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Comment by mcny | Hacker News Reader

But we are idiots.

There's a reason why flour has iron and salt has iodine, right? Individual responsibility simply does not scale.

We are idiots who will bear the consequences of our own idiocy. The big issue with all transactions done under significant information asymmetry is moral hazard. The person performing the service has far less incentive to ensure a good outcome past the conclusion of the transaction than the person who lives with the outcome.

Applies doubly now that many health care interactions are transactional and you won't even see the same doctor again.

On a systemic level, the likely outcome is just that people who manage their health better will survive, while people who don't will die. Evolution in action. Managing your health means paying attention when something is wrong and seeking out the right specialist to fix it, while also discarding specialists who won't help you fix it.

> We are idiots who will bear the consequences of our own idiocy

This is just factually not true. Healthy people subsidize the unhealthy (even those made unhealthy by their own idiocy) to a truly absurd degree.

Well, the biggest consequences aren't financial, they're losing your quality of life, or your life itself.

Sure?

So they do end up bearing most of the brunt of their own decisions. But you're also right, it's not entirely on them.

But the effects aren't just financial, look in an ER. People who for one reason or another haven't been able to take care of themselves in the emergency room for things that aren't an emergency, and it means your standard of care is going to take a hit.

Ah yeah, good point.

Neither does collective responsibility, for the same reason, particularly in any sort of representative government. Or did you expect people to pause being idiots as soon as they stepped into the ballot box to choose the people they wanted to have collective responsibility?

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