4 ms·

> I'm wondering what it will take to stop this Single payer.

by _jal 5y ago

tastyfreeze 5y ago
Single payer is not really a solution to the healthcare cost problem. All it does is give government more power that it doesn't have Constitional authorization to posses. A real solution to healthcare cost is making healthcare a functioning market where the buyer knows prices before they purchase.
- paxys 5y ago
  A free market solution will never work in healthcare because neither side has the ability to say no and walk away when they can't come to an agreement on price. A consumer cannot price shop and delay an appointment or procedure when it is a matter of life and death. A hospital or insurance company cannot say no to someone who they are 100% sure will never be able to pay the bill.
  - tastyfreeze 5y ago
    That is what insurance is supposed to be for. Medical insurance should be more like home or auto insurance. My home and auto policies do not cover maintenance and improvement but they do cover rare catastrophic events. My medical insurance covers every damn thing that has to do with medicine. If I go to the doctor for an annual check up there is no reason that insurance should be involved as that is a regular and elective cost. If I break my arm that is unexpected and probably costly so I would have insurance to cover something like that. Insurance is for uncommon events that you have little to no control over. The policy you choose should reflect how you want to mitigate your own risk of uncommon events happening.
    - paxys 5y ago
      Insurance companies actually want to pay for your regular, non-emergency medical costs because it is way cheaper for them to do so vs letting conditions go undetected and then paying orders of magnitudes more for surgeries, prescriptions and expert visits. Your annual checkup visits aren't what is causing ballooning healthcare costs, but actually lowering them.
      - tastyfreeze 5y ago
        I wasn't implying that annual checkups were causing ballooning cost. Having insurance cover it certainly doesn't help reduce cost. Other types of insurance give discounts for behavior that reduces their risk of a huge payout or they charge higher premiums for higher risk. There is no reason medical insurance can't do the same.
- handrous 5y ago
  It's possible that would work, but I'd prefer to try a system that's successfully in use in any other advanced economy, than to gamble on that. Meanwhile, if you can convince some other country to try "be very free market" as an experiment for their healthcare system, please do so, I'd love to see the results.
- jatone 5y ago
  we have that today. law was passed last year. its not going to do shit.
  - tastyfreeze 5y ago
    Are you talking about the CMS Price Transparency rule? That went into effect on January 1st this year. Is your hospital compliant yet? Mine isnt. I can request a quote for "shoppable services". They do not have a machine readable format listing of all their "standard charges" and they do not have a customer readable format listing of prices for "shoppable services". Rule changes like this take time to be implemented and effective. You cant very well expect current practices to change when effectively very little has changed in price transparency yet.
    - jatone 5y ago
      indeed I am, and yes I know. I'm asserting even if it was implemented fully it won't do shit. I have insurance why would I give a shit about the prices? my employer pays the majority of the costs. its only going to incentives the uninsured to go shopping and they're a very small market. thats precisely the problem. lack of choices in the insurance market where the incentives are not aligned.
      - tastyfreeze 5y ago
        Requiring price transparency is a step in the right direction. We didn't get in this mess all at once and we wont get out of it all at once. Relentless continuous incremental progress is the way to accomplish anything. So, after price transparency what is the next step to reach the goal of a healthcare free-market? I say it would be competition. Once prices are known publicly then it becomes easier for independent doctors to compete on price. There may be barriers to competition like limits on number of medical doctors that are granted licenses or something to that effect.
        jatone 5y ago
        why would I go to the cheaper hospital when I can go to the more expensive and better hospital at the same cost to me (nothing, its the insurance companies problem). price transparency does jack shit in such a market where the stakes are literally your health. healthcare services do not compete on price they compete on quality of service. the next step and what should have been the first step is a public option with a mandate that employers must offer it as one of the insurance coverages available. I'd even go further and say employers must offer public + 3 other private insurances and to opt out for an increase in base pay equal to what the employer contributes to the most expensive plan. the natural pressures on the government to minimize wasteful spending on social services will take care of the rest as suddenly private insurance will have to compete with cheaper to you public insurance.

> I'm wondering what it will take to stop this Single payer.

by _jal 5y ago

> I'm wondering what it will take to stop this Single payer.

Single payer is not really a solution to the healthcare cost problem. All it does is give government more power that it doesn't have Constitional authorization to posses. A real solution to healthcare cost is making healthcare a functioning market where the buyer knows prices before they purchase.

paxys 5y ago
A free market solution will never work in healthcare because neither side has the ability to say no and walk away when they can't come to an agreement on price. A consumer cannot price shop and delay an appointment or procedure when it is a matter of life and death. A hospital or insurance company cannot say no to someone who they are 100% sure will never be able to pay the bill.
- tastyfreeze 5y ago
  That is what insurance is supposed to be for. Medical insurance should be more like home or auto insurance. My home and auto policies do not cover maintenance and improvement but they do cover rare catastrophic events. My medical insurance covers every damn thing that has to do with medicine. If I go to the doctor for an annual check up there is no reason that insurance should be involved as that is a regular and elective cost. If I break my arm that is unexpected and probably costly so I would have insurance to cover something like that. Insurance is for uncommon events that you have little to no control over. The policy you choose should reflect how you want to mitigate your own risk of uncommon events happening.
  - paxys 5y ago
    Insurance companies actually want to pay for your regular, non-emergency medical costs because it is way cheaper for them to do so vs letting conditions go undetected and then paying orders of magnitudes more for surgeries, prescriptions and expert visits. Your annual checkup visits aren't what is causing ballooning healthcare costs, but actually lowering them.
    - tastyfreeze 5y ago
      I wasn't implying that annual checkups were causing ballooning cost. Having insurance cover it certainly doesn't help reduce cost. Other types of insurance give discounts for behavior that reduces their risk of a huge payout or they charge higher premiums for higher risk. There is no reason medical insurance can't do the same.
handrous 5y ago
It's possible that would work, but I'd prefer to try a system that's successfully in use in any other advanced economy, than to gamble on that. Meanwhile, if you can convince some other country to try "be very free market" as an experiment for their healthcare system, please do so, I'd love to see the results.
jatone 5y ago
we have that today. law was passed last year. its not going to do shit.
- tastyfreeze 5y ago
  Are you talking about the CMS Price Transparency rule? That went into effect on January 1st this year. Is your hospital compliant yet? Mine isnt. I can request a quote for "shoppable services". They do not have a machine readable format listing of all their "standard charges" and they do not have a customer readable format listing of prices for "shoppable services". Rule changes like this take time to be implemented and effective. You cant very well expect current practices to change when effectively very little has changed in price transparency yet.
  - jatone 5y ago
    indeed I am, and yes I know. I'm asserting even if it was implemented fully it won't do shit. I have insurance why would I give a shit about the prices? my employer pays the majority of the costs. its only going to incentives the uninsured to go shopping and they're a very small market. thats precisely the problem. lack of choices in the insurance market where the incentives are not aligned.
    - tastyfreeze 5y ago
      Requiring price transparency is a step in the right direction. We didn't get in this mess all at once and we wont get out of it all at once. Relentless continuous incremental progress is the way to accomplish anything. So, after price transparency what is the next step to reach the goal of a healthcare free-market? I say it would be competition. Once prices are known publicly then it becomes easier for independent doctors to compete on price. There may be barriers to competition like limits on number of medical doctors that are granted licenses or something to that effect.
      - jatone 5y ago
        why would I go to the cheaper hospital when I can go to the more expensive and better hospital at the same cost to me (nothing, its the insurance companies problem). price transparency does jack shit in such a market where the stakes are literally your health. healthcare services do not compete on price they compete on quality of service. the next step and what should have been the first step is a public option with a mandate that employers must offer it as one of the insurance coverages available. I'd even go further and say employers must offer public + 3 other private insurances and to opt out for an increase in base pay equal to what the employer contributes to the most expensive plan. the natural pressures on the government to minimize wasteful spending on social services will take care of the rest as suddenly private insurance will have to compete with cheaper to you public insurance.