Technically it's not discrimination, they actually cost more, and their insurance would therefore be more expensive, in a free market. To the extent that the society values "fairness" and wants to help those people, government / non-free-market solutions are needed, with the society paying for them collectively.
What would be more akin to actual insurance is insuring specific events within a specific timeframe, such as broken bones from year x to year y, and then the insurance can charge more to people who play sports versus people who don’t, since obviously they would experience more losses, just like people who drive more pay more for auto insurance.
However, this all gets murky with our requirement to force everyone to be provided with healthcare and people being in control of some things about their health (via diet and lifestyle) and not others (genetics, environment) and the inability to tease out causal factors.
The primary purpose of health “insurance” in today’s world is to serve as an agent for the buyer since the buyer typically has no idea about what they’re buying from healthcare providers and at what cost, so theoretically, the doctors, pharmacists, and statisticians employed by insurance companies can do proper vetting of treatments for the patient.
American "healthcare" is a sham in many ways. It's the only "transaction" a person enters into whereby you have zero idea of the final costs. I buy a car, I can negotiate and know before I sign. Ditto a house. Medical care in the US is designed to make money. Full stop. Not long ago, maybe even here on HN, an article was posted about American hospitals trawling the Internet for every bit of info they could glean about patients to both see if they would be monetary donors, as well as to ascertain if they were hiding their "wealth". This is what results from a for-profit system.
I have always believed that healthcare is a basic human right. I will never change my beliefs on this point. Profit and healthcare are mutually exclusive. When a cancer patient is literally refused treatment because a) their "health insurance" runs out or b) they cannot afford to pay, the system is morally bankrupt.
A friend of mine has a family member who needed a helicopter ambulance to save his life, as his accident was rural and he would have died. The 15-minute flight was almost $60k and they were billed for the full amount almost overnight. Insurance did not cover this. Another friend had a seizure and an ambulance was called, and the ensuing ride took about 10 minutes. Cost for the ambulance ride? $1200. This was in addition to the medical care, which in this case only paid 80%, even after deductions, etc.
Anyone who defends for-profit healthcare for reasons of "I'm not paying for others' mistakes, etc." is being short sighted. There is no way a cancer doctor should be making millions off the back of dying patients, many of whom have cancer through no fault of their own. Even smokers deserve compassion, because addiction is a beast that many play hell getting out from under. So many factors at play here. It's easy to sit back and play moral general, but unless and until it's you or yours, it's an entirely different animal.
We could easily afford single-payer in the US. The numbers being tossed out by various mouthpieces are intentionally misquoting to support the lobbyists and their ilk.
Many of you may know that almost all hospitals lease their equipment. The leases are not that expensive for most stuff, even MRI and like equipment. For the prices charged, they have paid their leases in full after less than a week, yet they charge for all manner of false bullshit, and I quote from personal experience:
"Mucous recovery system: $120" WTF is that, you may ask? After deciphering the code by obtaining a medical billing handbook, it turns out this is a box of Kleenex.
I'm 50 and I refuse to go to the doctor unless I have either an infection or I have to go because life demands it. Eat right, brush your teeth, exercise, and call it good. I cannot afford the insurance, deductibles, co-pays, additional money always being asked for, plus RX costs. Not everyone has the money for the sham that is American healthcare. When I do go, I go the low-income clinic, pay cash and get as good or better care than the expensive places. Remember, massive debt in America is largely brought on by medical crises.
Pushing back against this part but in support of your larger point: many of us don't really have that option due to chronic conditions. Society incentivizes us in various ways to hide them when we can, so people mostly don't realize how prevalent these conditions really are. By some criteria, American adults with no chronic conditions are in the minority. Much of that is due to hypertension and hyperlipidemia being their own diagnoses, but to pick one example, overall asthma prevalence may be as high as 8.3%. [1] [2]
[1] https://www.rand.org/blog/rand-review/2017/07/chronic-condit...
My family in England go into hospital, checkups, RXs, never a cost to them directly. Everything is paid for by dint of taxation, and the taxes are not as high as Americans are lead to believe. My UK family are not wealthy by any standard, yet the do far better than me in America. They get 6 weeks paid holiday, too, something almost unheard of here. Time off leads to less health issues. Everyone needs a good holiday release a few times a year to get away. No email, no calls, nothing work related. This is actually good for people, but Americans in general don't even use up their allotted time off. Sad.
Did you live in Switzerland? Doctors make a nice salary, many hospitals are private, yet the system seems to work well (from what my friends who live there are telling me).
> When a cancer patient is literally refused treatment because a) their "health insurance" runs out or b) they cannot afford to pay, the system is morally bankrupt.
Then every system is morally bankrupt.
We have to face the facts: resources aren't infinite, tradeoffs are necessary, and we can't help everyone. That's why even most "socialized medicine" has limitations and restrictions about what kinds of treatments they offer and to whom (e.g. you can't get a free breast scan every year).
We owe it to people to give them human dignity up to, and including, their last breath. Anything short of this is crass, careless, and evil. The West has always tended to value human life more so than other cultures, but in the last couple of decades, we have devolved horribly on this point.
When my first wife died of cancer, I did ridiculous amounts of research into costs. Pharmaceutical companies are utterly shams. They may make life-saving drugs, but at what cost? I learned that they intentionally manufacture as cheaply as possible and charge as much as possible. Look at the recent shamelessness with the Epi pens. Those cost very little to make. They would still see a profit at $20.
When my wife died, the chemo she was getting was $12k for a 500ml bag. Cost to manufacture? Less than $100. That is not a profit, that is outright effing theft.
LOL, I guess all that colonialism, looting, and wars were for the benefit of the natives.
It may be possible, for instance, due to a combination of structural and cycle of poverty factors that a black person in the part of town your store is would be more likely to commit a crime - that doesn't mean the store is non-discriminatory if they choose to ban all black people. The point is that you can't make decisions about people based on a protected trait, like race or disability.
(To be clear, the black crime example was used because I think that we can all see the most blatant forms of discrimination in race-based discrimination and the "black crime" trope is one of the drivers of that discrimination)
Senior discount at the diner? That is literally called price discrimination, look it up.
Isn't it funny, however, that "we" claim to value seniors, but almost to a man, elderly mom and dad are tossed into care homes as soon as it's inconvenient for their adult kids. Sadly, this is done for many reasons, many of which are to bilk people for their money. Most countries bring mom and dad or surviving parent into the home for the remainder of their natural life. In other cultures, not doing so is tantamount to an anathema. Welcome to America, land of the free to be bilked, and home of the brave should you step foot into hospital.
And in a society where sickness implies economic misery, people plan by building their own, ad-hoc mini-safety nets which are often less valuable and more expensive than a standardized solution. So most people would support averaging health costs if they perceive it as mostly efficient. That is, they would not mind a sick person next door getting treatment while paying the same cost as themselves. But if they think a bunch of doctors and crooks milking the system by making up and billing for fake services they will strongly push back. My 2c.
You don't have the same problem with, e.g. car insurance. Either you're speeding or you're not.
At least we can agree it is something negative. But I fail to have much sympathy for people who simply have to buy ice cream, chocolate, soda etc. You put the products in the shopping cart yourself knowing well it harms you, you use your cash/card to pay for it.
Sugar addiction is real, but it doesn't make you a zombie without any free will. If you want to paint yourself as pathetic weakling without your own will, that's your own personal choice and be clear about this with everybody, especially yourself. But you are not describing sugar issues, but your own underlying mental issues that can and should be tackled by professional.
Man up (or woman up), own your shit and have some respect for yourself.
On one hand, people at a healthy weight throughout their adolescence who start a slow and gradual weight gain with their 'Freshman 15' that ends with being moderately chubby in middle age - yes, you're correct, that's not only the result of poor life choices, but it can probably be corrected with better ones.
On the other hand, some people have negligent or ignorant parents and are (as a result) overweight or obese from a young age. This dramatically cripples their ability to make healthy food choices at an adult because it bakes in their psychological weight set point at an unhealthily high level very early on, and so normal attempts at intervention make their body think it is being starved. These folks need more than just life advice, they need medical intervention, or they stand a low chance of digging themselves out of their holes. And if they can't do that, it's a detriment not just to them but to society as a whole, which will eventually have to foot the bill for their medical costs later in life.
What about alcohol addiction? Heroin? What about depression?