Pre-Existing Conditions

President Trump recently signed a variant of Obamacare into law. Despite being pretty consistent with the law it replaced, many articles (and many comments responding to those articles) have brought up all of the old debate topics that popped up when Obama signed the original massive healthcare bill.

One topic in particular that seems to consistently divide people is insurance coverage of pre-existing conditions. If someone wants to buy health insurance but already has a medical condition for which health insurance would help alleviate costs, some argue that it is cruel to deprive them of the opportunity. Who needs it more, after all?

Answering this concern is straightforward and simple, and it’s a good lesson in how to respond to fuzzy emotional complaints (which are a terrible grounding for law). There are straightforward economic reasons that it’s actually impossible for health insurance to cover pre-existing conditions.

By “insurance”, I am referring to a system in which a large number of people pay money in proportion to some risk they may incur into a fund and out of which fund a small percentage of those people may withdraw money should they realize the risk accidentally. Paying money “in proportion to risk” simply means that some people are more likely to incur whatever risk the insurance hedges against, and so pay extra as a result to balance the flow of money in and out of the fund. The reason the risk must be realized accidentally is to avoid fraud.

All insurance works this way. Millions of people pay a car insurance company to protect their cars. Younger drivers, elderly drivers, and drivers with a history of traffic violations all pay more. More expensive cars also end up costing more, regardless of who is driving them. Thankfully, most people don’t get into car accidents, and so most of the people paying into the system never get anything out of it but peace of mind (or, in some places, the ability to legally drive their car). If someone goes out and bashes their car with a baseball bat in order to obtain a new one from insurance, their insurance company will decline the request; fraud would ruin the system.

Now imagine if suddenly, car insurance companies were required to cover cars which are already damaged. If you don’t have car insurance and you get into an accident, the car insurance company under penalty of law cannot decline you as a client. Nor can they hold you as a client indefinitely; you can always leave an insurance contract after a period of time. What would this do to the system?

Well, no one would buy car insurance until they got into a car crash. Why pay for something that does absolutely nothing for you? But can you see what this does to the equation? If 1000 people each pay $100 into car insurance each year and only 10 get into a car crash (we’ll estimate $10,000 as an average cost of each accident), then you have 1000 x $100 = $100,000 coming into the fund and 10 x $10,000 = $100,000 going out.

But if car insurance can be purchased on the spot even after a car accident to cover the car accident, 990 of those people won’t be paying anything. Why would they! They could get the benefits of insurance any time they actually needed them. The new equation is 10 x $100 = $1000 coming into the fund and 10 x $10,000 = $100,000 going out. $99,000 short to cover the expenses. The insurance company would foot the bill and would close. No company could take $99 in loss for every $1 of income.

This same analysis applies to medical insurance. No one would purchase medical insurance until they had a condition if it covered “pre-existing conditions”. This means that the only people paying into the fund are those who need to withdraw from it. You can hopefully see where this is going: “buying insurance” would cost as much, if not more, than paying out-of-pocket for all medical costs.

“But wait”, I hear you say. “What if the government also forced everyone to buy insurance?” This is exactly what they’d need to do. But now you’ve got an even bigger problem. First, in the United States, it is simply unconstitutional for the government to force citizens to buy a product or service. The Supreme Court, sympathetic to Obama, knew this. That’s why, despite Obama selling his Obamacare plan as something that would not raise taxes, the Supreme Court was forced to say that it increased taxes. Without forcing citizens to pay into the system, it would collapse.

But this isn’t the only problem, and it’s the reason the system collapses everywhere it is tried.

The more that insurance covers, the more expensive it is. That seems pretty straightforward. But the more it covers, the more expensive it also makes the services it covers. When insurance is used exclusively to pay for a particular service – and no one ever needs to pay out-of-pocket for it – that service increases in price. There’s no competition or bartering going on. The insurance company can raise rates and there isn’t much you can do about it.

This leads to a single-payer sort of system, where insurance companies simply can’t keep up with the demands of the government and are eventually just made into a government bureaucracy of their own. This costs incredible amounts of money (as it automatically raises the costs of services without limit), and is unreliable over longer periods of time and over populations with varied wealth and medical needs.

Much of this is beyond the scope of the problems with single-payer health care, but you can see already how it is all tied together, one problem necessitating a solution which itself becomes a problem, etc. The point is, any insurance which purports to cover “pre-existing conditions” isn’t insurance. It’s just an extra cost and added hassle on your way to paying the full cost of whatever service you want.

American Vices

They say you can tell a lot about a person by seeing what he loves. I think you can tell a lot by what a person hates, too. And not the sort of obvious denunciation-laden hatred that you see at Westboro Baptist “Church” protests. The hatred I’m speaking of is a silent contempt so ingrained in the people who hold it that they don’t consciously think about it.

For instance, American Christians often hold contempt for ritual and tradition. Sometimes this is expressed outwardly, but often it can be seen more clearly in other ways. For example, churches often consider it “progress” to substitute hymns for more modern forms of music, regardless of the quality of content or form that the music takes. While you might overhear people whisper their contempt for those curmudgeons who stand in the way of progress, you’ll often just see it in the shallow theology of the members. Hymns are a very efficient way of sowing theological truths into congregants, and this is lost when they are replaced.

One particular example comes to mind above all others though: wearing formal clothing to church. Putting aside the obviously contemptible reasons to wear a suit and tie when going to church (to appear better than others, to show off, to imagine oneself as more spiritual for doing so), there aren’t too many good reasons to avoid dressing one’s best when attending church.

It is good to dress and look one’s best when attending a funeral, a wedding, or a job interview. You want to give a good impression, but you also have some reverence of the event (at least in the first two scenarios). You know in the back of your mind that these are important things, and you should act importantly, no matter what you feel. But Americans love what the deem authenticity – that situation where you do or say whatever you like without reservation. So when it comes to church, many American Christians think it is actually wrong to dress well. They won’t often say this verbatim (although I’ve heard it). Instead, they’ll treat it as a spiritual accomplishment to no longer be concerned with their own appearance.

For instance, you might hear something like: “I learned it didn’t matter if I was wearing a t-shirt and jeans or a suit. It’s not about the outward appearance, but about the heart.”

On the face of it, who could argue? Of course the clothing we wear doesn’t have a salutary effect on us. Of course the health of our souls is not dictated by our clothing selection. But there is a silent contempt here veiled in spiritual language. For instance, consider this: “I learned it didn’t matter if I told my children that I loved them or not. It’s not about the outward appearance, but about the heart”.

“Aha”, I hear you say. “That’s different. If you love your children, you’ll tell them. The inward has an effect on the outward.” To which I can only agree, and by agreeing, prove my own point. The clothing we wear reflects the seriousness of organized worship.

Someone told me – and I think he was serious – that it was impossible to really know what was meant by “dressing one’s best”. What qualified as “best”? The Sun King of France had something very different in mind than Charles Spurgeon, for instance. But the fact of the matter is that everyone has an idea of what is best in their particular context, else we couldn’t even talk about it. What is “best” might have some subjective variability, but what is “best” is still a superlative, and we can’t make any comparisons without it. If it is better to wear a suit and tie (if you have the means) than to wear underwear alone, the existence of the superlative is already implied.

At the end of the day, it is wiser to dress your best than to argue that it doesn’t matter what you wear. And it is wiser to know what you secretly despise than to find out by having it challenged by someone who doesn’t make the same assumptions about the world as you.

This could easily dovetail into the objective nature of beauty, but I think I’ll save that for another post.

A Citybuilder I’m Building

I absolutely love Caesar 3. It’s a city-building game set in ancient Rome and it was so good that the demo, despite being extremely limited, was something I played over and over as a kid. The graphical style, the music, and the essence itself of the game was practically magical.

Five years later I learned to program. Ten years after that, I started working on my own city builder, and that’s what this is. I call it “Rise of Man”, but that isn’t the first name it’s had and it may not be the last. The game is a city builder with a twist (every game these days needs a twist). In the case of this game, the twist is an epoch-spanning civilization-customizing experience.

Players begin with a band of nomadic hunter-gatherers wandering the world. As players build up their cities and focus on particular methods of getting food, travelling, developing tools, entertaining their citizens, and forming governments, those choices have long-term impacts that define the sort of civilization that will develop. A player that focuses on spearing shore fish, for instance, may soon develop fishing rafts. And fishing rafts, if focused on, may give rise to a Polynesian-style culture that travels from island to distant island. Or, a player may simply be satisfied with rudimentary shipbuilding, focusing instead on gathering and ultimately farming so that permanent settlements and colonies will be possible.

This is a big project. I don’t know if I’ll ever finish it, but the core of the engine is in place. Below are some of the preliminary screenshots.

Pristine. Simple. In need of human involvement.
A tent has been built! Civilization advances!
A few starting structures, including a village center, some roads, and some build sites.
The world map, being world map-y.

March 2017 Update

The end of February was a busy, busy time, and this blog was not the only thing I neglected to maintain. I took a very nice week off of work, but instead of spending the time working on projects, I spent most of it with my family. It was good.

At the moment, this blog is only one of several simultaneous demands I need to meet. I’m also working on two video game projects (one of which has its own blog I’ll link to soon in a full post), some home renovations, and some online content creation. This, on top of being a father, husband, and working full time. This isn’t to complain about any of those things, but to suggest that this blog might become a place for me to, beyond what I already use it for, serve as a way to document all of these other projects.

I’ll probably have some posts about the two game projects soon.

Misconception Monday – Forgiving the Unrepentant

Misconception Monday on a Tuesday? Blasphemy! It’s my own fault for having written the whole outline to an article yesterday morning but failing to remember it was just an outline after all, and not a full post, so that when I went to publish it last night, I was disappointed. Since I had the day off yesterday anyway, today is basically Monday. Choose for yourself which of those excuses you find more forceful.

Today, I want to look at forgiveness. And fittingly, a misconception about it. I’ve never written an article in the form of Aquinas’ Summa Theologiae, but this whole topic works very well with the format. (If you are unfamiliar with it and have trouble following it, here’s a primer.)

Can we grant full forgiveness to someone who doesn’t repent?

Objection 1. It seems that we can forgive without demanding repentance, because people do it all the time. It is seen as a righteous act.

Objection 2. You need to be able to forgive those who you can’t see again (e.g. who are dead), so we must be able to forgive without demanding repentance.

Objection 3. Forgiveness helps the person wronged so they don’t hold a grudge, so it seems we should forgive even without repentance.

Objection 4. Jesus Himself says “Father forgive them for they know not what they do.” So it seems we ought to forgive even without repentance.

On the contrary, God Himself demands repentance as a prerequisite for granting His forgiveness. “Unless you repent, you too will perish” (Luke 13:3)

I answer that there are multiple kinds of forgiveness. The sort of forgiveness which grants full restoration is called exoneration. This kind of forgiveness requires repentance. It simply cannot occur without both parties being fully involved, because it is a restoration of a relationship. A relationship cannot be restored if one party is unwilling to acknowledge a breach. At best, a relationship of this sort could be abusive.

It is also possible to ignore small offenses and especially those done unintentionally. A person can also have a forgiving attitude, such that at the moment of genuine repentance from the offending party, they are quick to genuinely forgive. This is how Christians ought to live. Dr. Stephen Marmer has a short presentation on Dennis Prager’s PragerU site that describes an approach consistent with ancient Judaism which breaks forgiveness into three types.

Since hatred can damage one’s own soul if directed at others (who are made in God’s image and thus His reflection), it is good to fight the temptation to hate those who do wrong to us. When evil is done to us, we deserve (through justice) some sort of restitution. However, giving up this demand and releasing the person who has wronged us from the responsibility of providing restitution can help us move past the wrong.

Reply to Objection 1. People who say they forgive those who don’t repent can’t possibly mean full forgiveness, but a lesser kind. They demonstrate a forgiving attitude, which is indeed righteous, and they are well-prepared to act rightly if repentance ever occurs. This is a way of loving one’s enemy, which is itself a righteous act.

Reply to Objection 2. The lesser sorts of forgiveness can be given to those who can’t receive full forgiveness (e.g. who are dead). Even if the person can never repent, they can be released of their duty to provide restitution and we can fight the urge to remember them with hatred.

Reply to Objection 3. Lesser forms of forgiveness and having a charitable attitude take the burden away from those who are wronged, even without repentance. But they aren’t full forgiveness. As has been discussed several times already in this article, there are many ways for the person wronged to avoid any further damage even if the other party refuses to repent.

Reply to Objection 4. Jesus also teaches that ““If your brother sins, rebuke him; and if he repents, forgive him.” Clearly, he can’t mean both things at the same time in the same way, since they contradict. Jesus in His teaching is perfectly consistent: full forgiveness requires repentance, because full forgiveness is restoration. Without repentance, restoration is one-sided and incomplete. Jesus on the cross isn’t giving a thorough lesson in how forgiveness and repentance works. He’s demonstrating His love for a fallen world and those who don’t realize the gravity of what they’ve done. He demonstrates His love, not a process for forgiveness that trumps His far more thorough teaching during His ministry.

We are reassured of this because His apostles don’t transform this declaration of love into a new teaching on forgiveness. For the rest of their writing in the New Testament, they always make repentance a prerequisite for forgiveness. If we took His declaration on the cross as His standard for forgiveness, we are left with some massive theological problems. We must deliberately disobey Him in regard to forgiveness and we must set ourselves up as more forgiving than God Himself, who does require repentance. In matters where we aren’t completely sure of one interpretation or another, it’s always best to err on the side of some small confusion than on the side of total exegetical chaos. Life is messy; we ought not make it incomprehensible from our efforts at cleaning up the mess.

See this article by Wintery Knight for more information. And go follow his blog!