8 ms·

Why is health insurance legal? Serious question, right now it’s legally mandated to have. What would happen to medical prices if that requirement was reversed?

Why is health insurance legal? Serious question, right now it’s legally mandated to have. What would happen to medical prices if that requirement was reversed? Just food for thought. If you model it you’ll find interesting results.

alex_young 5y ago
A bunch of rare events would bankrupt anyone who encounters them?
- deleted 5y ago
  [deleted]
munk-a 5y ago
Lets look back to the 90s when it wasn't legally mandated: some people did just fine (those with a lot of cash sitting around), most people suffered worse than they do today and some people were completely screwed by the system. If it was illegal to pool health prices via insurance (instead of just not legally mandated for everyone to be insured) then the effect would be that those who went bankrupt under the old system would instead be dead.
- jtbayly 5y ago
  Why would those people die? I don't follow.
  - munk-a 5y ago
    You'd make it illegal to pool costs by barring insurance - meaning that healthcare providers would either need to provide service gratis for the majority of the population (which is, really, just another form of insurance so that's out) or they'd need to secure a personal loan with their bank some time between getting hit by a truck and the operating table. And for pre-existing conditions and long term health disabilities - the individual would need to somehow justify the profitability of their existence to a private underwriter who was willing to bear the cost - in most cases those people "aren't worth the cost of keeping them alive" (assuming you're looking strictly at numbers). Hence - a lot of people would end up dead.
    - notch656a 5y ago
      Can you really call it 'insurance' when it's a pre-existing condition? I realize we can call insurance whatever we want, but when I think of insurance I think of it a way to pool for mitigating risk of the unknown. No one would sell insurance that would fix your already destroyed roof.
      - giaour 5y ago
        > No one would sell insurance that would fix your already destroyed roof. But they will sell you homeowners insurance in areas prone to wildfires or hurricanes. The difference is that you are expected to know the amortized cost of disasters for your property and either insure against it or simply accept the risk. Either way, you as a homeowner are supposed to make an informed decision. If disaster is too likely to occur in a certain area, you can either move or not purchase a property in the first place. Science still hasn't figured out how to let us move into healthier bodies or choose our bodies prior to birth, so, alas, we are forced to seek fairness through other means.
        com2kid 5y ago
        > But they will sell you homeowners insurance in areas prone to wildfires And in areas with wild fires, tar roofs aren't legal for new construction! Roofs have to be built out of something non-flammable. Lessons to be learned perhaps.
        max599 5y ago
        Most of the building code is written with the blood of victims who died in a horrific accident. If you want to know why doors in public places have to open toward the outside in modern countries and why "panic bars" are often mandatory, the answer is large piles of dead children (literally). Depending on who you ask and the country they live in, they will refer to a different disaster, but the common element in all of them is 70 - 600 people stuck in hallways unable to escape due to bad exit designs (eg. people piling up against doors that open towards the inside).
  - deleted 5y ago
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  - PeterisP 5y ago
    Their life could be extended by some medical care they can't afford, so they would not get that care and die sooner instead.
- pyuser583 5y ago
  I was very much alive, working, and insured in the 90s. It wasn’t great. HMOs were being introduced (top down) and a lot of people had no idea how to use them. The prices were nowhere near as high. The huge jump happened in the 2000s. It was nuts. Regarding the bit about “health insurance companies could reject preexisting conditions” - most people got insurance through employers whose contracts required pre existing conditions be covered. There were absolutely some places you could get totally stuck and screwed. But things didn’t get bad until the 2000s, and it was mostly price that was the issue.
  - hotpotamus 5y ago
    Michael Crichton, MD, and author of Jurassic Park (any many others) wrote a book about the state of the art of medicine in the 1960's called "Five Patients". Each patient was a case study for some particular aspect of modern medicine. Through that lends, Crichton examined the costs of the hospital and noted that they were growing well beyond inflation 50 years ago and assumed that the obvious fix was a single payer system to manage costs.
dmitriid 5y ago
> If you model it you’ll find interesting results. No, we won't. The results are entirely predictable. Without medical insurance people die and/or go bankrupt. The main problem is that most Americans for some reason cannot imagine a system other than the US system, and equate all medical insurance with that.
- jjtheblunt 5y ago
  Those might be the interesting results, though, referred to?
_moof 5y ago
The federal health insurance mandated in the US was repealed as of 2019. You may still be subject to a state mandate though.
bogomipz 5y ago
I'm not following your first question do you mean to say why is mandating coverage legal? My understanding of the mandate was that(theoretically) by more people being insured the population be healthier and that would someone how drive prices down. Obviously that's a farce as prices go up year over year. It would be interesting to see how much more basic procedures would be now after being adjusted for inflation compared to what they were in say the 90's.
- OldTimeCoffee 5y ago
  This ignores the elephant in the room that in the 90s insurance companies just wouldn't pay, claim pre-existing condition, and bankrupt the patient.
smsm42 5y ago
If you made it illegal, people would start creating risk pools in ways that are technically legal. Such as membership clinics, special-purpose clubs, etc.
grecy 5y ago
> Why is health insurance legal? Why have health insurance at all? It's just a middle-man for profit scheme between patient and health care. Just have mandated health CARE for all and do away with health insurance altogether. Lots of companies would lose billions, but average people on the street would be the ones not spending that money.

alex_young 5y ago

A bunch of rare events would bankrupt anyone who encounters them?

deleted 5y ago
[deleted]

munk-a 5y ago

Lets look back to the 90s when it wasn't legally mandated: some people did just fine (those with a lot of cash sitting around), most people suffered worse than they do today and some people were completely screwed by the system. If it was illegal to pool health prices via insurance (instead of just not legally mandated for everyone to be insured) then the effect would be that those who went bankrupt under the old system would instead be dead.

jtbayly 5y ago
Why would those people die? I don't follow.
- munk-a 5y ago
  You'd make it illegal to pool costs by barring insurance - meaning that healthcare providers would either need to provide service gratis for the majority of the population (which is, really, just another form of insurance so that's out) or they'd need to secure a personal loan with their bank some time between getting hit by a truck and the operating table. And for pre-existing conditions and long term health disabilities - the individual would need to somehow justify the profitability of their existence to a private underwriter who was willing to bear the cost - in most cases those people "aren't worth the cost of keeping them alive" (assuming you're looking strictly at numbers). Hence - a lot of people would end up dead.
  - notch656a 5y ago
    Can you really call it 'insurance' when it's a pre-existing condition? I realize we can call insurance whatever we want, but when I think of insurance I think of it a way to pool for mitigating risk of the unknown. No one would sell insurance that would fix your already destroyed roof.
    - giaour 5y ago
      > No one would sell insurance that would fix your already destroyed roof. But they will sell you homeowners insurance in areas prone to wildfires or hurricanes. The difference is that you are expected to know the amortized cost of disasters for your property and either insure against it or simply accept the risk. Either way, you as a homeowner are supposed to make an informed decision. If disaster is too likely to occur in a certain area, you can either move or not purchase a property in the first place. Science still hasn't figured out how to let us move into healthier bodies or choose our bodies prior to birth, so, alas, we are forced to seek fairness through other means.
      - com2kid 5y ago
        > But they will sell you homeowners insurance in areas prone to wildfires And in areas with wild fires, tar roofs aren't legal for new construction! Roofs have to be built out of something non-flammable. Lessons to be learned perhaps.
        max599 5y ago
        Most of the building code is written with the blood of victims who died in a horrific accident. If you want to know why doors in public places have to open toward the outside in modern countries and why "panic bars" are often mandatory, the answer is large piles of dead children (literally). Depending on who you ask and the country they live in, they will refer to a different disaster, but the common element in all of them is 70 - 600 people stuck in hallways unable to escape due to bad exit designs (eg. people piling up against doors that open towards the inside).
- deleted 5y ago
  [deleted]
- deleted 5y ago
  [deleted]
- PeterisP 5y ago
  Their life could be extended by some medical care they can't afford, so they would not get that care and die sooner instead.
pyuser583 5y ago
I was very much alive, working, and insured in the 90s. It wasn’t great. HMOs were being introduced (top down) and a lot of people had no idea how to use them. The prices were nowhere near as high. The huge jump happened in the 2000s. It was nuts. Regarding the bit about “health insurance companies could reject preexisting conditions” - most people got insurance through employers whose contracts required pre existing conditions be covered. There were absolutely some places you could get totally stuck and screwed. But things didn’t get bad until the 2000s, and it was mostly price that was the issue.
- hotpotamus 5y ago
  Michael Crichton, MD, and author of Jurassic Park (any many others) wrote a book about the state of the art of medicine in the 1960's called "Five Patients". Each patient was a case study for some particular aspect of modern medicine. Through that lends, Crichton examined the costs of the hospital and noted that they were growing well beyond inflation 50 years ago and assumed that the obvious fix was a single payer system to manage costs.

dmitriid 5y ago

> If you model it you’ll find interesting results. No, we won't. The results are entirely predictable. Without medical insurance people die and/or go bankrupt. The main problem is that most Americans for some reason cannot imagine a system other than the US system, and equate all medical insurance with that.

jjtheblunt 5y ago
Those might be the interesting results, though, referred to?

_moof 5y ago

The federal health insurance mandated in the US was repealed as of 2019. You may still be subject to a state mandate though.

bogomipz 5y ago

I'm not following your first question do you mean to say why is mandating coverage legal? My understanding of the mandate was that(theoretically) by more people being insured the population be healthier and that would someone how drive prices down. Obviously that's a farce as prices go up year over year. It would be interesting to see how much more basic procedures would be now after being adjusted for inflation compared to what they were in say the 90's.

OldTimeCoffee 5y ago
This ignores the elephant in the room that in the 90s insurance companies just wouldn't pay, claim pre-existing condition, and bankrupt the patient.

smsm42 5y ago

If you made it illegal, people would start creating risk pools in ways that are technically legal. Such as membership clinics, special-purpose clubs, etc.

grecy 5y ago

> Why is health insurance legal? Why have health insurance at all? It's just a middle-man for profit scheme between patient and health care. Just have mandated health CARE for all and do away with health insurance altogether. Lots of companies would lose billions, but average people on the street would be the ones not spending that money.