[enoch_r]

> It's functionally isomorphic to a black box where I make a deposit, every time it denies someone medical treatment I get back monetary reward and I can withdraw my deposit at any time. If we ask ourselves, "Should this black box exist?" I cannot reasonably expect people to say, "Yes." Yet, here we are.

I am honestly extremely baffled about what your mental model here is. When UHC doesn't deny a claim, who is paying for that treatment? You can't just look at one side of the ledger when deciding whether the system is doing good or bad! They deny some claims and they pay for others! You're leaving out the whole second half!

[kelseyfrog]

I omitted it because it doesn't change the calculus.

    If the child were brought up into the sunlight out of that vile place, if it were cleaned and fed and comforted, that would be a good thing, indeed; but if it were done, in that day and hour all the prosperity and beauty and delight of Omelas would wither and be destroyed.

[kube-system]

According to who? It changes the calculus for me. I pay my health insurance because it covers the services I need. I could absolutely opt out if I wanted to, but I don't.

[enoch_r]

Look, in any system, there are going to have to be arguments where patients or doctors say some treatment is necessary, and the entity paying for the treatment says it's not.

For example, in Canada, the Ontario government refused to cover a cancer treatment that her doctors said could extend her life by a year or more: https://globalnews.ca/news/927721/milton-mother-devastated-a...

In the UK, two Cystic Fibrosis drugs were rejected for not being cost-effective even though they were clinically effective.

https://www.cysticfibrosis.org.uk/news/nice-rejects-orkambi

https://www.fiercepharma.com/pharma/nices-trikafta-snub-coul...

You will of course stick to your principles here? The single-payer healthcare systems in Canada and the UK are irredeemable and it's morally repugnant to look at any good they've done for anyone?

[salawat]

>in that day and hour all the prosperity and beauty and delight of Omelas would wither and be destroyed.

...and nothing of positive value would be lost. For a paradise predisposed on the infliction of suffering on another is ill-gotten, and taints anyone that avails themselves of it once it's true nature is known.

Our birthright is to toil to elevate one another; no more, no less. Omelas is a blight, a perversion, deserving of being scoured from the face of the Earth no matter where it pops up.

Glad to see someone else was touched by that work. Greetings fellow wanderer.