4 ms·

This is a real economic problem: adverse selection. But universal coverage doesnt solve it, it just makes everyone pay.

toomuchtodo 8y ago
That’s exactly what insurance is for, to spread the risk among the entire pool of participants. And the best way to expand the pool as large as possible is with universal healthcare (ie “everyone”). Everyone pays because everyone should pay.
- conanbatt 8y ago
  > Everyone pays because everyone should pay. But if everyone pays the same you just conceded the entire victory to adverse selection: people that do not participate in a risk pays for the risk in someone else. The most obvious demonstration of this effect is double-paying in countries that have both private and public healthcare services: you pay twice, once for the public you don't use, and then for the private one.
  - toomuchtodo 8y ago
    Society has some costs you can’t opt out of.
    - conanbatt 8y ago
      That a common and fine approach, but that doesnt make it cheaper, it makes it a whole lot more expensive. From my point of view, lowering the expense is the #1 priority. Expanding coverage, and adding new layers of taxation for it will increase expenditures. There are also many alternatives to adverse selection, my favorite is high deductible plans.
  - yardie 8y ago
    Which country has a parallel public/private healthcare system? Most countries with public healthcare have a private supplement that build on top of what the national system already provides: in home care, private hospital rooms, dental and vision, and concierge service. I've yet to see a private system attempt to replace a functional public system.
    - conanbatt 8y ago
      > Which country has a parallel public/private healthcare system? Most that I know of. Unless the state has absolute monopoly on primary care providers/General practitioners, you will have both systems in place.
      - yardie 8y ago
        > Unless the state has absolute monopoly on primary care providers/General practitioners Yes, that is what single-payer means. There is no parallel payment. You pay for basic service through taxes. You pay for better service through private. Private insurers like BUPA can only extend healthcare options. They don't replace it.
        conanbatt 8y ago
        That system is not inherently cheaper: people that go private pay twice (pay for public through taxes and then pay privately). I dont think its palatable in the US to make policies that could increase national healthcare spending.

That’s exactly what insurance is for, to spread the risk among the entire pool of participants. And the best way to expand the pool as large as possible is with universal healthcare (ie “everyone”). Everyone pays because everyone should pay.

conanbatt 8y ago
> Everyone pays because everyone should pay. But if everyone pays the same you just conceded the entire victory to adverse selection: people that do not participate in a risk pays for the risk in someone else. The most obvious demonstration of this effect is double-paying in countries that have both private and public healthcare services: you pay twice, once for the public you don't use, and then for the private one.
- toomuchtodo 8y ago
  Society has some costs you can’t opt out of.
  - conanbatt 8y ago
    That a common and fine approach, but that doesnt make it cheaper, it makes it a whole lot more expensive. From my point of view, lowering the expense is the #1 priority. Expanding coverage, and adding new layers of taxation for it will increase expenditures. There are also many alternatives to adverse selection, my favorite is high deductible plans.
- yardie 8y ago
  Which country has a parallel public/private healthcare system? Most countries with public healthcare have a private supplement that build on top of what the national system already provides: in home care, private hospital rooms, dental and vision, and concierge service. I've yet to see a private system attempt to replace a functional public system.
  - conanbatt 8y ago
    > Which country has a parallel public/private healthcare system? Most that I know of. Unless the state has absolute monopoly on primary care providers/General practitioners, you will have both systems in place.
    - yardie 8y ago
      > Unless the state has absolute monopoly on primary care providers/General practitioners Yes, that is what single-payer means. There is no parallel payment. You pay for basic service through taxes. You pay for better service through private. Private insurers like BUPA can only extend healthcare options. They don't replace it.
      - conanbatt 8y ago
        That system is not inherently cheaper: people that go private pay twice (pay for public through taxes and then pay privately). I dont think its palatable in the US to make policies that could increase national healthcare spending.