Serious Discussion Thread

[Oldandtired]

Not using talking points, exactly how will insurance costs go down...or even stay constant....if we elimintate pre-exisitng conditions.

It only works if you mandate everyone, no exceptions, has to buy health insurance. The idea is that the increased risk from elimination of Pre-Existing Conditions will be spread around to everyone. Because everyone now has health insurance, there will not be folks that are forced to welch on hospital bills, nor will there be medical related bankruptcy.

Part of that sounds reasonable on paper. Part of the reason costs for hospitals is so high is because a person without health insurance is basically a financial black hole for the hospital thanks to the vicious cycle that has developed. Costs increased to cover those that can't pay, meaning more can't pay, meaning costs increase and so on.

With everyone on insurance, theoretically everyone should be able to pay so you get the cycle back under control.

However, I'm against a mandate without a public option for those that can't afford insurance or can't get it through work. Following Katrina, my wife and I were part time employees (Visiting Assistant Professors) at a University. As part time employees, we didn't get health insurance and had to go out on the market on our own.

We were both 30, with no major health issues. We didn't drink, smoke, or do drugs. No STD's or bizarre health risking habits.

The insurance rates we got were ridiculous. I mean purely outrageous. COBRA was a joke and unaffordable on halftime pay. We sucked it up and bought insurance, but it was a major financial drain and the coverage was half of what we'd had as employees. As soon as we could switch to an employer based system we did. Our premiums and deductibles went down and our coverage and access to care increased.

In theory, with everyone on the market the plans and coverage should approach reasonable levels. In theory. I am very skeptical. I will probably not give up my employer based coverage until absolutely forced after my experience trying to "go it alone."

I am 100% in agreement with you. (Time to go kill myself)

But therefore, I see the PO as the only solution...and I am right now convinced that it will cost us an arm and a leg....but I am OK with it. Justr wish they would be honest and say it...so we can properly prepare for it.

I, for one, see no other choice but reform without the mandate, but with a public option...and, of course, eliminate the pre-existing clauses.

 

[Some Guy]

A point i'm not sure has been made too often on these boards is that the quality of the care provided nearly everywhere in the U.S. is top notch, and you simply can't provide a top notch service or good at a bargain basement price. Millions of dollars are invested into new drugs, therapies, procedures, tools, etc, all of which have led to much better life expectancies and quality of life, but you can't expect a company (or a government entity even) to not try to recoup their costs and turn a profit for developing cutting edge stuff.

In other words, when it comes to health care, there basically is no cheap option in America. Trying to provide top notch health care to people who simply can't afford to pay top notch prices (or even moderate prices) is proving to be a serious issue, and rightfully so. It would sort of be like trying to figure out a way to get everyone a BMW, Mercedes or Audi as their car when most people can't afford them.

From a purely economical standpoint, you simply can't add more people who can't pay their way to a system and expect the level of the product provided to the group to stay constant. Let's say you have a group of 10 people that all go out to dinner every week and they all get the same meal. 5 people can pay in $10 each, 3 pay in $20 each and 2 pay in $50 each. That's $210 total to spread among the 10 people, so each person can have a meal that costs $21. You can get a pretty damn good meal for $21. Add 10 more people to the group who can only pitch in $1 each and now you have $220 to spread amongst 20 people, which equates $11 each. You're going to have to accept a lower quality meal at that price.

The above principle would apply for health care as well. If you're going to add more people to a system that can't pay for it then the quality for everyone is going to have to go down sooner or later in some fashion. In my opinion, that's exactly what would happen with universal health care (and does happen with universal health care countries) here if we were to move toward that.

So, i think it's more beneficial for everyone if, rather than looking to change the system to fit those who can't pay in, we looked to see what could be done to get more people the ability to pay in.

 

[Oldandtired]

A point i'm not sure has been made too often on these boards is that the quality of the care provided nearly everywhere in the U.S. is top notch, and you simply can't provide a top notch service or good at a bargain basement price. Millions of dollars are invested into new drugs, therapies, procedures, tools, etc, all of which have led to much better life expectancies, but you can't expect a company to not try to recoup their costs to develop cutting edge stuff.

In other words, when it comes to health care, there basically is no cheap option. Trying to provide top notch health care to people who simply can't afford to pay top notch prices (or even moderate prices) is proving to be a serious issue, and rightfully so. It would sort of be like trying to figure out a way to get everyone a BMW, Mercedes or Audi as their car when most people can't afford them.

From a purely economical standpoint, you simply can't add more people to a system that can't pay their own way and expect the level of the product provided to the group to stay constant. Let's say you have a group of 10 people that all go out to dinner every week and they all get the same meal. 5 people can pay in $10 each, 3 pay in $20 each and 2 pay in $50 each. That's $210 total to spread among the 10 people, so each person can have a meal that costs $21. You can get a pretty damn good meal for $21. Add 10 more people to the group who can only pitch in $1 each and now you have $220 to spread amongst 20 people, which equates $11 each. You're going to have to accept a lower quality meal at that price.

The above principle would apply for health care as well. If you're going to add more people to a system that can't pay for it then the quality for everyone is going to have to go down sooner or later in some fashion. In my opinion, that's exactly what would happen with universal government health care (and does happen with universal health care countries) here if we were to move toward that.

So, i think it's more beneficial for everyone if, rather than looking to change the system to fit those who can't pay in, we looked to see what could be done to get more people the ability to pay in.

And what do we do with the 24 year old guy that survived lukemia as a child and was just iussued a notice from his parents policy that he is no longer considered a household memeber and therefore must get his own insurance policy?

TAHT is where I am having trouble from a moral standpoint.

 

[Dr.Traveler]

Not using talking points, exactly how will insurance costs go down...or even stay constant....if we elimintate pre-exisitng conditions.

It only works if you mandate everyone, no exceptions, has to buy health insurance. The idea is that the increased risk from elimination of Pre-Existing Conditions will be spread around to everyone. Because everyone now has health insurance, there will not be folks that are forced to welch on hospital bills, nor will there be medical related bankruptcy.

Part of that sounds reasonable on paper. Part of the reason costs for hospitals is so high is because a person without health insurance is basically a financial black hole for the hospital thanks to the vicious cycle that has developed. Costs increased to cover those that can't pay, meaning more can't pay, meaning costs increase and so on.

With everyone on insurance, theoretically everyone should be able to pay so you get the cycle back under control.

However, I'm against a mandate without a public option for those that can't afford insurance or can't get it through work. Following Katrina, my wife and I were part time employees (Visiting Assistant Professors) at a University. As part time employees, we didn't get health insurance and had to go out on the market on our own.

We were both 30, with no major health issues. We didn't drink, smoke, or do drugs. No STD's or bizarre health risking habits.

The insurance rates we got were ridiculous. I mean purely outrageous. COBRA was a joke and unaffordable on halftime pay. We sucked it up and bought insurance, but it was a major financial drain and the coverage was half of what we'd had as employees. As soon as we could switch to an employer based system we did. Our premiums and deductibles went down and our coverage and access to care increased.

In theory, with everyone on the market the plans and coverage should approach reasonable levels. In theory. I am very skeptical. I will probably not give up my employer based coverage until absolutely forced after my experience trying to "go it alone."

I am 100% in agreement with you. (Time to go kill myself)

But therefore, I see the PO as the only solution...and I am right now convinced that it will cost us an arm and a leg....but I am OK with it. Justr wish they would be honest and say it...so we can properly prepare for it.

I, for one, see no other choice but reform without the mandate, but with a public option...and, of course, eliminate the pre-existing clauses.

I think I agree. I am 100% against reform without the Public Option. I just do not believe it can work.

I have issues with the Public Option though. I would prefer very much that it was run at the State level, as the States have the best chance to be responsive to (and know) the citizen's need. That would also allow such a program to compensate for differing cost of living issues in differing regions.

I think that the best plan is to phase in the public option. Anyone without insurance is automatically enrolled. After that let people decide whether or not to opt in to the public option or stay with the Private. I do think that a Private industry option would survive, much like UPS and FedEx not only survive, but thrive, alongside the USPS.

 

[Dr.Traveler]

A point i'm not sure has been made too often on these boards is that the quality of the care provided nearly everywhere in the U.S. is top notch, and you simply can't provide a top notch service or good at a bargain basement price.

Actually, that's a good point I've been thinking about the last few weeks too. In my head I call it the "Star Trek Medicine vs. Battlefield Medicine" issue.

Everyone thinks they deserve Star Trek level medical care. That's access to all of the cutting edge medical procedures, products, and drugs no matter what the cost or availablity. Everyone knows this costs an arm and a leg, but when it is their life on the line, or the life of their relative, they insist they deserve it.

On the other hand, when asked to pay for someone else's care through taxes or increased premiums, people think that everyone else deserves "Battlefield Medicine." Namely you get an asprin, some pain killers, and we'll stitch up your holes and set your broken bones. Once you aren't in immediate danger of dying people think that their obligations to somebody else ends.

Morally, that doesn't wash. Because of that we're standing at the edge of an economic abyss.

 

[Some Guy]

And what do we do with the 24 year old guy that survived lukemia as a child and was just iussued a notice from his parents policy that he is no longer considered a household memeber and therefore must get his own insurance policy?

TAHT is where I am having trouble from a moral standpoint.

Who wouldn't have a moral quandary about that? I don't like the thought of that as well, but on the flip side, life isn't fair. I'm not trying to make an argument in this thread for or against the preexisting conditions stuff, mostly just reviewing the economics of the situation regarding the quality of care.

 

[Oldandtired]

And what do we do with the 24 year old guy that survived lukemia as a child and was just iussued a notice from his parents policy that he is no longer considered a household memeber and therefore must get his own insurance policy?

TAHT is where I am having trouble from a moral standpoint.

Who wouldn't have a moral quandary about that? I don't like the thought of that as well, but on the flip side, life isn't fair. I'm not trying to make an argument in this thread for or against the preexisting conditions stuff, mostly just reviewing the economics of the situation regarding the quality of care.

As I am.
From an economics standpoint, the only way to rid the system of pre existing condition dilemmas is a public option paid for by the taxpayer....and it will be very costly.....no doubt about it.....but for the life of me, I can not find any other solution that makes sense......with the exception of the madate to buy insurance.....but I can not see that ever making it past the first case brought up to the SCOTUS.

 

[Procrustes Stretched]

You seem to believe that the best solution is the one on the table...and maybe it is.....but I have yet to hear anyone tell the truth.

We will need a public option if we are going to eliminate pre existing condition clauses. It will cost the taxpayer more as eliminating pre existing conditions will increase the cost to care for all those insured..

And guess what....if congress was honest and admitted this and explained that this will be the only way we can ensure that a 24 year old who survived lukemia as a child will get inusred.....it will be very difficult for people to argue it.

But instead, they are saying it will cost less and debating the validity of that....and not addrerssing the truth...

Healthcare is expensive and cancer survivovors are getting fucked when they become adults.......lets see some Republican say "who cares" to THAT!

And yes...I am a conservative...but I am also a realist.....we need to do it right or not do it at all...and not doing it at all is not fair to that 24 year old cancer survivor....so we must fdo it right.

We need to know it will cost us a lot of money and come to terms with it...and start a PO.

The truth? Truth is what it is. I guess you are hearing spin, and lies, and misconceptions, and willful ignorance, deceit and deception...it's politics. It's about $$$$$$$ and power.

Your public option scenario is leaving out far too much to be tackled. There is the cost of the uninsured already. There is the larger pools of people to spread the costs/margins. There is more. A simplistic and marginally informed argument is what it amounts to.

We already pay the highest amount in dollars for health care. You are missing the forest for the trees.

You have ignored any and all links to informed and intelligent info posted. You have an opinion and no matter the facts---the truth, you will not be swayed.

At least that is how I read you.

Prove me wrong.

Prove you wrong?

How is this.

I have been against the reform that is being proposed from day 1. And then I decided to look into it on my own....

ANd I am a staunch conservative who is a realists and I recognize the need for reform, the need to eliminate pre existing clauses and the need for a public option.

And I havbe posted that several times.

No, I have not gone to your links...I have saved them and plan to address them all at one....when I have the time.

Sorry Dante....you seem to be clouded...I was asking legit questions so I can either confirm my new hypothesis, or debunk it.

You do not know when one is asking legit questions...maybe you should take a break from the "I am right, you are worng, I am smart, you are an idiot" faux debate forum.

I really was looking for answers......and I thought your thread was an opening to get them. Instead, you opted to recite and then insinuate.

Sorry to have bothered you....and if you have time...take a look at some of the other recent posts of mine.

nope. you are stuck. and that appears to be obvious to all except you.

all questions may be legitimate, but that doesn't make them all germane to the issue at hand.

you assume you have a new hypothesis. I assume others have went down that road and for whatever 'legit' reason, they have abandoned it.

you have mentioned a few times that you are conservative. I have no reason why you would, except that you are stuck with preconceived ideas on how people view and tackle subjects like health care. Saying you see the need for reform is like saying you see the sky is blue.

We are not representatives of parties or politicians, so I assumed you were speaking as a person, and not a label.

 

[Procrustes Stretched]

...

However, I'm against a mandate without a public option for those that can't afford insurance or can't get it through work. Following Katrina, my wife and I were part time employees (Visiting Assistant Professors) at a University. As part time employees, we didn't get health insurance and had to go out on the market on our own.

We were both 30, with no major health issues. We didn't drink, smoke, or do drugs. No STD's or bizarre health risking habits.

The insurance rates we got were ridiculous. I mean purely outrageous. COBRA was a joke and unaffordable on halftime pay. We sucked it up and bought insurance, but it was a major financial drain and the coverage was half of what we'd had as employees. As soon as we could switch to an employer based system we did. Our premiums and deductibles went down and our coverage and access to care increased.

In theory, with everyone on the market the plans and coverage should approach reasonable levels. In theory. I am very skeptical. I will probably not give up my employer based coverage until absolutely forced after my experience trying to "go it alone."

COBRA is a halfhearted attempt to address a huge flaw in the system we have. Sucks. Been there.

Public option and a mandate equal s sane approach, but political and financial interests will throw everything they have at it. Power and $$$$$$$ are at stake. Lots of both.

 

[Oldandtired]

The truth? Truth is what it is. I guess you are hearing spin, and lies, and misconceptions, and willful ignorance, deceit and deception...it's politics. It's about $$$$$$$ and power.

Your public option scenario is leaving out far too much to be tackled. There is the cost of the uninsured already. There is the larger pools of people to spread the costs/margins. There is more. A simplistic and marginally informed argument is what it amounts to.

We already pay the highest amount in dollars for health care. You are missing the forest for the trees.

You have ignored any and all links to informed and intelligent info posted. You have an opinion and no matter the facts---the truth, you will not be swayed.

At least that is how I read you.

Prove me wrong.

Prove you wrong?

How is this.

I have been against the reform that is being proposed from day 1. And then I decided to look into it on my own....

ANd I am a staunch conservative who is a realists and I recognize the need for reform, the need to eliminate pre existing clauses and the need for a public option.

And I havbe posted that several times.

No, I have not gone to your links...I have saved them and plan to address them all at one....when I have the time.

Sorry Dante....you seem to be clouded...I was asking legit questions so I can either confirm my new hypothesis, or debunk it.

You do not know when one is asking legit questions...maybe you should take a break from the "I am right, you are worng, I am smart, you are an idiot" faux debate forum.

I really was looking for answers......and I thought your thread was an opening to get them. Instead, you opted to recite and then insinuate.

Sorry to have bothered you....and if you have time...take a look at some of the other recent posts of mine.

nope. you are stuck. and that appears to be obvious to all except you.

all questions may be legitimate, but that doesn't make them all germane to the issue at hand.

you assume you have a new hypothesis. I assume others have went down that road and for whatever 'legit' reason, they have abandoned it.

you have mentioned a few times that you are conservative. I have no reason why you would, except that you are stuck with preconceived ideas on how people view and tackle subjects like health care. Saying you see the need for reform is like saying you see the sky is blue.

We are not representatives of parties or politicians, so I assumed you were speaking as a person, and not a label.

I mentioned I am a conservative as I wanted it to be understood that whereas I believe in smaller government, I do not see it possible as it pertains to healthcare.

But I am done with you Dante. You offered me great links and I thank you for them....but you are otherwise useless as it pertains to your own thinking...as is evident by your holier than thou attitude despite your being 100% wrong with your observation.

You, sir, do way too much assuming for someone who is obvisuly a poor judge of character.

I wish you luck in life....cause you are sure going to need it. You will be taken by every con man out there....and I have no doubt you already have been.

Cya.

 

[Procrustes Stretched]

I am 100% in agreement with you. (Time to go kill myself)

But therefore, I see the PO as the only solution...and I am right now convinced that it will cost us an arm and a leg....but I am OK with it. Justr wish they would be honest and say it...so we can properly prepare for it.

I, for one, see no other choice but reform without the mandate, but with a public option...and, of course, eliminate the pre-existing clauses.

there are estimates on the costs of a public option. maybe you don't like the answers out there? of course there is a short view of estimated costs and a long term one.

In the end we will save money. Everyone already get emergency care. Costs will go down eventually.

see the CBO and other links I posted. For somebody who claims to be seeking answers you appear at first glance to be woefully ignorant.

and please spare me the feigned offense. ignorance can be bliss, or so I've heard.

 

[Procrustes Stretched]

And what do we do with the 24 year old guy that survived lukemia as a child and was just iussued a notice from his parents policy that he is no longer considered a household memeber and therefore must get his own insurance policy?

TAHT is where I am having trouble from a moral standpoint.

A moral standpoint would be better made by declaring health care as a fundamental right, as many of the progressives and socialists do.

Your family case is disturbing, but public policy will not and should not be made based on your personal issue. Life is unfair.It sucks, but it's true. It may be time to check your conservative credentials (the ones you've brought into this discussion) at the door.

 

[Dr.Traveler]

As I am.
From an economics standpoint, the only way to rid the system of pre existing condition dilemmas is a public option paid for by the taxpayer....and it will be very costly.....no doubt about it.....but for the life of me, I can not find any other solution that makes sense......with the exception of the madate to buy insurance.....but I can not see that ever making it past the first case brought up to the SCOTUS.

That's where I am. I have no illusion about the cost of a public option or what it will mean for the average person.

At this point though, I just don't see any other option. Doing nothing means a lot of the forces that are pushing the actual COST of care up will continue, which will drive insurance costs up. That will drive more folks into the realm of the uninsured, and drive up costs more. That eventually ends wtih a disconnect, where nobody can afford anything but the most basic health care.

 

[Dr.Traveler]

...

However, I'm against a mandate without a public option for those that can't afford insurance or can't get it through work. Following Katrina, my wife and I were part time employees (Visiting Assistant Professors) at a University. As part time employees, we didn't get health insurance and had to go out on the market on our own.

We were both 30, with no major health issues. We didn't drink, smoke, or do drugs. No STD's or bizarre health risking habits.

The insurance rates we got were ridiculous. I mean purely outrageous. COBRA was a joke and unaffordable on halftime pay. We sucked it up and bought insurance, but it was a major financial drain and the coverage was half of what we'd had as employees. As soon as we could switch to an employer based system we did. Our premiums and deductibles went down and our coverage and access to care increased.

In theory, with everyone on the market the plans and coverage should approach reasonable levels. In theory. I am very skeptical. I will probably not give up my employer based coverage until absolutely forced after my experience trying to "go it alone."

COBRA is a halfhearted attempt to address a huge flaw in the system we have. Sucks. Been there.

Public option and a mandate equal s sane approach, but political and financial interests will throw everything they have at it. Power and $$$$$$$ are at stake. Lots of both.

That's why this failed in 1992 and why its on life support here. Truly innovating healthcare will put a lot of administrative types out of business and make a lot of wealthy folks much less wealthy.

 

[Procrustes Stretched]

I think I agree. I am 100% against reform without the Public Option. I just do not believe it can work.

I have issues with the Public Option though. I would prefer very much that it was run at the State level, as the States have the best chance to be responsive to (and know) the citizen's need. That would also allow such a program to compensate for differing cost of living issues in differing regions.

I think that the best plan is to phase in the public option. Anyone without insurance is automatically enrolled. After that let people decide whether or not to opt in to the public option or stay with the Private. I do think that a Private industry option would survive, much like UPS and FedEx not only survive, but thrive, alongside the USPS.

State level? Block grants?

and there are people who say a private for profit industry will coexist alongside public insurance, It does in other countries---countries that look like Capitalist Democracies.

FRONTLINE: sick around the world: five capitalist democracies & how they do it | PBS

 

[Some Guy]

That's where I am. I have no illusion about the cost of a public option or what it will mean for the average person.

At this point though, I just don't see any other option. Doing nothing means a lot of the forces that are pushing the actual COST of care up will continue, which will drive insurance costs up. That will drive more folks into the realm of the uninsured, and drive up costs more. That eventually ends wtih a disconnect, where nobody can afford anything but the most basic health care.

Right. You can't drive down the costs of health insurance without driving down the costs of providing health care. IMO, there's a few ways to do that though maybe still not enough for some people.

 

[Oldandtired]

As I am.
From an economics standpoint, the only way to rid the system of pre existing condition dilemmas is a public option paid for by the taxpayer....and it will be very costly.....no doubt about it.....but for the life of me, I can not find any other solution that makes sense......with the exception of the madate to buy insurance.....but I can not see that ever making it past the first case brought up to the SCOTUS.

That's where I am. I have no illusion about the cost of a public option or what it will mean for the average person.

At this point though, I just don't see any other option. Doing nothing means a lot of the forces that are pushing the actual COST of care up will continue, which will drive insurance costs up. That will drive more folks into the realm of the uninsured, and drive up costs more. That eventually ends wtih a disconnect, where nobody can afford anything but the most basic health care.

Personally, I am sick of the "cost" debate. That is not the issue as once we eliminate PE clauses, costs are going to skyrocket....and we will long for the days of 7K policies.....but I am OK with that.
The real debate is how to achieve not punishing those with pre-existing conditions.

 

[Procrustes Stretched]

A point i'm not sure has been made too often on these boards is that the quality of the care provided nearly everywhere in the U.S. is top notch, and you simply can't provide a top notch service or good at a bargain basement price.

Nobody of any importance that I know of has argued for bargain basement pricing.

Top Notch Care is NOT available all over America. That is a myth.

and health insurance is not research and development of medicine. It is a vehicle for cost coverage and profit.

Actually, that's a good point I've been thinking about the last few weeks too. In my head I call it the "Star Trek Medicine vs. Battlefield Medicine" issue.

Everyone thinks they deserve Star Trek level medical care. That's access to all of the cutting edge medical procedures, products, and drugs no matter what the cost or availablity. Everyone knows this costs an arm and a leg, but when it is their life on the line, or the life of their relative, they insist they deserve it.

On the other hand, when asked to pay for someone else's care through taxes or increased premiums, people think that everyone else deserves "Battlefield Medicine." Namely you get an asprin, some pain killers, and we'll stitch up your holes and set your broken bones. Once you aren't in immediate danger of dying people think that their obligations to somebody else ends.

Morally, that doesn't wash. Because of that we're standing at the edge of an economic abyss.

It's not a good point. It's close to a red herring.

The economic abyss argument is usually put aside for defense related projects, yet in debates about life/health it appears to rear it's ugly head.

 

[Dr.Traveler]

I think I agree. I am 100% against reform without the Public Option. I just do not believe it can work.

I have issues with the Public Option though. I would prefer very much that it was run at the State level, as the States have the best chance to be responsive to (and know) the citizen's need. That would also allow such a program to compensate for differing cost of living issues in differing regions.

I think that the best plan is to phase in the public option. Anyone without insurance is automatically enrolled. After that let people decide whether or not to opt in to the public option or stay with the Private. I do think that a Private industry option would survive, much like UPS and FedEx not only survive, but thrive, alongside the USPS.

State level? Block grants?

and there are people who say a private for profit industry will coexist alongside public insurance, It does in other countries---countries that look like Capitalist Democracies.

FRONTLINE: sick around the world: five capitalist democracies & how they do it | PBS

There are a lot of "OMG END OF THE WORLD!!!" types when it comes to the fate of the Private insurance industry.

What folks don't realize is that a lot of the actuaries, claims adjusters, and other administrative types will just move from private industry to the government payroll should the Private industry have to downsize.

Plus, as long as Private insurance isn't made illegal, there's still going to be folks who opt for that so that they'll have greater freedom of choice on treatment and doctors than a public option is likely to give. I know I won't just run and jump into the Public Option, at least as long as I can get insurance through my employer.

I think block grants at the state level might be the best way to do things though. You risk duplication of some of the beauracracy across the 50 states, but again, each state knows pretty well the living conditions and health issues that their citizen is facing. That kind of local knowledge is likely to save money in the long run.

 

[Some Guy]

The real debate is how to achieve not punishing those with pre-existing conditions.

I don't think you can't. Look at any other insurance industries and the risk of payout directly affects the premium. Someone who gets in lots of car accidents will have to pay more for car insurance. Someone who's in bad health or very old will have to pay more for life insurance. The higher the probability one will draw more from the system than they pay in, the higher the premium.

Take the profit element out and put everyone in the same system and you're still going to have to pay for those who draw more out than they put in.