What kind of an educated scientific person, working in health insurance and dealing with sick people, develops anything that makes this possible?
If you can't start with being the change you want to see in the world there is no hope
You probably agree with me. It just struck me that our misunderstanding comes from the different approaches europe and the us are following. While we tend to make up rules in advance, the american strategy is often about giving the market more options and having it regulate itself by class action lawsuites down the line. When we talk about health you must admit the „free market“ strategy has failed and europe is doing a far better job.
If your job is to make people's lives worse, at some point you need to take responsibility for choosing to do that job anyway. Very few of the people actually implementing models like this are without options when it comes to providing for themselves in ways that don't cause harm.
So there's not much difference is there?
Actually there is. The difference is in a quirk of moral evolutionary psychology. The tragedy of the commons. As an individual each of those entities contributes negligible evil to society. In aggregate that negligible evil becomes prominent.
Morality is divided up into fractional shares and sold like a collateral debt obligation. Every time you step into a car and let that thing spew green house gases into the air you are contributing to the destruction of the world. The individual is still guilty. We call corporations evil, but what we don't realize is that corporations are a mirror of humanity.
Most of the time you can increase Y to get the answer "yes".
In many cases Y can even be factored out by changing it to "Would you do X so you wouldn't get fired?"
Empirical answers differ a lot from people's theoretical principles.
The business of insurance is to make money by denying care that people paid for