> It's worth mentioning that in both countries, there's heavy government regulation No disagreements that there exists regulation that can be helpful. Definite

> It's worth mentioning that in both countries, there's heavy government regulation No disagreements that there exists regulation that can be helpful. Definitely an important part of the discussion. Even in Singapore, which is largely a market based system driven by price discovery relies on a healthy (heh) amount of regulation. In the US, the food system is largely market-based, but the FDA (as well as state and local health departments) impose important regulations. > In Switzerland the premium is capped at a percentage of a person's income with the government making up the shortfall, and insurance companies can't make a profit. Keep in mind that in the US, health insurance companies report an average profit of ~5%. Even if you eliminated that entirely, you wouldn't see any savings worth writing home about. I work at an insurance company, and the majority of claims I see are pretty asinine. $500 added to provide sign language service to a deaf patient, or $300 charged for a papoose used while giving a child a cleaning. Because of the third-party-payer model in which the care is priced and paid for AFTER the services are rendered, the patient has little skin in the game. In the best case (for the patient) the insurance company simply pays the asking price (resulting in a sort of moral hazard), and in the worst case, the insurance company doesn't cover it and the patient gets a surprise bill in the mail. > Doesn't this argument apply to insurance schemes in general, both public and private? Yes, it's another reason why using insurance to pay for all care can be a sub-optimal way to allocate resources. Not having skin in the game can result in patient overconsumption. > Agree, although I'm weary of assigning significant blame due to this factor. Are doctors making record wages? Are hospitals making record profits? Yes, and yes[1][2] > I'm skeptical how big of an effect this can be. Wikipedia has a chart that shows medicare spending as percent of GDP[1]. If you combine that with total US healthcare spending by GDP[2], you see that it accounts for less than a fifth of total US healthcare spending. The effect I'm talking about is removing the largest consumers of healthcare (rich old people) from the market, which impacts how the ultimate price of goods/services is determined by the market. [1] https://www.politico.com/agenda/story/2017/10/25/doctors-salaries-pay-disparities-000557 https://www.politico.com/agenda/story/2017/10/25/doctors-sal... [2]https://freopp.org/transcending-obamacare-why-the-health-laws-struggles-argue-for-a-new-approach-to-health-reform-5517bd69e0d8 https://freopp.org/transcending-obamacare-why-the-health-law...