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I find the idea that employers should have anything to do with healthcare quite revolting. Healthcare should be a deal between you and the government for which

I find the idea that employers should have anything to do with healthcare quite revolting. Healthcare should be a deal between you and the government for which you should pay taxes. This and some other reasons are why I cannot fathom living in the US under 250K a year.

colechristensen 7y ago
Why? Why is one large bureaucracy better than the other?
- mellosouls 7y ago
  One of the large bureaucracies will be there as long as you're alive, and there is no need to switch between health provider paperwork or worry it will disappear when you change jobs or become unemployed.
- freeone3000 7y ago
  Because one isn't in an adversarial relationship with you?
  - ohithereyou 7y ago
    I have some bad news for you - the administrative state is very much in an adversarial relationship with you if you do anything other than breathe.
  - baddox 7y ago
    You may be in the fortunate position that your government is not in an adversarial relationship with you. There are many people with that good fortune. But there are also many people who are not in that position.
- pjc50 7y ago
  The government isn't an "at will" arrangement from which you can be sacked?
- Ericson2314 7y ago
  Because I want to switch jobs without switching doctors loads of paper work, and health is the sort of fickle thing where if I get really sick they will always be able to price-gouge me so I rather remove the profit motive.
  - colechristensen 7y ago
    I've had several jobs, several insurance plans and a couple on the individual market. Never had to switch doctors and the paperwork amounted to the receptionist asking if my insurance was current and handing them my card.
- arcticbull 7y ago
  One word: accountability. Your employer is not accountable to you, you’re at best a cost center. Your government is accountable to you via process known as democracy.
  - deleted 7y ago
    [deleted]
  - baddox 7y ago
    Democracy clearly, empirically does not imply that the government is accountable to you.
    - iudqnolq 7y ago
      [Citation needed] And I'm asking you not just to show that a bunch of bad stuff has happened, but that in its totality at least one country most people would consider a democracy (a good but imperfect shortcut for this is if Freedom House rates them as such) has essentially no accountability.
      - baddox 7y ago
        Well, if you think that showing many many examples of democratic governments wronging individuals and then not being held accountable for those wrongs (including many examples of long-standing systematic wrongs, not just one-off extreme cases) is NOT sufficient evidence for the claim “democratic governments are not accountable to you,” then I don’t know what evidence would satisfy you.
        iudqnolq 7y ago
        Let me guess: you're thinking of civil foreiture and qualified immunity in the US? I don't dispute the US is non ideal, I do dispute that as a whole the government is unaccountable. For example, what do you think would happen if Gavin Newsome (governor of California) had someone killed for disrespecting him? That's the kind of thing really unaccountable governments get away with. So I'm asking you to not only show that bad things have happened and not been adequately punished, but that the government is fundamentally as unaccountable as a reference unaccountable government, like the U.S.S.R under Stalin or Britain under Oliver Cromwell. Yes, that's an extreme requirement. But you made an extreme claim when you said not just that democracies are insufficiently accountable to be completely just but that they are unaccountable.
- CobrastanJorji 7y ago
  You can't be fired from America because you get sick.
pdonis 7y ago
> Healthcare should be a deal between you and the government No, health care should be between me and my physician and whatever other experts I decide to consult. The government has no business meddling in it. Health insurance or health care cost sharing might be things we could arrange cooperatively through government, but it doesn't seem like it's possible to do that without having the government try to meddle in what care people get.
- nodemaker 7y ago
  Well then there will be a variable cost depending on the treatment you need and the prices that the market decides. No amount of money in your bank could give you any financial security as you are basically one accident, surgery or even treatment away from bankruptcy. It could be that this one pill you need is suddenly priced at a million dollars a pill and you cant survive anymore. (Hypothetically can happen in a totally free market). I for one wouldn't like this level of risk with something so vital to my wellbeing. I would rather prefer that the government took this risk on my behalf of me and just charged me a flat rate throughout my life. (Btw this is the case already in almost all developed countries) In general there are some things where government intervention is needed. Police, Education, Healthcare and Pension as these things cannot have a totally variable cost decided by a free market.
  - pdonis 7y ago
    > It could be that this one pill you need is suddenly priced at a million dollars a pill and you cant survive anymore. (Hypothetically can happen in a totally free market). No, it can't, because in a totally free market nobody would have monopoly rights to produce particular drugs or provide particular treatments, so if one provider tried to charge a price nobody who needed the treatment could afford, they would go out of business. If it proved to be impossible for anyone to make the drug or provide the treatment at a price anyone could afford, then that would be a failure of the free market, yes; but it's an extremely unlikely failure mode as compared with the much more common failure modes of government granted monopolies and government determined prices. That said, in a democratic country if the majority shares your risk preference, then that majority can vote for politicians who will enact it: > I would rather prefer that the government took this risk on my behalf of me and just charged me a flat rate throughout my life. And that would be a form of cost sharing, which I mentioned--all taxpayers share the costs of expensive treatments, on the assumption that only a small percentage of them will actually end up having an illness that incurs those costs. However, that still only protects you on the assumption that in fact only a small percentage of people end up having the costly illnesses. But the illnesses people are generally worried about with respect to high costs--cancer, heart disease, arterial sclerosis leading to a high risk of stroke, liver disease, kidney disease, diabetes--are not that rare. So either we keep paying more and more taxes as a higher and higher percentage of people have the illness, to the point where we are just as badly off as if we each paid our own costs individually, or many people end up not getting the treatments at all because there isn't enough money to go around, so the risk you thought you were offloading to the government is back on you again. This scheme also ignores the possibility of making the treatments cheaper. But the way to do that is to allow free market competition; we don't have that in the US since prices are not set by supply and demand but by a combination of government agencies and private health insurance companies. > In general there are some things where government intervention is needed. Police, Education, Healthcare and Pension as these things cannot have a totally variable cost decided by a free market. This is not the obvious truth you appear to think it is. It is an extremely strong claim which is not at all clearly established by actual historical evidence.

colechristensen 7y ago

Why? Why is one large bureaucracy better than the other?

mellosouls 7y ago
One of the large bureaucracies will be there as long as you're alive, and there is no need to switch between health provider paperwork or worry it will disappear when you change jobs or become unemployed.
freeone3000 7y ago
Because one isn't in an adversarial relationship with you?
- ohithereyou 7y ago
  I have some bad news for you - the administrative state is very much in an adversarial relationship with you if you do anything other than breathe.
- baddox 7y ago
  You may be in the fortunate position that your government is not in an adversarial relationship with you. There are many people with that good fortune. But there are also many people who are not in that position.
pjc50 7y ago
The government isn't an "at will" arrangement from which you can be sacked?
Ericson2314 7y ago
Because I want to switch jobs without switching doctors loads of paper work, and health is the sort of fickle thing where if I get really sick they will always be able to price-gouge me so I rather remove the profit motive.
- colechristensen 7y ago
  I've had several jobs, several insurance plans and a couple on the individual market. Never had to switch doctors and the paperwork amounted to the receptionist asking if my insurance was current and handing them my card.
arcticbull 7y ago
One word: accountability. Your employer is not accountable to you, you’re at best a cost center. Your government is accountable to you via process known as democracy.
- deleted 7y ago
  [deleted]
- baddox 7y ago
  Democracy clearly, empirically does not imply that the government is accountable to you.
  - iudqnolq 7y ago
    [Citation needed] And I'm asking you not just to show that a bunch of bad stuff has happened, but that in its totality at least one country most people would consider a democracy (a good but imperfect shortcut for this is if Freedom House rates them as such) has essentially no accountability.
    - baddox 7y ago
      Well, if you think that showing many many examples of democratic governments wronging individuals and then not being held accountable for those wrongs (including many examples of long-standing systematic wrongs, not just one-off extreme cases) is NOT sufficient evidence for the claim “democratic governments are not accountable to you,” then I don’t know what evidence would satisfy you.
      - iudqnolq 7y ago
        Let me guess: you're thinking of civil foreiture and qualified immunity in the US? I don't dispute the US is non ideal, I do dispute that as a whole the government is unaccountable. For example, what do you think would happen if Gavin Newsome (governor of California) had someone killed for disrespecting him? That's the kind of thing really unaccountable governments get away with. So I'm asking you to not only show that bad things have happened and not been adequately punished, but that the government is fundamentally as unaccountable as a reference unaccountable government, like the U.S.S.R under Stalin or Britain under Oliver Cromwell. Yes, that's an extreme requirement. But you made an extreme claim when you said not just that democracies are insufficiently accountable to be completely just but that they are unaccountable.
CobrastanJorji 7y ago
You can't be fired from America because you get sick.

pdonis 7y ago

> Healthcare should be a deal between you and the government No, health care should be between me and my physician and whatever other experts I decide to consult. The government has no business meddling in it. Health insurance or health care cost sharing might be things we could arrange cooperatively through government, but it doesn't seem like it's possible to do that without having the government try to meddle in what care people get.

nodemaker 7y ago
Well then there will be a variable cost depending on the treatment you need and the prices that the market decides. No amount of money in your bank could give you any financial security as you are basically one accident, surgery or even treatment away from bankruptcy. It could be that this one pill you need is suddenly priced at a million dollars a pill and you cant survive anymore. (Hypothetically can happen in a totally free market). I for one wouldn't like this level of risk with something so vital to my wellbeing. I would rather prefer that the government took this risk on my behalf of me and just charged me a flat rate throughout my life. (Btw this is the case already in almost all developed countries) In general there are some things where government intervention is needed. Police, Education, Healthcare and Pension as these things cannot have a totally variable cost decided by a free market.
- pdonis 7y ago
  > It could be that this one pill you need is suddenly priced at a million dollars a pill and you cant survive anymore. (Hypothetically can happen in a totally free market). No, it can't, because in a totally free market nobody would have monopoly rights to produce particular drugs or provide particular treatments, so if one provider tried to charge a price nobody who needed the treatment could afford, they would go out of business. If it proved to be impossible for anyone to make the drug or provide the treatment at a price anyone could afford, then that would be a failure of the free market, yes; but it's an extremely unlikely failure mode as compared with the much more common failure modes of government granted monopolies and government determined prices. That said, in a democratic country if the majority shares your risk preference, then that majority can vote for politicians who will enact it: > I would rather prefer that the government took this risk on my behalf of me and just charged me a flat rate throughout my life. And that would be a form of cost sharing, which I mentioned--all taxpayers share the costs of expensive treatments, on the assumption that only a small percentage of them will actually end up having an illness that incurs those costs. However, that still only protects you on the assumption that in fact only a small percentage of people end up having the costly illnesses. But the illnesses people are generally worried about with respect to high costs--cancer, heart disease, arterial sclerosis leading to a high risk of stroke, liver disease, kidney disease, diabetes--are not that rare. So either we keep paying more and more taxes as a higher and higher percentage of people have the illness, to the point where we are just as badly off as if we each paid our own costs individually, or many people end up not getting the treatments at all because there isn't enough money to go around, so the risk you thought you were offloading to the government is back on you again. This scheme also ignores the possibility of making the treatments cheaper. But the way to do that is to allow free market competition; we don't have that in the US since prices are not set by supply and demand but by a combination of government agencies and private health insurance companies. > In general there are some things where government intervention is needed. Police, Education, Healthcare and Pension as these things cannot have a totally variable cost decided by a free market. This is not the obvious truth you appear to think it is. It is an extremely strong claim which is not at all clearly established by actual historical evidence.