Adam Shostack <adam@homeport.org> writes:
Many insurance companies with Mutual in their name (Liberty Mutual is large in the Northeastern US) get that from being founded as mutual insurance companies, where you pay to be part of the mutual insurance group, and when you get sick, injured, etc, the group pays money towords your treatment. I think it broke down with increases in mobility. They were implicitly based on reputation capital, and were not highly fraud resistant.
Adam's suggestion of a charity which only pays for the treatment of those who donate thus recreates an old system.
Saying that it would be a charity is just a statement of reality. There exist no methods to insure when there is a near certainty of a payout being required, as I think we all agree (Tim, Adam, Jon). To call it anything other than charity is misleading, so I am really just arguing for honesty in advertising. (Something socialists are not big on :-) An insurance company would probably find customers and hope to make a profit by offering a mutual fund, or charitable donation service. There would be an agreement as to who could claim, and what types of illness were covered, maximum payouts etc. Then the business would use the funds (minus it's profit margin) to pay for those treatments affordable within the current funds. This means that as funds may be limited that some people will go untreated, if their treatments are too expensive and funds are short. Efficient usage of funds is expected -- if it costs $1m to fix up some old guy to live for a couple more years as opposed to giving cheaper treatments to several younger people, well the old guy gets to die. This might seem heartless to socialist types, but this kind of decision gets made all the time by medics, who don't have unlimited funds even in socialist countries. In the UK some practices are funds holding, which means that they get to manage their own money, they get to decide which drugs to use, and who to give them to, and they get to use profits (or more correctly surplus government grants) in certain ways (equipment, etc). (Or they did, Labour were threatening to confiscate these surpluses). I talk to medics a bit, as I am into medical messaging security, and some of the people are bilingual medics and medical informatics people. Examples are drugs which are 3% more effective but cost 5x the price. These kinds of optimisation of available resources problems are all over the place in medicine, and doctors balance these within budgets. Another example is that doctors are able to tell smokers with lung cancer who refuse to stop smoking that they will not treat them. Or switch off life support machines if it looks pretty hopeless, and is costing a fortune to keep a half-alive person ticking over. The failure with mutual funds is that people will attempt to start donating once they realise they have some big medical bills coming (if only donators get payouts). To combat this the company might perhaps have a policy of not paying out within 5 years of the first donation. Then you'll have the counter attack of people re-selling proof of donation receipts. And then the company can counter that with a hash of DNA code mixed in to the donation receipt such that only with the patients consent can the receipt be used to link to him. The key point is the choice. Many companies, many choices, freedom to donate or not, or to stipulate terms of donation (eg., not to fund lung cancer treatment for smokers). It seems to me that people are on average more generous and charitable than socialists would have us believe also. For example a charity to support people who had no insurance, or hit the maximum payout on their insurance might get donations. Perhaps even enough donations that it would cover most cases. Adam -- Now officially an EAR violation... Have *you* exported RSA today? --> http://www.dcs.ex.ac.uk/~aba/rsa/ print pack"C*",split/\D+/,`echo "16iII*o\U@{$/=$z;[(pop,pop,unpack"H*",<> )]}\EsMsKsN0[lN*1lK[d2%Sa2/d0<X+d*lMLa^*lN%0]dsXx++lMlN/dsM0<J]dsJxp"|dc`