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I don't know if America's "size" is really used as an argument against single-payer working here but if it is, I'm sure what is meant is population size. What's

by extra88 10y ago

I don't know if America's "size" is really used as an argument against single-payer working here but if it is, I'm sure what is meant is population size. What's an example of referencing a country's large size meaning more diverse or heterogeneous rather than greater population? But I agree that "size" in this case definitely does not mean geographic size. Geographic size might be a factor for why America doesn't have better telecommunications or rail system, not health care.

extra88 10y ago
I'll walk that last part back a bit, geographic size, and having sparsely populated areas, can make providing health care for all more difficult and therefore more costly. But I think it would be a very minor factor and Australia serves as a good example of that, it has a much smaller population but some of it is comparably far-flung.
bmelton 10y ago
I agreed with, and upvoted your answer, but upon reflection, so long as insurance policies in America are still constrained by state borders, there might well be a (fairly arbitrary) hurdle on risk pools. States with more and a higher concentration of population centers may benefit from a more diverse risk pool than states that look more like Alaska.
- extra88 10y ago
  Trump and some Republicans have argued for allowing selling policies across state lines but I think more knowledgable people have said it would not make a significant difference in health care costs and poses some race-to-the-bottom risks. I think most insurance providers are multi-state entities so higher costs in one state can be balanced by lower costs in others. But there may be some limits; if the ACA requirement that insurers use 80% of revenue on health care costs is applied per-state, they may not be able balance out a really unhealthy state. But this isn't an issue due to America's geographic or population size or even the quantity of states, it's that America has much more political power at the state level.

by extra88 10y ago

extra88 10y ago

I'll walk that last part back a bit, geographic size, and having sparsely populated areas, can make providing health care for all more difficult and therefore more costly. But I think it would be a very minor factor and Australia serves as a good example of that, it has a much smaller population but some of it is comparably far-flung.

bmelton 10y ago

I agreed with, and upvoted your answer, but upon reflection, so long as insurance policies in America are still constrained by state borders, there might well be a (fairly arbitrary) hurdle on risk pools. States with more and a higher concentration of population centers may benefit from a more diverse risk pool than states that look more like Alaska.

extra88 10y ago
Trump and some Republicans have argued for allowing selling policies across state lines but I think more knowledgable people have said it would not make a significant difference in health care costs and poses some race-to-the-bottom risks. I think most insurance providers are multi-state entities so higher costs in one state can be balanced by lower costs in others. But there may be some limits; if the ACA requirement that insurers use 80% of revenue on health care costs is applied per-state, they may not be able balance out a really unhealthy state. But this isn't an issue due to America's geographic or population size or even the quantity of states, it's that America has much more political power at the state level.