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Notes -
Some quick hits:
A) Cremieux argues that much of the gap in life expectancy between America and Europe is due to obesity. But America is good at one thing at least – spending money on health care. Combine high spending with effective weight loss drugs, and the U.S. is on track to significantly narrow its life expectancy gap with Europe.
Self-driving cars will close the gap further.
B) Drug overdose deaths are down in King County (Seattle area) this year after more the tripling between 2019–2023. This is probably because fentanyl has already killed a significant percentage of the junky population. There has also been some modest progress in cracking down on open air drug markets. In the last 2 years, about 1 in 1000 King County residents died of a drug overdose.
C) Health insurance companies have a terrible reputation. But it's hard to fix. It's a viscious cycle which goes something like this:
Company has bad reputation
Due to bad reputation, the company has trouble getting talent, so they compensate by paying a lot
This selects for people who care more about money than reputation
Money-grubbing behavior leads to bad reputation
If you were next in line at United Health, how would you fix the problem?
Note: Many societies in the past (India, Japan) created special undercastes to do necessary but unsavory work such as working with dead bodies. Should we do likewise and create a special caste of health insurance workers that are not allowed to work in other fields and we can treat like shit with impunity? Reddit probably thinks so.
D) Epistemic status: uncertain.
Many people in the China tariff post said that China is "not expansionist".
But what is today China was, 2500 years ago, just a small collection of states along the Yellow River. Gradually, over the millenia, they absorbed more and more territory into their country.
It's as if the Roman Empire still existed today and controlled all of Europe.
Genetically speaking, the Han people seem to have done much better than Rome. The Romans, the people who lived in the city of Rome circa 500 BC, essentially all died out. For centuries, Rome's population could only be sustained from continual influxes of people from the countryside, and later, far flung areas of the Roman sphere. This doesn't seem to be the case in China. Even today, there are people who can trace direct male lineage to Confucius who lived around 500 BC.
If I'm in a car accident, my auto insurance company pretty much just pays for my accident (or at least that was my limited experience and the experience of others I know). There are occasional disputes about the amounts and autobody companies do have to deal with those disputes, but I am not aware of any auto insurance companies that attempt to just delay approval of repairs until their customers give up or die. In principle, it seems like they could do that - the insured party may decide they can't afford to wait and argue, they just need their car fixed, and then the insurance company can refuse to pay. I'm sure that does happen from time-to-time, but it doesn't really seem like a going concern.
My infinitely naïve solution is to just offer insurance products that you intend to actually make good on rather than deceiving people into believing they're covered in order to create additional profit margins. I'm sure many people would still be bitter about actual facts, but it seems clear that health insurance companies aren't simply dealing with cold actuarial facts and communicating costs clearly, they're lying to people, they're fighting legitimate medical care, and they profit from figuring out ways to legally avoid paying for treatment.
Car insurance is actual insurance; health insurance is by and large prepayment.
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