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The parent post said nothing about healthcare and the insurances markets being screwed up because of government. The argument for single-payer hinges on the th

The parent post said nothing about healthcare and the insurances markets being screwed up because of government. The argument for single-payer hinges on the theory that the profit motive is incompatible with the very idea of insurance (that is, as long as denying services is more profitable than providing them, an insurance market is an inefficient way to provide said services).

bhupy 6y ago
It's complicated. 1) "Single payer" is not the only way to deliver universal healthcare. Germany, Switzerland, Netherlands, Singapore all have thriving multi-payer systems. In Switzerland and the Netherlands, ALL insurance is private. In Singapore, while the government covers catastrophic care, 70% of total health expenditures are private. 2) The biggest problem in the US is that healthcare is just more expensive, and American insurers end up having to pay more. An example: doctors in America earn more (PPP adjusted) than in any other country. MRI's in America cost more (even on the Medicare fee schedule) than almost any other country. A lot of this is actually caused by a series of well-intentioned policies passed over the last half century. 3) In the US, for-profit insurance profit margins are a pretty meagre 5%, which doesn't really make a dent in costs. Also, some of the biggest insurance providers are non-profits (Blue Cross Blue Shield, Kaiser) 4) Medicare fee schedules aren't that much better, in fact the part of Medicare that's actually working the best is Medicare Part C (Medicare Advantage), which relies on private payers. Source: I work at a claims adjuster
- MiroF 6y ago
  At least in Switzerland, the government pays if you are paying more than 8% of your income, the government caps deductibles, and the government prohibits profit seeking for the basic plan. Very different from the US
  - bhupy 6y ago
    Sure, I'm not defending the US status quo, just attacking the idea that "single-payer" is the best/only solution. Not arguing for an anarchist free-for-all either — some of the most successful private healthcare regimes (Switzerland, Singapore) are also well regulated.

bhupy 6y ago

It's complicated. 1) "Single payer" is not the only way to deliver universal healthcare. Germany, Switzerland, Netherlands, Singapore all have thriving multi-payer systems. In Switzerland and the Netherlands, ALL insurance is private. In Singapore, while the government covers catastrophic care, 70% of total health expenditures are private. 2) The biggest problem in the US is that healthcare is just more expensive, and American insurers end up having to pay more. An example: doctors in America earn more (PPP adjusted) than in any other country. MRI's in America cost more (even on the Medicare fee schedule) than almost any other country. A lot of this is actually caused by a series of well-intentioned policies passed over the last half century. 3) In the US, for-profit insurance profit margins are a pretty meagre 5%, which doesn't really make a dent in costs. Also, some of the biggest insurance providers are non-profits (Blue Cross Blue Shield, Kaiser) 4) Medicare fee schedules aren't that much better, in fact the part of Medicare that's actually working the best is Medicare Part C (Medicare Advantage), which relies on private payers. Source: I work at a claims adjuster

MiroF 6y ago
At least in Switzerland, the government pays if you are paying more than 8% of your income, the government caps deductibles, and the government prohibits profit seeking for the basic plan. Very different from the US
- bhupy 6y ago
  Sure, I'm not defending the US status quo, just attacking the idea that "single-payer" is the best/only solution. Not arguing for an anarchist free-for-all either — some of the most successful private healthcare regimes (Switzerland, Singapore) are also well regulated.