4 ms·

I would love dental insurance that covers that tail risk, but it doesn't seem to exist. Every dental plan I've had covers at most $1500 or $2000 per year. That'

by paholg 3y ago

I would love dental insurance that covers that tail risk, but it doesn't seem to exist. Every dental plan I've had covers at most $1500 or $2000 per year. That's meaningless when something comes up that costs ten times as much.

semiquaver 3y ago
The problem for insurers is adverse selection and the long timescale of dental problems. The only people likely to sign up for plans that cover $10,000+ dental bills are those who know they have such a bill coming up in their future, which would cause the market price for such a plan to be so high as to make self-insurance a better prospect. This is less of a problem with health insurance since the most expensive ailments can’t generally be put off for an extended period of time (and because of universal coverage requirements, such as they are)
- panarky 3y ago
  This is market failure. Insurance works best when risk is spread out over a large pool. In private markets, insurers profit by excluding 'bad risks' which leads inevitably to coverage limitations, exclusions, and high costs for those with the greatest need. Universal healthcare systems remove this profit motive and market failure. Everyone contributes, and everyone is covered, regardless of pre-existing conditions. This eliminates adverse selection and allows for better preventative care, ultimately reducing costs and improving overall health outcomes. Markets are great for some use cases, but disastrous for healthcare.
  - bko 3y ago
    > Universal healthcare systems remove this profit motive and market failure. How does universal healthcare system remove profit motive? Are doctors going to stop seeking profit? Maybe if the government knows exactly how much to pay for a service such that there is no profit, but of course information is decentralized and central planning and price controls fails basically every time it has been tried. Plus profit serves a purpose. If I'm a doctor providing a service and there is more demand than I can handle, naturally I raise my prices, signaling to others that there is profit to be made by providing that service. > Everyone contributes, and everyone is covered, regardless of pre-existing conditions Is covered for what and at what price? Presumably you want to reduce overall costs, so total reimbursements will be less. So naturally with a lower price you'll have fewer providers willing to provide that service, which means there will necessarily be a shortage. And now you have to worry about rationing
    - panarky 3y ago
      Do you believe that compensating a doctor for her labor and expertise is the same as an insurance corporation declining care in order to give a larger share of your premium payment to its officers and shareholders? Because in a system with universal care, we would still have doctors who are compensated for their labor and expertise, but we wouldn't need the rent-seeking insurance corporation, or its officers, or its shareholders, all to prevent people from receiving care. How much more care could be provided, for the same cost, without all that waste, fraud, abuse and economic rent?
      - 6510 3y ago
        You know what would be funny, if the same fund also paid for [part of] their education. Could do student housing, provide a car, cook food, give them some money each month, build a new university. Train lots of doctors. When they get jobs ask donations. I mean, I pay plenty for health care but I never use it. I'd be much more interested in buying lots of physicians. Pampered empathic physicians. But I do want annual speeches from them. A website full of them.
    - jrajav 3y ago
      And why exactly is it that we aren't continually having this debate over skilled workers building and maintaining road infrastructure? Firefighters? Police officers? Postal workers? I truly don't understand how we have many successful and thriving examples of publicly funded services, yet somehow healthcare - which we all equally need, and which is equally a backbone of a healthy society - is somehow unique in needing profit incentives to function. The free-market theory only applies to products which you have a choice to engage with, and which are not essential to life and the basic productivity of all society.
      - MichaelZuo 3y ago
        Have you genuinely never heard a debate about private policing, private toll roads, etc…? Private police patrolling is often far more controversial than all the healthcare debate combined.
      - 3y ago
  - wakawaka28 3y ago
    Markets are great for health care itself as they create competition. Insurance that pays 100% from the day you join is financially unsound, unless everyone is forced to join. So-called "universal" health care would suffer from the same constraints. If you really want to make health care affordable, increase the supply of everything and cut the red tape. The cost issue is mostly due to a lack of supply rather than an issue with who pays. Of course well-financed entities like governments and insurance companies are capable of distorting prices. But if there were enough clinics, doctors, and supplies, we would all be able to afford basic health care even on a meager income.
  - tim333 3y ago
    Given that healthcare is a complicated problem economically, I'm not sure why countries like the US say don't look at other counties where where the system works better and copy them. See this for example https://www.statista.com/statistics/1109036/satisfaction-health-system-worldwide-by-country/ https://www.statista.com/statistics/1109036/satisfaction-hea... Singapore has low costs and high satisfaction. Maybe copy that one?
    - semiquaver 3y ago
      Singapore is a police state that doles out corporal punishment for things like spitting on the sidewalk. Not sure that it should be a model for how to run a society, or that practices there are portable to places where such draconian punishments aren’t routine. https://en.m.wikipedia.org/wiki/Caning_in_Singapore https://en.m.wikipedia.org/wiki/Caning_in_Singapore
      - tim333 3y ago
        Singapore isn't that bad really. They don't cane people for spitting, they fine for that kind of thing. I felt much safer there than say Austin TX where I went recently. But anyway Belgium is also on the list and other places. I did mention Singapore to a friend in the UK who works with the NHS and he said it wouldn't work here because Singaporeans are responsible and look after their health while Brits don't. Not sure about that one.

by paholg 3y ago

semiquaver 3y ago

The problem for insurers is adverse selection and the long timescale of dental problems. The only people likely to sign up for plans that cover $10,000+ dental bills are those who know they have such a bill coming up in their future, which would cause the market price for such a plan to be so high as to make self-insurance a better prospect. This is less of a problem with health insurance since the most expensive ailments can’t generally be put off for an extended period of time (and because of universal coverage requirements, such as they are)

panarky 3y ago
This is market failure. Insurance works best when risk is spread out over a large pool. In private markets, insurers profit by excluding 'bad risks' which leads inevitably to coverage limitations, exclusions, and high costs for those with the greatest need. Universal healthcare systems remove this profit motive and market failure. Everyone contributes, and everyone is covered, regardless of pre-existing conditions. This eliminates adverse selection and allows for better preventative care, ultimately reducing costs and improving overall health outcomes. Markets are great for some use cases, but disastrous for healthcare.
- bko 3y ago
  > Universal healthcare systems remove this profit motive and market failure. How does universal healthcare system remove profit motive? Are doctors going to stop seeking profit? Maybe if the government knows exactly how much to pay for a service such that there is no profit, but of course information is decentralized and central planning and price controls fails basically every time it has been tried. Plus profit serves a purpose. If I'm a doctor providing a service and there is more demand than I can handle, naturally I raise my prices, signaling to others that there is profit to be made by providing that service. > Everyone contributes, and everyone is covered, regardless of pre-existing conditions Is covered for what and at what price? Presumably you want to reduce overall costs, so total reimbursements will be less. So naturally with a lower price you'll have fewer providers willing to provide that service, which means there will necessarily be a shortage. And now you have to worry about rationing
  - panarky 3y ago
    Do you believe that compensating a doctor for her labor and expertise is the same as an insurance corporation declining care in order to give a larger share of your premium payment to its officers and shareholders? Because in a system with universal care, we would still have doctors who are compensated for their labor and expertise, but we wouldn't need the rent-seeking insurance corporation, or its officers, or its shareholders, all to prevent people from receiving care. How much more care could be provided, for the same cost, without all that waste, fraud, abuse and economic rent?
    - 6510 3y ago
      You know what would be funny, if the same fund also paid for [part of] their education. Could do student housing, provide a car, cook food, give them some money each month, build a new university. Train lots of doctors. When they get jobs ask donations. I mean, I pay plenty for health care but I never use it. I'd be much more interested in buying lots of physicians. Pampered empathic physicians. But I do want annual speeches from them. A website full of them.
  - jrajav 3y ago
    And why exactly is it that we aren't continually having this debate over skilled workers building and maintaining road infrastructure? Firefighters? Police officers? Postal workers? I truly don't understand how we have many successful and thriving examples of publicly funded services, yet somehow healthcare - which we all equally need, and which is equally a backbone of a healthy society - is somehow unique in needing profit incentives to function. The free-market theory only applies to products which you have a choice to engage with, and which are not essential to life and the basic productivity of all society.
    - MichaelZuo 3y ago
      Have you genuinely never heard a debate about private policing, private toll roads, etc…? Private police patrolling is often far more controversial than all the healthcare debate combined.
    - 3y ago
- wakawaka28 3y ago
  Markets are great for health care itself as they create competition. Insurance that pays 100% from the day you join is financially unsound, unless everyone is forced to join. So-called "universal" health care would suffer from the same constraints. If you really want to make health care affordable, increase the supply of everything and cut the red tape. The cost issue is mostly due to a lack of supply rather than an issue with who pays. Of course well-financed entities like governments and insurance companies are capable of distorting prices. But if there were enough clinics, doctors, and supplies, we would all be able to afford basic health care even on a meager income.
- tim333 3y ago
  Given that healthcare is a complicated problem economically, I'm not sure why countries like the US say don't look at other counties where where the system works better and copy them. See this for example https://www.statista.com/statistics/1109036/satisfaction-health-system-worldwide-by-country/ https://www.statista.com/statistics/1109036/satisfaction-hea... Singapore has low costs and high satisfaction. Maybe copy that one?
  - semiquaver 3y ago
    Singapore is a police state that doles out corporal punishment for things like spitting on the sidewalk. Not sure that it should be a model for how to run a society, or that practices there are portable to places where such draconian punishments aren’t routine. https://en.m.wikipedia.org/wiki/Caning_in_Singapore https://en.m.wikipedia.org/wiki/Caning_in_Singapore
    - tim333 3y ago
      Singapore isn't that bad really. They don't cane people for spitting, they fine for that kind of thing. I felt much safer there than say Austin TX where I went recently. But anyway Belgium is also on the list and other places. I did mention Singapore to a friend in the UK who works with the NHS and he said it wouldn't work here because Singaporeans are responsible and look after their health while Brits don't. Not sure about that one.