Seriously thoughtful US/Europe Cultural Divide -- Musings

[Nate the great]

@tirsales
I was typing my post when you finished yours. I didn't see your post until after (I type slowly).

@zsb
Why are you so angry? It's really unpleasant. You make me want to avoid you.

[zerospinboson]

Originally Posted by Nate the great

Why are you so angry? It's really unpleasant. You make me want to avoid you.

I'm annoyed because I'm being forced to explain concepts here that should already have been covered in high school level economics classes, and because I get the feeling I'm talking to a wall, for one reason or the other.

[pilotbob]

Originally Posted by zerospinboson

I'm annoyed because I'm being forced to explain concepts here that should already have been covered in high school level economics classes, and because I get the feeling I'm talking to a wall, for one reason or the other.

Perhaps you should visit the other thread where we have pretty much agreed that people don't change their minds on forums, and you shouldn't get upset about it or make it personal.

https://www.mobileread.com/forums/showthread.php?t=44692

BOb

[Gomoto]

Age at entry determines financial contribution to (private) health insurance over here. You enter at an older age, you have to pay for it (higher contributions, bearing the risk before entry)

The choice is yours anyway

[Xenophon]

So... Nate the great is voluntarily uninsured, and views this as choosing to bet that his medical expenses will be less than the insurance would have been.

Zerospinboson appears to be making the argument that insurance programs are untenable if the only people who enter the program are those who realistically expect to take more money out than they put in.

It seems to me that both of you are right! (more or less...) In the US insurance system, Nate's side of the bet leaves him open to the possibility of bankruptcy if he has bet wrong. In the mean time, he's paying out of pocket for any medical expenses he incurs. He is not "free-riding" in the sense that he's liable for any and all medical expenses that come his way.

But zsb's point is also correct. If you allow too much in the way of self-selection, you destroy the insurance program. It only works by spreading the risk over many people -- in the full knowledge that most of those people will pay a bit more than their actual expenses in any given year, and a few will pay less (sometimes far less).

In our admittedly partly broken US system there are several things that help encourage people not to make the bet that Nate is making. First, as people move into their prime earning years (middle-age, more or less), they begin to accumulate assets -- a house, retirement accounts, and the like. As these people have more to lose, they have more incentive to sign up with the insurance program. Second, a standard feature of all US health insurance programs (the private ones, not Medi*) is an exclusion for pre-existing conditions. Any problem that you develop while uninsured will not be covered for the first two years of insurance. Thus, if Nate is hit by a truck tomorrow (let's hope not!) and requires ongoing medical care as a result he would not be able to add health insurance so as to collect immediately. Instead, he'd pay into the plan for two years with full coverage for anything new, but not for the results of that hypothetical truck accident. Only after two years would his insurance pay out anything at all for a pre-existing condition. And that, too, is part of the bet that Nate is making. Finally, there's the convenience factor -- it's much easier to do sane budgeting when you can realistically predict your expenses. Medical insurance is one vehicle for making medical expenses predictable.

So my take is that Nate isn't a free-rider, but that he has self-selected out of the insurance pool. Zsb's point about the problems of self-selection is an important one! But from an my American (and admittedly fairly radical) point of view, Nate is free to make that decision. The question I would ask is this: "Is a two-year exclusion for pre-existing conditions enough to reduce self-selection bias sufficiently to keep the insurance pool viable?" I'm not an expert in this area, so I honestly don't know the answer to that question.

[Xenophon]

Originally Posted by Gomoto

Age at entry determines financial contribution to (private) health insurance over here. You enter at an older age, you have to pay for it (higher contributions, bearing the risk before entry)

The choice is yours anyway

Where is "over here?" I can't tell from your post or profile.

Xenophon

[Gomoto]

"Where is over here?"

You really have to ask? Thanks for starting this interesting discussion by the way! I adore the precious cultural achievment of the welfare state according to one of my prior posts, so over here should be a part of the european union, me thinks.

Personally I think, I am more interested in the question what is freedom, than in deciding the final verdict on government-funded vs. private-funded charity.

[Ea]

Originally Posted by Xenophon

I see what you mean. And if you equate the word "socialist" or "socialism" with the dictionary definition, many Americans will sound like they are "seeing Socialism wherever they want." Maybe even most. But note that common usage in America does not match the dictionary definition any more.
...

I haven't realised before now that the American definition of socialism is so different from the text book definition and is used as a casual short hand in common usage. Usually when I have seen it used this way by Americans, such as stating that countries in Europe are 'socialist states' I have thought:

It's like 'liberal'. The American definition is also quite different from the European - but not many people here are aware of it - and I only learned about it last year. Likewise with the use of 'socialism'.

[tirsales]

Originally Posted by pilotbob

Also, we perhaps could encorage people to stay healthy. If you smoke, drink or are over weight you pay a higher co-pay or something.

Problem with this approach: where do you stop? Sport is healthy - extensive sport is not. Drinking is very unhealthy - one small glass of wine each evening is healthy. Taking ASS is unhealthy - (very) small provisions might be healthy. etc
(Taking weight: Some people suffer from genetic or otherwise "born with" maladise that (directly or indirectly) lead to them being overweight - should they pay more?
Whats with sport-addicts having an accident - afterwards they might not be able to do any more sport and then they (in all likelihood) will gain weight. Pay more?

Could someone explain the "american meaning" of "liberal"?

[moz]

Originally Posted by Nate the great

I find it interesting how many things are considered to be a "fundamental human right" that no government would have dreamed of funding 100 years ago.

You mean like the UK outlawing slavery in 1957 and the Australians recognising aborigines as human beings in 1968? Plus la change, old chap. Oddly, women having the vote is not much over 100 years old, despite them paying taxes even in the US for more than 200 years. I think the Australians really should have changed in 1946, on the centenary of New Zealand doing the same thing. Just to make a point, you know.

There are more cultural similarities between the US and UK than differences, especially as seen from anglonesia. A lot flows from the nature of empire, both countries having a long-time habit of exporting their attitudes. I mean, we get TV and movies from both places and they're depressingly similar, as is the bought media. Then there's the "separated by a common language" thing and oddities like the US still using imperial measurements while the UK has switched to the French system. What's with the imperial units - do you just like the name? It's not as if you even *have* a king to base your measurements on.

[Ea]

Originally Posted by tirsales

...
Could someone explain the "american meaning" of "liberal"?

I think it was me who brought it up. I am primarily thinking 'liberal' in a political sense, and I understand the American everyday usage of the word to refer to someone who is left-leaning, as in "bleeding-heart liberal", without being an outright "socialist".

In Europe (as far as I know) what we call 'liberal' politics, and consider right-wing politics, fits much better with what in America is called 'libertarian'.

In a non-political sense, I would say there are greater overlap between the European and American usage of 'liberal'

[HarryT]

The "Liberal Party" in the UK - now called the "Social Democrats" - is left-wing. In fact they are arguably further to the left in their politics than the labour party which is currently in power, and who are rather "middle of the road", politically speaking.

[Ea]

Originally Posted by HarryT

The "Liberal Party" in the UK - now called the "Social Democrats" - is left-wing. In fact they are arguably further to the left in their politics than the labour party which is currently in power, and who are rather "middle of the road", politically speaking.

Heh, that's the problem with saying anything general about Europe. We're not not homogenous enough. It's still my impression though that 'liberal' is most often referring to right-wing politics - what is your understanding of it if you look beyond Britain?

[HarryT]

Originally Posted by Ea

Heh, that's the problem with saying anything general about Europe. We're not not homogenous enough. It's still my impression though that 'liberal' is most often referring to right-wing politics - what is your understanding of it if you look beyond Britain?

I'm afraid that I honestly don't know enough about the political parties in other European countries to be able to usefully comment on them. I'd better leave that to people who are more knowledgeable than myself.

[tirsales]

"Out of the book" liberal has a strange meaning Wiki.
In my eyes a liberal state my only make laws that restrict freedom if the achieved result values (considerably) higher then the restriction. In effect this values *freedom* (and transparency) very high.