Posts Tagged ‘philosophy’

Two of the central planks of the Patient Protection and Affordable Care Act (PPACA) go by the names of ‘guaranteed issue’ and ‘community rating’. According to guaranteed issue, no health insurance company is permitted to deny someone coverage based upon a pre-existing condition. According to community rating, insurance companies must offer the same policies to everyone for the same price. The idea is that health status is largely something beyond anyone’s control, and so it is unfair for those who, through no fault of their own, suffer ill health to have to pay a price for it. Whatever you think of the merits of these ideas, they’re embedded (in spirit, despite lots of exceptions) in the PPACA.

The worry, in theory, is that many people will wait till they develop a pre-existing condition to get coverage, saving premium expenses in the meantime. The reason is if they do so, they will not have to worry about being denied coverage because of guaranteed issue, and they will pay the same price then whether they buy it now or not. If people in fact do this, insurance companies will only have relatively sick people on their rolls, forcing them to raise premiums to cover the cost of their claims. Higher premiums, in turn, will encourage the relatively healthy among the insured to forgo insurance, rendering the pool still sicker, driving up premiums more. And so on and so forth.

This problem is known as ‘adverse selection’. The ultimate outcome, in principle, is that the price of insurance will spiral upwards until it is no longer a profitable business, causing a disappearance of the market. This has not happened in any of the states that have guaranteed issue and community rating policies, but it has been shown that their premiums rise faster than in states without those policies. What we can expect, then, is that they will quickly and sharply drive up the cost of health insurance.

The purpose of requiring everyone to buy health insurance is to prevent this spiral from getting off the ground. If everyone has insurance, no one can forgo it until they get sick, making adverse selection a non-issue. Arguably, there are other reasons to be wary of such a mandate, but most experts agree it is essential if community rating and guaranteed issue are to work without causing premiums to explode. If the Supreme Court rules the mandate unconstitutional, leaving these other pieces in place, the PPACA is going to cause a lot of problems no one particularly intended.This is why they may choose to eliminate guaranteed issue and community rating, too, in which case the core of the bill will be withdrawn.

I’m not a lawyer, but for what it’s worth, the mandate isn’t that big a deal. Suppose that the government decided to tax every citizen, to pay for a ‘motherhood and apple pie fund’. They then also decide that they’re going to cut a check of the same size to everyone who has health insurance. Nobody would dispute the constitutionality of either of those measures in the slightest, and yet together they amount to a fine for those who do not have health insurance. The only difference is that this is called a ‘tax’, while the mandate’s fee is a ‘penalty’. Note that the penalty is collected by the IRS, and you cannot go to jail for refusing to pay it. Sounds like a distinction without a difference to me.

Legal opponents raise the question of what limits there are on the government if it can require you to buy something. This, to me, is pretty silly. It isn’t requiring you to do anything. It’s just using the word ‘require’ to stigmatize those who choose not to get health insurance, making them feel like outlaws. It also asks them to pay a fine for doing so. The government isn’t coming into anyone’s home, insisting that they buy health insurance at the point of a gun. They’re just making your life a bit more difficult if you don’t get health insurance. Welcome to society. Sometimes the government has to make certain things more of a headache for the sake of promoting the general welfare. PPACA may or may not promote the general welfare, but saying that the government can’t give you a headache for making certain decisions is to say that the government cannot affirmatively try to solve any social problems at all. If you don’t like the PPACA, try to elect some folks who will get rid of it. Don’t try to make it impossible for the government to solve large social problems going forward.

Advertisements

The new riddle of induction

Posted: February 10, 2012 by alephnaughty in Philosophy, Science
Tags: , , ,

Suppose every blueberry you’ve observed to date has been blue. You take this to be evidence for:

(H1) All blueberries are blue.

As a consequence, you predict:

(P1) The first blueberry I observe on February 11, 2012 will be blue.

Now, define “bleen” to mean “blue until February 10, 2012–green thereafter”. By this definition, every blueberry you’ve observed to date has been bleen. You take this to be evidence for:

(H2) All blueberries are bleen.

As a consequence, you predict:

(P2) The first blueberry I observe on February 11, 2012 will be bleen.

A blueberry that will be bleen on February 11, 2012, though, will be green–not blue. Thus, (P2) flatly contradicts (P1). Is there any evidence that favors (H1) over (H2)? We might complain that (H2) is couched in terms of a derivative property–“bleen” is defined in terms of “blue” and “green”. We might take this observation to favor (H1), and therefore (P1).

But define “grue” to mean “green until February 10, 2012–blue thereafter”. Imagine a culture that only understands “bleen” and “grue”–not “green” and “blue”. To them, “green” means “grue until February 10, 2012–bleen thereafter”, while “blue” means “bleen until February 10, 2012–grue thereafter”. Their complaint about (H1) is that it is couched in terms of a derivative property–“blue” is defined in terms of “bleen” and “grue”. They take this observation to favor (H2), and therefore (P2). Could we really be right, and they really be wrong?

What else could favor (H1) over (H2)? If nothing, isn’t this a problem for every hypothesis of the form “All X are Y”? And don’t we (implicitly) make predictions founded upon such hypotheses in our everyday reasoning? Doesn’t this problem undermine the very way in which we learn from our observations and experiences?

The problem of the broken clock

Posted: February 9, 2012 by alephnaughty in Philosophy
Tags: , , ,

Sorry, I’m in a philosophical mood today. Deal with it.

Suppose you have a clock that has never failed you during the many years that you’ve had it. You look at the clock, which reads 5:00 pm. As a result, you come to believe that it is indeed 5:00 pm. And you’re right–it is 5:00 pm.

Now suppose that one hour passes. You look at the clock once more, which still reads 5:00 pm. Of course, it is now in fact 6:00 pm. It seems that your clock is broken.

According to Plato, knowledge is justified, true belief. On the one hand, one hour earlier you believed that it was 5:00 pm. You were justified in believing that it was 5:00 pm, for your hitherto reliable clock said so. And the time really was 5:00 pm. You had a justified, true belief that it was 5:00 pm. On the other hand, if the time had really been, say, 2:30 pm, you would have nevertheless believed it was 5:00 pm. And you would have been wrong.

So… did you know it was 5:00 pm? Or is Plato missing something?

What makes something a cloud?

Posted: February 9, 2012 by alephnaughty in Philosophy
Tags: ,

When you observe a cloud in the sky, it certainly seems like you’re observing one thing–namely, the cloud. And yet, if you were to zoom in on it, you might not even notice the cloud. Instead you’d see lots of individual water droplets, some closer to the center of the cloud, some further away. If you look at the edges of the cloud, the water droplets are so spread out that some of them probably are not even part of the cloud in any meaningful sense. And yet there is no hard and fast point at which we’d say this droplet is part of the cloud–that one next to it is not. As a result, there are many groups of water droplets that have just as much claim to being that cloud as any other group of water droplets. It would seem, then, that there are many clouds. And yet it also seems that there is just one. What makes one group of water droplets qualify as that cloud, rather than another? Or is there no cloud at all?

Suppose I have two containers, both full of (what I believe to be) a single fluid. Each container’s volume is 500 mL. I then empty the contents of the two containers into a third, the volume of which is 1000 mL. To my surprise, the container is only 75% full–it holds just 750 mL of the fluid. How should I revise my beliefs in light of this discovery?

Among my presumptions was that volume is additive when mixing a single fluid. One conclusion that suggests itself is that the two containers in fact contained different fluids. Another is that volume is not necessarily additive.

A third conclusion, however, does not suggest itself: 500 + 500 = 750. Why not? What is it about 500 + 500 = 1000 that justifies my willingness to concede that the fluids were different, or that volume is not necessarily additive, but not that 500 + 500 = 750? The surprising outcome of my experiment shows that at least one of my presumptions is incorrect, but it does not indicate which. What is it about this experiment that prevents it from lending support to the hypothesis that 500 + 500 = 750?