of catering to this specific demographic.

View on HN

> The idea of knowing you're going to get dementia sometime in the next decade is interesting. But I don't think it's straight-forward as to whether or not knowing is a good idea.

It's not fun, but being able to do long-term planning around challenging medical conditions is without a doubt better than not knowing. This includes everything from financial planning to finding a house that is ideal for your condition (no stairs, single level, etc.)

Ideally we'll have a better understanding of disease-modifying drugs in the near future that can slow progression of Parkinson's. If we get confirmation that drugs like Exenatide actually do slow the progression of Parkinson's (trials ongoing) then you'd definitely want to know as early as possible.

Knowing you will have something incurable has only downsides. You will dread the time ahead of you instead of enjoying your present time.

If I know I only have N good years left, I can spend all my money instead of dying with it unspent.

It depends on the person, but I'd wager that that perspective isn't even close to the majority one. Death is waiting for everyone, having an actual date range for it doesn't really change _that_ much.

We have all have something incurable in the future. It’s called death. Do you dread the time ahead of you?

I do.

Well if your already dread the time ahead of you then you might as well know, it can't get much worse eh?

I've known several folks over the years that found peace with their diagnosis, and were able to live their remaining good time with joy and grace. I know I would want to know. FWIW.

I'd definitely take a different career/life path if I knew I had a few years left. Being able to predict the future has implications on actions.

"Would public venues allow soon-to-be dementia patients line cutting priority etc? Think amusement parks, transit reservations, hotel booking, bars, movie theaters -- all of it. There could be a whole industry built overnight of catering to this specific demographic."

Do we do this for people with cancer?

IME, the prognoses there are on the order of months, generally. Although not likely always formalized and treated with a blanket policy, you can probably get priority service in at least some circumstances.

This situation is unique because of the time span. I'm sure there would be an increased sustained and consistent demand for nostalgia-focused apps. And probably for many other products I haven't considered.

We already do that. We think you may get cancer or dementia, we deny you insurance converge and proceed to drain you of opportunity

If insurances dont cover you for future risks its not worth calling it this way. Insurance's only purpose is to help the minority of us who will get serious problems throughout their lives, not that exclude them.

If it’s predictable you’ll fail, that’s not insurance. Insurance is about unpredictable failures. It may sound odd, but it’s the nature of it.

Coverage or cost sharing then

Maybe but the cost is already high even when you exclude those who deliberately drive it up.

Describing people with cancer and dementia as deliberately driving up insurance prices just seems wrong

There is probably a difference between someone losing their health insurance after the insurance company finds out about their upcoming Parkinson disease, or their car's insurance sending an SMS about tripling the premium, and someone creating a life insurance contract for a million bucks one day after their diagnosis with a quickly killing unstoppable cancer type.

Insurance is absolutely not here with "the purpose of helping the minority of us."

Insurance is a business built on exploiting information asymmetries to make money from groups who they try to show empirically can't actually cost more than they pay. If they can find a way to exploit extra information in order to show you're in a riskier group and hence exclude you from coverage, they will. They have absolutely no reason not to.

Insurance companies and you absolutely have an oppositional relationship; they love when we collectively ignore this.

Who's "we".

Most developed countries (and many less developed countries) have some government coverage for cancer or dementia.

In New Zealand we can also pay for premium private insurance - although I don't think that helps much for chronic conditions.

Dementia will often still drain your bank account in New Zealand because the government here will take all your equity to pay for nursing home fees. But you do get looked after a bit when you have nothing, so there is that. You can avoid having all your equity taken but it does take some planning, some costs and some effort (e.g. give equity to children more than 7 years before you lose your marbles, e.g. use a family trust, e.g. if married it is very important to ensure your will limits equity damage to one if the other falls ill).

> We think you may get cancer or dementia, we deny you insurance converge

Pre-existing conditions can't be used to deny health insurance coverage in the United States.

This has been true since 2014.

Please don't perpetuate the myth that people should avoid screenings for fear of losing health coverage.

Practicality matters. Squeezing you dry isn’t denying coverage by the letter of the word, but the effect is the same.

How much opportunity is drained form everyone who relies on insulin to survive every month?

Doubling down on your ignorance. Impressive

Do you deny that people who need insulin to live pay through the nose for the privilege of not dying?

We could spend our remaining days living it up, but after we're dead all those experiences won't make one whit of difference to us. What will live on is our legacy, in the minds of those still living. I'd rather not be remembered as someone who pushed others aside and spent their inheritances.

Something to think about.

> What will live on is our legacy, in the minds of those still living.

For two or three generations, that is, with very few notable exceptions.

I would like to know how many US political leaders currently have dementia. I bet more than 10% of Congress.

Is this the same for Russia, China and India? Are political elites generally just older globally.

If it allows you to prepare and get your affairs in order to better deal with it as it brings your life to a halt, then it's a great thing.

See: Gattaca

Reply on news.ycombinator.com