4 ms·

That sounds ideal.

jschwartzi 6y ago
This is actually what I'm asking for. Raise peoples' wages, make it illegal to offer health insurance as a benefit, and provide a single-payer option for everyone. Make sure there's a universal basic income rather than something means-tested. Or, barring that, raise the minimum wage so most people who are working don't need the safety net. Means-testing causes huge bureaucracies in the US. The rules around the means-testing make it very difficult for the social programs to actually provide anything in a reasonable amount of time. Or if they do they have byzantine requirements like you have to make X number of job-seeking contacts during the week, you have to interview, and you have to take classes from people who haven't searched for a job outside of the public sector in 20 years. Or for food stamps you're limited to only a few sections of the store.
- sukilot 6y ago
  Why illegal?
  - stetrain 6y ago
    It would force insurance companies to compete on healthcare plans for everyone, and give employees the ability to choose their plan. Right now employers get a discount for pooling their employees together for insurance, and as an employee you either take that discounted plan (which your employer pays part of) or go out on your own which is almost always significantly more expensive. Getting rid of the bundling and pooling would actually make the insurance market competitive and give people a choice. It would also mean that having good health care is no longer something your employer holds over you, increasing your ability to change jobs, walk out of a bad employment situation, or go out on your own as a freelancer/contractor. Getting rid of the employer health insurance advantage this way, or via a more radical single-payer system, would actually boost self-employment and very-small business, who currently have disadvantages in getting or providing these benefits.
    - jschwartzi 6y ago
      As an example my fiancé and I decided that we could support both of us on my income. So she quit her job. And then we had a very long difficult time figuring out that it would cost a lot of money for her to have a baby on my insurance because the out of pocket maximum would just about wipe out my savings. But her old insurance has a maximum that’s about 10% of what mine would be in the same situation. So we’re paying almost twice as much per month for COBRA continuation. Whereas if I could take the 400 a month my employer spends on my behalf I could get insurance that’s just about as good as she’s getting. In the US insurance system your employer gets to decide what it costs for you to get medical care. The ACA cemented all the worst parts of the insurance system and made it illegal for me to choose my own insurance if I want to work for a larger company.
      - stetrain 6y ago
        The insurance marketplace brought about by the ACA actually seems like a pretty decent idea. The problem is that not everyone is using it and most people are still tied to whatever plan their employer picks. Usually politicians say something like "People like the health plans they have and want to keep them." Meanwhile I have changed jobs once in the last 3 years but in that same timespan I have had 6 different health plans / providers because companies renegotiate their plan every year and often pick a new one because they can get a better deal or the previous plan increased in price. Having my own chosen plan via an open marketplace that was mine and not my employers would have actually resulted in more stability.

That sounds ideal.

This is actually what I'm asking for. Raise peoples' wages, make it illegal to offer health insurance as a benefit, and provide a single-payer option for everyone. Make sure there's a universal basic income rather than something means-tested. Or, barring that, raise the minimum wage so most people who are working don't need the safety net. Means-testing causes huge bureaucracies in the US. The rules around the means-testing make it very difficult for the social programs to actually provide anything in a reasonable amount of time. Or if they do they have byzantine requirements like you have to make X number of job-seeking contacts during the week, you have to interview, and you have to take classes from people who haven't searched for a job outside of the public sector in 20 years. Or for food stamps you're limited to only a few sections of the store.

sukilot 6y ago
Why illegal?
- stetrain 6y ago
  It would force insurance companies to compete on healthcare plans for everyone, and give employees the ability to choose their plan. Right now employers get a discount for pooling their employees together for insurance, and as an employee you either take that discounted plan (which your employer pays part of) or go out on your own which is almost always significantly more expensive. Getting rid of the bundling and pooling would actually make the insurance market competitive and give people a choice. It would also mean that having good health care is no longer something your employer holds over you, increasing your ability to change jobs, walk out of a bad employment situation, or go out on your own as a freelancer/contractor. Getting rid of the employer health insurance advantage this way, or via a more radical single-payer system, would actually boost self-employment and very-small business, who currently have disadvantages in getting or providing these benefits.
  - jschwartzi 6y ago
    As an example my fiancé and I decided that we could support both of us on my income. So she quit her job. And then we had a very long difficult time figuring out that it would cost a lot of money for her to have a baby on my insurance because the out of pocket maximum would just about wipe out my savings. But her old insurance has a maximum that’s about 10% of what mine would be in the same situation. So we’re paying almost twice as much per month for COBRA continuation. Whereas if I could take the 400 a month my employer spends on my behalf I could get insurance that’s just about as good as she’s getting. In the US insurance system your employer gets to decide what it costs for you to get medical care. The ACA cemented all the worst parts of the insurance system and made it illegal for me to choose my own insurance if I want to work for a larger company.
    - stetrain 6y ago
      The insurance marketplace brought about by the ACA actually seems like a pretty decent idea. The problem is that not everyone is using it and most people are still tied to whatever plan their employer picks. Usually politicians say something like "People like the health plans they have and want to keep them." Meanwhile I have changed jobs once in the last 3 years but in that same timespan I have had 6 different health plans / providers because companies renegotiate their plan every year and often pick a new one because they can get a better deal or the previous plan increased in price. Having my own chosen plan via an open marketplace that was mine and not my employers would have actually resulted in more stability.