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The real answer is for government to make employer sponsored health insurance "optional". As in, employers no longer need to provide health insurance and for he

The real answer is for government to make employer sponsored health insurance "optional". As in, employers no longer need to provide health insurance and for health insurance enrollment to be open 24/7, much like car insurance. This will cause a large population in America to shop around all the time, reducing prices pressures. Simultaneously, they need to reduce the regulatory burden on health insurance companies (but always accept pre-existing conditions). This way more health insurance startups can compete with the large legal entities that are health insurance companies. With these two in place, no employer will ever control healthcare for employees, insurance companies will need to learn to live in thin margins and medical providers don't need to bear the administrative burden of insurance, this, reduce cost or pay more to the providers and nurses. In this way, insurance companies that cannot compete on price will fail and that is healthy capitalism.

abofh 4y ago
What would be the point of a health insurance startup? It's just a risk pool. You get cancer, it costs (let's say) 3 million. He doesn't, risk, 1.5 million. Insurance companies exist to hedge risk - the federal government doesn't need to hedge, it can literally inflate the risk out of the market. Pay my doctor's well, they deserve it. I don't even remember who I bought insurance from - don't care if they get paid.
- nine_zeros 4y ago
  > What would be the point of a health insurance startup? It's just a risk pool. You get cancer, it costs (let's say) 3 million. He doesn't, risk, 1.5 million. To start with, they would have lower costs of executive pay than entrenched players. A startup can disrupt with operational costs. Later they can negotiate better prices with providers, source cheaper drugs from around the world, use technology more efficiently. There is so much room to do something here, if the regulatory burden were low.
pessimizer 4y ago
> The real answer is for government to make employer sponsored health insurance "optional." The real answer is not to acknowledge employer sponsored health insurance at all, and to treat it (tax it) just like every other form of compensation. Its current treatment is a nearly 100 year old remnant of attacks against unions. If you stop the giveaway to employers, employee-provided health insurance would evaporate, and the government would be forced to take rational action on healthcare provision and costs. Health insurance is as much of a scam as casino gambling, and should be regulated out of existence.
cortesoft 4y ago
The problem is that heath insurance has widely different risk profiles, way more than something like car insurance. The most risky car driver is going to cost the insurance company a lot less than the most expensive medical insurance user. Because of this, an individual buyer of health insurance is going to have a hugely variable cost of insurance, based on their risk profile. Currently, this risk is spread out by grouping employees of a company together, spreading the cost. That is why larger companies get much cheaper rates. Health insurance risk is so varied, and so often not something the individual can control, that the only fair and efficient way to insure everyone is to create a single, large, cohort... spread the risk to every citizen via universal coverage.
- nine_zeros 4y ago
  > The problem is that heath insurance has widely different risk profiles, way more than something like car insurance. The most risky car driver is going to cost the insurance company a lot less than the most expensive medical insurance user. That's the point. The insurance business can only exist if it can pay for healthcare of an "average pool". They cannot just go seek the healthiest people for group coverage any more. They must maintain their business and profits for the "average pool". There are a large number of ways to provide such an insurance. They can negotiate with providers, drug distributors, invest in securities, improve productivity with technology and even cut CEO pay so that their intake of premiums <= outlay for insurance. That's it. If insurance companies can't manage costs, they will have to raise premiums. Because of 24/7 open enrollment, people will exit any insurance provider that raises premiums too much. If the insurance company can't compete, they will have to file for bankruptcy and customers can just go to another insurance provider. The risk-based business model that exists today is predatory. It does not have to be this way. Most other countries with private insurance don't have the American predatory system either.

abofh 4y ago

What would be the point of a health insurance startup? It's just a risk pool. You get cancer, it costs (let's say) 3 million. He doesn't, risk, 1.5 million. Insurance companies exist to hedge risk - the federal government doesn't need to hedge, it can literally inflate the risk out of the market. Pay my doctor's well, they deserve it. I don't even remember who I bought insurance from - don't care if they get paid.

nine_zeros 4y ago
> What would be the point of a health insurance startup? It's just a risk pool. You get cancer, it costs (let's say) 3 million. He doesn't, risk, 1.5 million. To start with, they would have lower costs of executive pay than entrenched players. A startup can disrupt with operational costs. Later they can negotiate better prices with providers, source cheaper drugs from around the world, use technology more efficiently. There is so much room to do something here, if the regulatory burden were low.

pessimizer 4y ago

> The real answer is for government to make employer sponsored health insurance "optional." The real answer is not to acknowledge employer sponsored health insurance at all, and to treat it (tax it) just like every other form of compensation. Its current treatment is a nearly 100 year old remnant of attacks against unions. If you stop the giveaway to employers, employee-provided health insurance would evaporate, and the government would be forced to take rational action on healthcare provision and costs. Health insurance is as much of a scam as casino gambling, and should be regulated out of existence.

cortesoft 4y ago

The problem is that heath insurance has widely different risk profiles, way more than something like car insurance. The most risky car driver is going to cost the insurance company a lot less than the most expensive medical insurance user. Because of this, an individual buyer of health insurance is going to have a hugely variable cost of insurance, based on their risk profile. Currently, this risk is spread out by grouping employees of a company together, spreading the cost. That is why larger companies get much cheaper rates. Health insurance risk is so varied, and so often not something the individual can control, that the only fair and efficient way to insure everyone is to create a single, large, cohort... spread the risk to every citizen via universal coverage.

nine_zeros 4y ago
> The problem is that heath insurance has widely different risk profiles, way more than something like car insurance. The most risky car driver is going to cost the insurance company a lot less than the most expensive medical insurance user. That's the point. The insurance business can only exist if it can pay for healthcare of an "average pool". They cannot just go seek the healthiest people for group coverage any more. They must maintain their business and profits for the "average pool". There are a large number of ways to provide such an insurance. They can negotiate with providers, drug distributors, invest in securities, improve productivity with technology and even cut CEO pay so that their intake of premiums <= outlay for insurance. That's it. If insurance companies can't manage costs, they will have to raise premiums. Because of 24/7 open enrollment, people will exit any insurance provider that raises premiums too much. If the insurance company can't compete, they will have to file for bankruptcy and customers can just go to another insurance provider. The risk-based business model that exists today is predatory. It does not have to be this way. Most other countries with private insurance don't have the American predatory system either.