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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> extropy-chat-bounces@lists.extropy.org [mailto:extropy-chat-bounces@lists.extropy.org] <b>On Behalf Of </b>Adrian Tymes<br><b>Sent:</b> Thursday, November 28, 2013 10:07 AM<br><b>To:</b> rafal@smigrodzki.org; ExI chat list<br><b>Subject:</b> Re: [ExI] Warren Buffett is worried too and thinks Republicans are "asinine"<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><div><div><div><p class=MsoNormal>On Thu, Nov 28, 2013 at 9:54 AM, Rafal Smigrodzki <<a href="mailto:rafal.smigrodzki@gmail.com" target="_blank">rafal.smigrodzki@gmail.com</a>> wrote:<o:p></o:p></p><p class=MsoNormal>### EMTALA says (you know about EMTALA, don't you?) a hospital can't<br>turn away a person with a medical emergency, no matter whether they<br>are insured or not. Why should a 26 year old be stupid enough to pay<br>15k per year for coverage they won't use (chronic disease and<br>pre-death care of the elderly), if they know they can get emergency<br>care for free anyway?<span style='color:#1F497D'> Rafal</span><o:p></o:p></p><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal style='margin-bottom:12.0pt'><span style='color:#1F497D'>>…</span>Because they suffer from other non-emergency conditions that the elderly don't, and the elderly are helping to pay for those conditions too.<o:p></o:p></p></div><div><p class=MsoNormal><span style='color:#1F497D'>>…</span>In general, the more people who pay for a pool of medical insurance, the cheaper it is for everyone in the pool - even when the pool covers conditions exclusive to small fractions of the pool. It's an economy of scale effect, with substantial per-person dividends when the pool covers millions of people - as in the difference between affordable and unaffordable for many, perhaps most, people in the US.<span style='color:#1F497D'> Adrian<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Adrian I would agree with this line of reasoning but for what I see as an enormous flaw in the reasoning: the price differential between the highest cost group and the lowest was dictated to be 3. Why 3? Did not the architects of this system talk to the insurance people? If they had, they would realize the ratio should be more like in the 6 to 8 range. If the government wanted to dictate an arbitrary ratio, 3 is way too low. Then to design the system to depend on the lowest risk people to overpay was a flaw in the design.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Young people, especially young men, already underestimate their health risks for reasons easy to see: you and I did all kinds of crazy stuff back then that we couldn’t do now: played tackle football without pads for instance, and all manner of insanity. We would take a handful of aspirin and a few days later all would be well. No wonder we felt invincible. For the most part, we were. Our bodies would quickly heal themselves, and even then doctors couldn’t do much for a young healthy person, unless there was an actual broken bone.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>So the insurance people would have told the ACA authorities that young people, especially young men, are a very tough sell. The price ratio should be about 8 rather than 3. We saw a spectacular failure in the Brosurance ads. They had kegstanding bros commenting that not having insurance was crazy, as if the young men would consider crazy a bad thing. They had a drunken male teenager perched on a keg acknowledging he could “totally fall” and oh how wonderful it is I am insured. OK then, a 19 yr old drunkard could fall off a keg. How tall is a keg? Would that hurt him? Would that ad sell a single insurance policy?<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Then these critically necessary young males who have never even seen a slow website are sent to this place where they are giving spinning rainbows for minutes on end, and offered an overpriced product which they don’t really want. <o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>What could go wrong?<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>My prediction: Saturday’s do-over ACA rollout will be an even more spectacular failure than 1 October.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>spike<o:p></o:p></span></p></div></div></div></div></div></body></html>