7 ms·

Easy access to insurance that isn't provided by an employer is important for entrepreneurship, but if by "proper universal healthcare" you mean single-payer ins

by natrius 16y ago

Easy access to insurance that isn't provided by an employer is important for entrepreneurship, but if by "proper universal healthcare" you mean single-payer insurance, I disagree. The individual insurance market sucks in America because of preexisting conditions and the higher taxes on individual insurance than on employer-provided insurance. The former is getting fixed. I'm not sure if the latter actually made it into the final bill, but I don't think it did, and that's a shame. Beyond that, the only advantage single-payer systems have is the lower prices that result from wielding monopsony power. I don't think it's possible to maintain the quality and pace of improvement of health care when people are funding it less than they would be willing to. Health care is expensive because we value it so much that we throw tons of money at it. People try to provide better care in order to get some of that money, and if you take some of the money away, there will be less people advancing the industry, which isn't what people want.

onoj 16y ago
Having lived in two countries that have free public health care at a good level, I can say that starting my own business is much more relaxing in that environment. I would not dream of doing the same in the USA at my age or family situation.
- natrius 16y ago
  Of course it's more relaxing. You don't have to worry about researching your insurance options because the choice has already made for you. I don't think "more relaxing" is a very compelling reason to choose a policy on its own, especially when the cost of that relaxation is a slowed pace of advancement in medicine. If the U.S. government stops incentivizing the connection between employment and insurance, starting a company wouldn't need to have any effect on your health care. No single-payer system required.
  - pierrefar 16y ago
    I'm starting in the UK and I'm more relaxed because I don't have to worry about health care - I'm covered come rain or shine. I'm not relaxed because of avoiding researching options. Also, you assume a slow in advancement in medicine. This can't be further from the truth. Small example: all of the patients registered in the UK (i.e. residents) are getting digital patient records.
    - natrius 16y ago
      I don't assume a slower localized advancement in medicine. There is a global market for medical technology, and it will be sold wherever it is profitable enough to do so. The fact remains: the further the price of health care is forced down by insurers who comprise the bulk of their respective insurance markets (usually governments), the less money will be available to incentivize people to produce medical technology. Americans will be covered rain or shine once the healthcare reform bill kicks in. If you can afford it, you have to by insurance. If you can't, it will be subsidized so you can afford it. That's the goal, anyway. Markets require choice to function properly. I think the American approach is less likely to result in unintended consequences.
rortian 16y ago
Just show me where the US excels, especially on per dollar terms, on health care on any metric relative to any other modern industrial economy. We spend more on health care in large part because we have way too much surgery going on. There's other stuff going on too, but there's a lot of waste to go with us 'valu[ing] it so much'.
- natrius 16y ago
  I don't think per-dollar outcomes are a good metric to optimize for. That will get you high quality care at low prices today, but the future quality of health care will be lower than it would've been otherwise. If there's too much surgery going on, that can be fixed without a single-payer system. My point about the value we place on health care is that even if we fixed all the problems with health care in America, we'd end up paying more than countries with single-payer systems because those systems force the price down below what people would be willing to pay on their own. That is a bad thing.
  - rortian 16y ago
    >because those systems force the price down below what people would be willing to pay on their own This is very far from the truth. Worry not, rich people can spend to their hearts content in single payer countries. They still spend less and have better outcomes. In the abstract maybe we do want to spend a lot of money for health care. However, medical costs have been growing at double digit rates. Hopefully that pattern does not continue for too much longer.
    - natrius 16y ago
      Yes, I know that one can still purchase supplemental care in single-payer countries. However, there are plenty of people in the middle who are paying full price for health care in America who wouldn't purchase supplemental care in a single-payer system. That will lead to less funding for advances in health care that people are willing to pay for. That is a bad thing. Medical costs are rising because people have more and more disposable income, and they're choosing to spend it on the things they value most, like health care and education. Instead of letting that price signal serve as motivation for more people to supply the goods and services that people value most, single-payer systems force prices down and result in less investment in the products that people want to purchase. Forcing people to buy a product from a single vendor hinders competition. Forcing prices down by hindering competition is bad for the future of any market. It's a bad idea.
JeffJenkins 16y ago
The difficulty with pre-existing conditions is that if the insurance companies can't reject people because of them, people will wait until they need insurance to get it. Since the insured population will be much more sick than the population as a whole, insurance will be much more expensive (or much worse in quality). That will cause some people who need insurance not to get it, and for the people who aren't sick to shy even further from it. The solution is requiring everyone to pay for insurance so that the pool of insured people is as large as possible. My personal preference is either a single payer, or multiple payers who are all registered non-profits and required to keep a very high Medical Loss Ratio. The individual mandate will do this to some degree in the US, but it may still be cheaper to just pay the fine than get insurance.
- Dove 16y ago
  I think the problem with pre-existing conditions is that insurance benefits are misaligned with the risks they're supposed to mitigate. The policies are written to cover care month by month rather than condition by condition. Say I buy an insurance policy to mitigate the risk of treating cancer, should I develop it. I would like a contract that said, "The average cost of treating this is $X and its incidence is %0.Y so if you pay us $X * %0.Y + Profit, we'll agree to pay to treat you if you ever develop it." Or say I already have cancer and want help treating it. I'd like a policy that said, "It might cost you $10,000 or it might cost you $500,000 to treat this. But we'll offer you the average cost split into payments over several years, and we'll absorb shocks in the price for you." It seems bizarre to me that health insurance is sold the way it is. It's as if I had auto insurance that paid for repair work to be done that month--whether or not the accident occurred while on that particular contract.

by natrius 16y ago

onoj 16y ago

Having lived in two countries that have free public health care at a good level, I can say that starting my own business is much more relaxing in that environment. I would not dream of doing the same in the USA at my age or family situation.

natrius 16y ago
Of course it's more relaxing. You don't have to worry about researching your insurance options because the choice has already made for you. I don't think "more relaxing" is a very compelling reason to choose a policy on its own, especially when the cost of that relaxation is a slowed pace of advancement in medicine. If the U.S. government stops incentivizing the connection between employment and insurance, starting a company wouldn't need to have any effect on your health care. No single-payer system required.
- pierrefar 16y ago
  I'm starting in the UK and I'm more relaxed because I don't have to worry about health care - I'm covered come rain or shine. I'm not relaxed because of avoiding researching options. Also, you assume a slow in advancement in medicine. This can't be further from the truth. Small example: all of the patients registered in the UK (i.e. residents) are getting digital patient records.
  - natrius 16y ago
    I don't assume a slower localized advancement in medicine. There is a global market for medical technology, and it will be sold wherever it is profitable enough to do so. The fact remains: the further the price of health care is forced down by insurers who comprise the bulk of their respective insurance markets (usually governments), the less money will be available to incentivize people to produce medical technology. Americans will be covered rain or shine once the healthcare reform bill kicks in. If you can afford it, you have to by insurance. If you can't, it will be subsidized so you can afford it. That's the goal, anyway. Markets require choice to function properly. I think the American approach is less likely to result in unintended consequences.

rortian 16y ago

Just show me where the US excels, especially on per dollar terms, on health care on any metric relative to any other modern industrial economy. We spend more on health care in large part because we have way too much surgery going on. There's other stuff going on too, but there's a lot of waste to go with us 'valu[ing] it so much'.

natrius 16y ago
I don't think per-dollar outcomes are a good metric to optimize for. That will get you high quality care at low prices today, but the future quality of health care will be lower than it would've been otherwise. If there's too much surgery going on, that can be fixed without a single-payer system. My point about the value we place on health care is that even if we fixed all the problems with health care in America, we'd end up paying more than countries with single-payer systems because those systems force the price down below what people would be willing to pay on their own. That is a bad thing.
- rortian 16y ago
  >because those systems force the price down below what people would be willing to pay on their own This is very far from the truth. Worry not, rich people can spend to their hearts content in single payer countries. They still spend less and have better outcomes. In the abstract maybe we do want to spend a lot of money for health care. However, medical costs have been growing at double digit rates. Hopefully that pattern does not continue for too much longer.
  - natrius 16y ago
    Yes, I know that one can still purchase supplemental care in single-payer countries. However, there are plenty of people in the middle who are paying full price for health care in America who wouldn't purchase supplemental care in a single-payer system. That will lead to less funding for advances in health care that people are willing to pay for. That is a bad thing. Medical costs are rising because people have more and more disposable income, and they're choosing to spend it on the things they value most, like health care and education. Instead of letting that price signal serve as motivation for more people to supply the goods and services that people value most, single-payer systems force prices down and result in less investment in the products that people want to purchase. Forcing people to buy a product from a single vendor hinders competition. Forcing prices down by hindering competition is bad for the future of any market. It's a bad idea.

JeffJenkins 16y ago

The difficulty with pre-existing conditions is that if the insurance companies can't reject people because of them, people will wait until they need insurance to get it. Since the insured population will be much more sick than the population as a whole, insurance will be much more expensive (or much worse in quality). That will cause some people who need insurance not to get it, and for the people who aren't sick to shy even further from it. The solution is requiring everyone to pay for insurance so that the pool of insured people is as large as possible. My personal preference is either a single payer, or multiple payers who are all registered non-profits and required to keep a very high Medical Loss Ratio. The individual mandate will do this to some degree in the US, but it may still be cheaper to just pay the fine than get insurance.

Dove 16y ago
I think the problem with pre-existing conditions is that insurance benefits are misaligned with the risks they're supposed to mitigate. The policies are written to cover care month by month rather than condition by condition. Say I buy an insurance policy to mitigate the risk of treating cancer, should I develop it. I would like a contract that said, "The average cost of treating this is $X and its incidence is %0.Y so if you pay us $X * %0.Y + Profit, we'll agree to pay to treat you if you ever develop it." Or say I already have cancer and want help treating it. I'd like a policy that said, "It might cost you $10,000 or it might cost you $500,000 to treat this. But we'll offer you the average cost split into payments over several years, and we'll absorb shocks in the price for you." It seems bizarre to me that health insurance is sold the way it is. It's as if I had auto insurance that paid for repair work to be done that month--whether or not the accident occurred while on that particular contract.