3 ms·

> Which to say that, imo, "restoring the free market" isn't a useful action in this mess. State controlled medicine is essentially the only solution to the alre

> Which to say that, imo, "restoring the free market" isn't a useful action in this mess. State controlled medicine is essentially the only solution to the already partly collapsed US health care system. I don't trust the US government is competent enough to run healthcare. If it can do better than the existing system, let it create a new voluntary, unsubsidized insurer, free of the BS rules it has created. Competition is the source of quality and low prices. Any monopoly is an invitation for poor quality and high prices.

bcrosby95 3y ago
The great thing about the "50 states" model is states can try random experiments. For example, Texas has done a lot to try to bring more competition but none of them have done a thing for the high cost of healthcare.
- oatmeal1 3y ago
  That would be great if we had real federalism. The states cannot try anything really unique, because they are hamstrung by federal law and federal subsidies with strings attached.
- FireBeyond 3y ago
  Yup. The big one to me being capping malpractice payouts. "Healthcare costs a lot because physicians have to carry very expensive malpractice insurance because of astronomical judgments". Texas caps malpractice payments and everything stays exactly the same. Also, malpractice insurance in itself isn't typically as onerous as people believe it to be. What is onerous, and what that industry does differently to most other insurance segments is "tail insurance". Tail insurance is the concept that major malpractice suits may appear well after your claims-made liability policy has ended. In most cases it's actually DOUBLE the premium you're paying for malpractice insurance, implying the insurer believes that your coverage is less than one-third of the claims they expect to pay. What -should- happen is that you carry "claims-made and prior acts" coverage. The challenge there is that in many cases your employer will cover claims-made as part of your compensation or part of their insurance, but don't elect prior acts coverage (and because of the way they do it, I suspect it's not as simple as "let me pay the difference"). But in general capping malpractice payouts has done nothing to offset malpractice coverage costs, let alone flow-through to end consumer costs.

bcrosby95 3y ago

The great thing about the "50 states" model is states can try random experiments. For example, Texas has done a lot to try to bring more competition but none of them have done a thing for the high cost of healthcare.

oatmeal1 3y ago
That would be great if we had real federalism. The states cannot try anything really unique, because they are hamstrung by federal law and federal subsidies with strings attached.
FireBeyond 3y ago
Yup. The big one to me being capping malpractice payouts. "Healthcare costs a lot because physicians have to carry very expensive malpractice insurance because of astronomical judgments". Texas caps malpractice payments and everything stays exactly the same. Also, malpractice insurance in itself isn't typically as onerous as people believe it to be. What is onerous, and what that industry does differently to most other insurance segments is "tail insurance". Tail insurance is the concept that major malpractice suits may appear well after your claims-made liability policy has ended. In most cases it's actually DOUBLE the premium you're paying for malpractice insurance, implying the insurer believes that your coverage is less than one-third of the claims they expect to pay. What -should- happen is that you carry "claims-made and prior acts" coverage. The challenge there is that in many cases your employer will cover claims-made as part of your compensation or part of their insurance, but don't elect prior acts coverage (and because of the way they do it, I suspect it's not as simple as "let me pay the difference"). But in general capping malpractice payouts has done nothing to offset malpractice coverage costs, let alone flow-through to end consumer costs.