Life’s Not Fair, But We Can Still Strive for Fairness: The Idea of Good-Luck Insurance

The fact that life isn’t fair is usually offered to victims as an alternative to despair (or maybe revenge), but I think this is short-sighted. A much better way to use it, in my opinion, is to let it inspire us toward behaving fairly. The fundamental unfairness of Life is — or could be — a principle axiom of personal ethics.

“Why should we strive for ethical excellence?”, some unscrupulous cynic may ask. Because Life is unfair, I say! To the extent that Life is not fair, we should do what we can to make it as fair as we can make it.

Now, when we think of examples of Life’s unfairness, we often think of unhappy examples — being born with a crack addiction, or with your intestine’s on the outside of your body, or with cancer (can you tell that the mother of my children is a NICU nurse?). But that is just half of the story, really. Life is every bit as full of happy examples: being born to wealthy parents, or surviving a cancerous tumor, or guessing the winning numbers in a large-payout lottery (arguably an unhappy example, since many such winners lack the financial expertise for managing the prize, wind up blowing the whole jackpot within a year or two, and many even accumulate an overwhelming mountain of debt in the process).

And in the same way that we have invented insurance to mitigate the risks of unhappy examples, I’m thinking it might be good to invent a different kind of insurance to mitigate the risks of the happy examples too. We might call it something like Good-Luck Insurance.

The basic idea here is that a subscriber or customer would receive a regular stream of payments — we might call them anti-premiums, because they flow toward the customer instead of toward the insurer — and in exchange, whenever he or she got especially lucky in some way (as defined by the policy), then he or she would have to give back to the insurer some portion of the “prize”.

So, for example, let’s say I “bought” a surgery policy. Once “purchased”, I would immediately begin receiving monthly anti-premiums, which I could then spend on anything I wanted (food, clothing, shelter, leisure, etc.) But if I ever survived any kind of surgery, I would have to pay back to the insurer some portion of the premiums I had received over the years. On the other hand, if I never even had surgery, I would just keep all those premiums!

Now, you might think this is basically what Communism is all about (or is it Socialism, I know there’s supposed to be a difference, but I’m not at all clear on what it is — feel free to explain it to me in a comment below!), but there’s really a huge and critical difference, which is that Communism (Socialism?) is imposed on all citizens, whereas good-luck insurance is strictly voluntary. Nobody would be obliged to purchase a policy, and you would only purchase the particular coverage you wanted.

I think one great benefit of such an insurance product is that it would be yet another means by which we could all choose to strive for fairness in the context of an unfair Life. Given that Life is as unfair as it is, I’m thinking we need all the help we can get.

That’s the basic idea of Good-Luck insurance. Please let me know what you think in the comments!

We Need To Stop Calling Them “Invisible” Disabilities

I’ve noticed that it’s common to say things like “he has a so-called ‘invisible’ disability” with the scare quotes around disability and the phrase so-called as a qualifier. I’m assuming this is done to signal the speaker or writer’s understanding that there’s really nothing about an actual disability that is invisible, especially to the person struggling to cope with it.

But I think we need to up our game a bit with this business of disclaiming the idea that a disability can be invisible. I’m thinking we need to either quit using the expression at all, or brazenly interrupt the conversation in order to pontificate on the real problem, which is that the person with the disability is being judged as unreliable in some sense.

To my view, the problem with this class of disabilities is not at all that they are invisible in some way, but that they are mostly visible to just one person, and that person is just assumed for some reason to be an unreliable witness. The issue at hand is one of patient credibility, not disability “invisibility”.

Now, this is actually not to say that all patients should be simply believed without question. I could say a lot more about that and plan to in a future post, but for now I’ll just clarify that what I’m mainly asserting in this post is that if the problem of these so-called “invisible” disabilities is ever to be solved, it must first be properly understood, and in this case that means recognizing that the core issue is really one of witness credibility or reliability.

As I see it — for now, and until I encounter the sort of evidence that might help me change my mind — the “invisibility” thing is just a distraction.

A Better Way To Handle The Malingering Problem

Here are my current thoughts on what I see as a much better way to at least handle the malingering problem. I wish I could say I think it could solve it entirely, but that’s probably not realistic. People are people, and some people seem utterly incorrigible. But even if the following cannot totally solve the malingering problem, the basic gist strikes me as quite promising, and at the very least I think that pondering this sort of approach out in the open could be productive and eventually lead to whatever the best solution(s) may be. Anyway, here’s what I’m thinking:

  1. Insurance companies should not be allowed to make any of their own claim payment decisions. That is just asking for trouble. Their job is just to design and sell policies, collect claims, etc.
  2. The decision to pay or deny claims should be made by a neutral party, whose job it is to collect the relevant information and make the decision.
  3. Doctors should have the right to prescribe a medical leave, and given such a prescription, the initial, default decision should be to pay the fucking claim. This is totally consistent with the core principle of our Justice system to assume innocence and demand proof of guilt. It is also consistent with the way FMLA claims are processed, where’s it is primarily the doctor who decides.
  4. The doctors should be held accountable for their decisions with random audits, and if the auditors discover evidence of fraud on the part of either the doctor or the patient, that evidence should be brought to the appropriate investigative authorities.
  5. If insurance companies and investors don’t like the profits they can make under this system, they should go into a different line of business. This will motivate the establishment and development of suitable non-profit alternatives.

Aside from putting a lot more power in the hands of doctors to provide the kind of care their patients need, it will also reduce the risk of “fox” bias in the decisions regarding which “chickens to eat”. It will also lower the risk of accidentally punishing an honestly but “invisibly” disabled person for being punished for the fraudulent behavior of others.

I’m sure that a lot more could be said about the above, but I think that’s a good place to start.