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I don't see how that would be any better than what we have now. If employer provided healthcare was removed, that would leave us with a bunch of private healthc

I don't see how that would be any better than what we have now. If employer provided healthcare was removed, that would leave us with a bunch of private healthcare companies. These private companies would drive up the cost even more. If an affordable or free healthcare option was offered on top of making employer provided healthcare illegal, then I completely am behind your idea.

photonbeam 3y ago
Its not a given that prices would increase Look at how these systems work in other countries
- ekianjo 3y ago
  Sounds like you have no clue about whats happening in other countries
  - zer0tonin 3y ago
    Well let me enlighten you, as someone who doesn't live in america. I pay a bit less than 150 euros a months in health insurance in the Netherlands. It is not tied to my employer in any way. If I was poor I could ask for those payments to be subsidized by the state. If I am sick I can just get an appointment with my GP within the day and not pay a thing, they can refer me to specialists or blood tests if needed, which are also fast and free. The remaining healthcare costs for medications or dentistry are so low I don't even notice them. Hope this will shed some light to you about what's happening in other countries.
    - patrec 3y ago
      The problem with the above account is that the 150 euros you claim to pay per month for health "insurance" is transparently a fantasy number, and in reality you probably pay closer to an order of magnitude more into the Dutch health system.
      - ben_w 3y ago
        According to wikipedia: > Funding for all short-term health care is 50% from employers, 45% from the insured person and 5% by the government. … > Premiums paid by the insured are, on average, €137 per month for basic health care - https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands Only an order of magnitude if you're in base-2. That said, this doesn't quite track with the numbers for https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... and https://en.wikipedia.org/wiki/International_dollar https://en.wikipedia.org/wiki/International_dollar But even then, counting all payers and not just the residents' sticker price, the USA is the high-priced outlier.
        patrec 3y ago
        > Only an order of magnitude if you're in base-2. Nope. Look at how much the Netherlands actually spends on Healthcare, it's about 11.2% of GDP in 2021 [1]. Per capita GDP in 2021 was ~53k€. ((53k€*11.2%)/12) ≈ 495€ Only problem is, like most developed countries, close to a majority of people are net recipients (around 40%). Someone will have to pay their share too. Chances are, if you're posting on HN, that's you, as you'll be somewhere in the top 5% income bracket. I think if the OP does the math based on their actual numbers, they'd be more likely to find themselves in the ~1000€/month ballpark than the 150€/month they seem to think they are paying. > But even then, counting all payers and not just the residents' sticker price, the USA is the high-priced outlier. The Netherlands (11% of GDP) is not quite as extreme as the US (17%), but it's certainly nothing to write home about, especially as I don't get the impression that either health care expenditure as percentage of GDP or demographics are moving in a favorable direction. [1] https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2021&locations=NL&start=2001 https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2...
        ben_w 3y ago
        My second link is pretty much the same as the numbers you're giving. What's the difference between my first and my second? I don't know. If you force me to guess, post-retirement and/or terminal care, possibly? > like most developed countries, close to a majority of people are net recipients (around 40%) Yes, and? Isn't much the same also true for private insurance? You've got the potential for arguing about what "fair" looks like; I'm fine with it being funded like a progressive tax, based on income rather than risk factors, but that's not hugely important. > I think if the OP does the math based on their actual numbers, they'd be more likely to find themselves in the ~1000€/month ballpark than the 150€/month they seem to think they are paying. I would assume that zer0tonin pays whatever they say they pay. They're likely to have better insight into their own finances than random internet strangers like thee and me. > The Netherlands (11% of GDP) is not quite as extreme as the US (17%), but it's certainly nothing to write home about, especially as I don't get the impression that either health care expenditure as percentage of GDP or demographics are moving in a favorable direction. The direction of movement may or may not be favourable (given the pandemic I assume "not"), but the USA is kinda the outlier in developed nations for spending a lot without delivering particularly good outcomes: https://commons.wikimedia.org/wiki/File:Life_expectancy_vs_healthcare_spending.jpg https://commons.wikimedia.org/wiki/File:Life_expectancy_vs_h... (Sourced from: https://ourworldindata.org/us-life-expectancy-low https://ourworldindata.org/us-life-expectancy-low)
    - rgblambda 3y ago
      That's less than half of what the typical UK taxpayer pays for healthcare. Surely the Dutch health system is also partially funded by government revenue?
      - shapefrog 3y ago
        According to our research, the average cost of an individual private health insurance plan sits at around £85 per month or £1,020 per year! A typical family premium (two adults in their 40s and two children under 10) can vary from £700 to £1,800 a year. The average price of a private healthcare policy in the UK is £1,032.84 per year (February 2022) Google results ...
        rgblambda 3y ago
        >The average price of a private healthcare policy in the UK is £1,032.84 per year I did use the word "taxpayer". The UK's health service costs £2700 per head of population. Obviously what people contribute towards that varies. Also my question remains unanswered. Is the Dutch health system topped up by government funding?
      - FireBeyond 3y ago
        It’s very well documented that US healthcare and insurance costs are the highest per capita in the world.
  - ffgjgf1 3y ago
    The Swiss healthcare system is privatized to a higher degree than the US one (no Medicare/aid equivalents) yet it seems to be doing mostly fine because of sensible regulation?
    - CaptainZapp 3y ago
      While generally true it needs to be noted that health insurance is very expensive in Switzerland. I'm not complaining since, first, this is a political decision and second, the level of service is outstanding. For example: psychotherapy is paid for or, if your doc orders an MRI you get an appointment after tomorrow. There's also no such shit as in network health providers (exceptions apply for some insurance models) or pre-existing conditions for the basic health plan (which is still pretty good and comprehensive). While I do think that it's an overall good system it is expensive (and subsidized for people who can't afford it). Also, health insurance is mandatory.
    - roydivision 3y ago
      - It is mandatory to have health insurance, if you don't chose one the state will chose one for you - On the whole it's very expensive, although this is somewhat offset by the high standard of living - The insurance companies are legally forced to provide a lowest tier plan
  - FireBeyond 3y ago
    As someone born in the UK, grew up in Australia and now in the US, who knows of paying a seven thousand dollar copay after my “platinum” insurance for “elective” surgery to remove a kidney stone that was too big to pass, versus a nine day stay for gout in Australia that resulted in a $38 out of pocket because I wanted premium TV channels in my room.
ars 3y ago
> that would leave us with a bunch of private healthcare companies. It's already a bunch of private companies. > These private companies would drive up the cost even more. Other way around - by having to actually directly compete for customers, instead of just having to convince a few large corporation prices would go down, not up. Although we really should not ignore that insurance companies are not the drivers of higher costs, it's health care providers that do that. It's enjoyable to blame insurance companies, but the reality is their profits are capped by law - they are not the problem. Dr.'s will have to take a pay cut, and there will have to be mass layoffs, there's no other way to reduce costs.
- unusualmonkey 3y ago
  > It's enjoyable to blame insurance companies, but the reality is their profits are capped by law - they are not the problem. What a delightfully naive view. Answer me two simple questions: 1) How are insurance companies profits capped? 2) How does increasing or decreasing costs affect thier allowable profits?
  - ars 3y ago
    1: Obama care: 80/20 rule. 2: Costs change nothing. But increased health care expenses do allow them to earn more (the 20).
    - unusualmonkey 3y ago
      So if increasing healthcare expenses allow them to earn more profits, then why do you think having capped profits means that insurance companies are 'not the problem'? Insurance companies are incentivised, under law, to have the highest healthcare expenses possible.
      - ars 3y ago
        > Insurance companies are incentivised, under law, to have the highest healthcare expenses possible. Yes, that is true. But it doesn't change the fact that prices will have to change at the healthcare providers. Dr.s will earn less, people will be fired as positions are eliminated. There's no other way to reduce prices. Where do you think all that "incentivized" money is going? It's going to people in healthcare will either take a pay-cut or will lose their jobs.

photonbeam 3y ago

Its not a given that prices would increase Look at how these systems work in other countries

ekianjo 3y ago
Sounds like you have no clue about whats happening in other countries
- zer0tonin 3y ago
  Well let me enlighten you, as someone who doesn't live in america. I pay a bit less than 150 euros a months in health insurance in the Netherlands. It is not tied to my employer in any way. If I was poor I could ask for those payments to be subsidized by the state. If I am sick I can just get an appointment with my GP within the day and not pay a thing, they can refer me to specialists or blood tests if needed, which are also fast and free. The remaining healthcare costs for medications or dentistry are so low I don't even notice them. Hope this will shed some light to you about what's happening in other countries.
  - patrec 3y ago
    The problem with the above account is that the 150 euros you claim to pay per month for health "insurance" is transparently a fantasy number, and in reality you probably pay closer to an order of magnitude more into the Dutch health system.
    - ben_w 3y ago
      According to wikipedia: > Funding for all short-term health care is 50% from employers, 45% from the insured person and 5% by the government. … > Premiums paid by the insured are, on average, €137 per month for basic health care - https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands Only an order of magnitude if you're in base-2. That said, this doesn't quite track with the numbers for https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... and https://en.wikipedia.org/wiki/International_dollar https://en.wikipedia.org/wiki/International_dollar But even then, counting all payers and not just the residents' sticker price, the USA is the high-priced outlier.
      - patrec 3y ago
        > Only an order of magnitude if you're in base-2. Nope. Look at how much the Netherlands actually spends on Healthcare, it's about 11.2% of GDP in 2021 [1]. Per capita GDP in 2021 was ~53k€. ((53k€*11.2%)/12) ≈ 495€ Only problem is, like most developed countries, close to a majority of people are net recipients (around 40%). Someone will have to pay their share too. Chances are, if you're posting on HN, that's you, as you'll be somewhere in the top 5% income bracket. I think if the OP does the math based on their actual numbers, they'd be more likely to find themselves in the ~1000€/month ballpark than the 150€/month they seem to think they are paying. > But even then, counting all payers and not just the residents' sticker price, the USA is the high-priced outlier. The Netherlands (11% of GDP) is not quite as extreme as the US (17%), but it's certainly nothing to write home about, especially as I don't get the impression that either health care expenditure as percentage of GDP or demographics are moving in a favorable direction. [1] https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2021&locations=NL&start=2001 https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2...
        ben_w 3y ago
        My second link is pretty much the same as the numbers you're giving. What's the difference between my first and my second? I don't know. If you force me to guess, post-retirement and/or terminal care, possibly? > like most developed countries, close to a majority of people are net recipients (around 40%) Yes, and? Isn't much the same also true for private insurance? You've got the potential for arguing about what "fair" looks like; I'm fine with it being funded like a progressive tax, based on income rather than risk factors, but that's not hugely important. > I think if the OP does the math based on their actual numbers, they'd be more likely to find themselves in the ~1000€/month ballpark than the 150€/month they seem to think they are paying. I would assume that zer0tonin pays whatever they say they pay. They're likely to have better insight into their own finances than random internet strangers like thee and me. > The Netherlands (11% of GDP) is not quite as extreme as the US (17%), but it's certainly nothing to write home about, especially as I don't get the impression that either health care expenditure as percentage of GDP or demographics are moving in a favorable direction. The direction of movement may or may not be favourable (given the pandemic I assume "not"), but the USA is kinda the outlier in developed nations for spending a lot without delivering particularly good outcomes: https://commons.wikimedia.org/wiki/File:Life_expectancy_vs_healthcare_spending.jpg https://commons.wikimedia.org/wiki/File:Life_expectancy_vs_h... (Sourced from: https://ourworldindata.org/us-life-expectancy-low https://ourworldindata.org/us-life-expectancy-low)
  - rgblambda 3y ago
    That's less than half of what the typical UK taxpayer pays for healthcare. Surely the Dutch health system is also partially funded by government revenue?
    - shapefrog 3y ago
      According to our research, the average cost of an individual private health insurance plan sits at around £85 per month or £1,020 per year! A typical family premium (two adults in their 40s and two children under 10) can vary from £700 to £1,800 a year. The average price of a private healthcare policy in the UK is £1,032.84 per year (February 2022) Google results ...
      - rgblambda 3y ago
        >The average price of a private healthcare policy in the UK is £1,032.84 per year I did use the word "taxpayer". The UK's health service costs £2700 per head of population. Obviously what people contribute towards that varies. Also my question remains unanswered. Is the Dutch health system topped up by government funding?
    - FireBeyond 3y ago
      It’s very well documented that US healthcare and insurance costs are the highest per capita in the world.
- ffgjgf1 3y ago
  The Swiss healthcare system is privatized to a higher degree than the US one (no Medicare/aid equivalents) yet it seems to be doing mostly fine because of sensible regulation?
  - CaptainZapp 3y ago
    While generally true it needs to be noted that health insurance is very expensive in Switzerland. I'm not complaining since, first, this is a political decision and second, the level of service is outstanding. For example: psychotherapy is paid for or, if your doc orders an MRI you get an appointment after tomorrow. There's also no such shit as in network health providers (exceptions apply for some insurance models) or pre-existing conditions for the basic health plan (which is still pretty good and comprehensive). While I do think that it's an overall good system it is expensive (and subsidized for people who can't afford it). Also, health insurance is mandatory.
  - roydivision 3y ago
    - It is mandatory to have health insurance, if you don't chose one the state will chose one for you - On the whole it's very expensive, although this is somewhat offset by the high standard of living - The insurance companies are legally forced to provide a lowest tier plan
- FireBeyond 3y ago
  As someone born in the UK, grew up in Australia and now in the US, who knows of paying a seven thousand dollar copay after my “platinum” insurance for “elective” surgery to remove a kidney stone that was too big to pass, versus a nine day stay for gout in Australia that resulted in a $38 out of pocket because I wanted premium TV channels in my room.

ars 3y ago

> that would leave us with a bunch of private healthcare companies. It's already a bunch of private companies. > These private companies would drive up the cost even more. Other way around - by having to actually directly compete for customers, instead of just having to convince a few large corporation prices would go down, not up. Although we really should not ignore that insurance companies are not the drivers of higher costs, it's health care providers that do that. It's enjoyable to blame insurance companies, but the reality is their profits are capped by law - they are not the problem. Dr.'s will have to take a pay cut, and there will have to be mass layoffs, there's no other way to reduce costs.

unusualmonkey 3y ago
> It's enjoyable to blame insurance companies, but the reality is their profits are capped by law - they are not the problem. What a delightfully naive view. Answer me two simple questions: 1) How are insurance companies profits capped? 2) How does increasing or decreasing costs affect thier allowable profits?
- ars 3y ago
  1: Obama care: 80/20 rule. 2: Costs change nothing. But increased health care expenses do allow them to earn more (the 20).
  - unusualmonkey 3y ago
    So if increasing healthcare expenses allow them to earn more profits, then why do you think having capped profits means that insurance companies are 'not the problem'? Insurance companies are incentivised, under law, to have the highest healthcare expenses possible.
    - ars 3y ago
      > Insurance companies are incentivised, under law, to have the highest healthcare expenses possible. Yes, that is true. But it doesn't change the fact that prices will have to change at the healthcare providers. Dr.s will earn less, people will be fired as positions are eliminated. There's no other way to reduce prices. Where do you think all that "incentivized" money is going? It's going to people in healthcare will either take a pay-cut or will lose their jobs.