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But it seems obvious that inserting a group of middlemen into an already expensive system is going to make it more expensive. The complexity of dealing with al

But it seems obvious that inserting a group of middlemen into an already expensive system is going to make it more expensive. The complexity of dealing with all the insurance companies is literally overwhelming. It is so confusing to me that "socialized healthcare" is such a dirty word, when the whole purpose of insurance is, a it's core, introducing socialism into healthcare. If you are anti-socialism, cancel your healthcare and just private pay for your healthcare. :-) Sadly, we in the US seem to be sliding in that direction with the noises being made about "healthcare pools".

vondur 2y ago
Most working people in the US are on private healthcare. What you are saying makes no sense. Most everyone agrees our current system isn’t working and needs fixing.
Ajedi32 2y ago
Yes, insurance is effectively a form of voluntary socialism implemented on top of the free market. That's why it sucks so much in the first place. (Which isn't to say a purely market based system would be better; people buy insurance for a reason.) As I see it, health insurance is uniquely bad for a few additional reasons: 1. People don't treat it as insurance against catastrophic events so much as a subscription for ongoing care, which greatly expands the scope of what costs are socialized. 2. It's often paid for through employers, which reduces consumer choice in deciding what plans to purchase. 3. Demand for healthcare services is relatively inelastic and with modern medicine there's often almost no limit to how much it can cost. If you wreck your car, at most your car insurance company is on the hook for the cost of the vehicle (and perhaps some additional costs up to a fixed limit). But if you're suffering from some disease with no known cure, you could easily spend tens of millions trying hundreds of different procedures trying to find something that will work to mitigate the effects of the disease, and that's an ongoing cost that goes on forever until you're either cured or dead. Somebody has to decide which procedures are worth it or not, and if you're not paying for it yourself that "somebody" isn't going to be you, which creates lots of inefficiencies and is heartbreaking for everyone involved. This is also why we end up with systems such as "in network" and "out of network" providers, and government regulations intended to make things more fair at the cost of even more layers of inefficient bureaucracy. A few other thoughts: > If you are anti-socialism, cancel your healthcare and just private pay for your healthcare. Even for those who might be inclined to do so, this often isn't viable because of #2; they'd be leaving a bunch of free money on the table. I've also heard stories of some healthcare providers charging private individuals many times what they'd charge an insurance company for the same thing, though I'm not sure how common that still is today. > inserting a group of middlemen into an already expensive system is going to make it more expensive This is true, though note that government healthcare just replaces one set of middlemen with another.
- dragonwriter 2y ago
  > Yes, insurance is effectively a form of voluntary socialism implemented on top of the free market. No, its not. Socialism is when the working class exercises control of the (non-financial) means of production. Insurance is neither about workers qua workers or control of the non-financial means of production. Using disproportionate control of financial resources to sell risk-leveling as a service and therebu increase your disproportionate control of financial resources isn’t socialism.
  - linsomniac 2y ago
    ... which is why I put quotes around my use of the term above. Single-payer plans are often referred to as "socialized healthcare", whether it fits the dictionary definition of socialism or not. So, can we focus on problems and solutions and not argue about definitions? I don't think it brings anything to the table.
    - dragonwriter 2y ago
      > Single-payer plans are often referred to as "socialized healthcare" This is mainly an Americanism which is grounded in a similar mistake about socialism, though in a society which is actually democratic and predominantly working class, a State directed use of resources for a particular public service is at least not-entirely-unrelated to socialism (though if it is a single payer atrangement where the payees are private owners of the means of production actually employing providers of service, it is still not socialism; actually socialized medicine is, for example, where the worker-controlled state controls the hospitals, equipment, and other capital used in providing healthcare, and employs the doctors, nurses, etc. directly), whereas a commercial offering by a private capitalist profit-making entity is... nothing like socialism. > So, can we focus on problems and solutions and not argue about definitions? You are literally attributing a problem specific to capitalism to “socialism” and badly twisting the definition of socialism to do it. That’s not really a sign of being interested in “problems and solutions”, but of being interested in promoting ideological fantasies about capitalism. If you were interested in what works, you'd look at why the problem is unique to the US and what distinguishes the US healthcare system from those of other developed economies.
TheGRS 2y ago
Simplifying the system should be the goal for lawmakers IMO. But that would never really get much traction. Getting care to people who need it has an obvious priority, so we layer more and more complexity over the current system.
User23 2y ago
Capitalism with transfer payments (the Nordic model) and socialism (Union of Soviet Socialist Republics model) are two very different things. Regardless of how we might wish it to be, it's an observable fact that the latter sense is how the word socialized is understood in the USA. And yeah, people rightly object to totalitarian control over their health care, whether it's by a government or a for profit cartel that has managed to achieve a stranglehold on medical payments.

vondur 2y ago

Most working people in the US are on private healthcare. What you are saying makes no sense. Most everyone agrees our current system isn’t working and needs fixing.

Ajedi32 2y ago

Yes, insurance is effectively a form of voluntary socialism implemented on top of the free market. That's why it sucks so much in the first place. (Which isn't to say a purely market based system would be better; people buy insurance for a reason.) As I see it, health insurance is uniquely bad for a few additional reasons: 1. People don't treat it as insurance against catastrophic events so much as a subscription for ongoing care, which greatly expands the scope of what costs are socialized. 2. It's often paid for through employers, which reduces consumer choice in deciding what plans to purchase. 3. Demand for healthcare services is relatively inelastic and with modern medicine there's often almost no limit to how much it can cost. If you wreck your car, at most your car insurance company is on the hook for the cost of the vehicle (and perhaps some additional costs up to a fixed limit). But if you're suffering from some disease with no known cure, you could easily spend tens of millions trying hundreds of different procedures trying to find something that will work to mitigate the effects of the disease, and that's an ongoing cost that goes on forever until you're either cured or dead. Somebody has to decide which procedures are worth it or not, and if you're not paying for it yourself that "somebody" isn't going to be you, which creates lots of inefficiencies and is heartbreaking for everyone involved. This is also why we end up with systems such as "in network" and "out of network" providers, and government regulations intended to make things more fair at the cost of even more layers of inefficient bureaucracy. A few other thoughts: > If you are anti-socialism, cancel your healthcare and just private pay for your healthcare. Even for those who might be inclined to do so, this often isn't viable because of #2; they'd be leaving a bunch of free money on the table. I've also heard stories of some healthcare providers charging private individuals many times what they'd charge an insurance company for the same thing, though I'm not sure how common that still is today. > inserting a group of middlemen into an already expensive system is going to make it more expensive This is true, though note that government healthcare just replaces one set of middlemen with another.

dragonwriter 2y ago
> Yes, insurance is effectively a form of voluntary socialism implemented on top of the free market. No, its not. Socialism is when the working class exercises control of the (non-financial) means of production. Insurance is neither about workers qua workers or control of the non-financial means of production. Using disproportionate control of financial resources to sell risk-leveling as a service and therebu increase your disproportionate control of financial resources isn’t socialism.
- linsomniac 2y ago
  ... which is why I put quotes around my use of the term above. Single-payer plans are often referred to as "socialized healthcare", whether it fits the dictionary definition of socialism or not. So, can we focus on problems and solutions and not argue about definitions? I don't think it brings anything to the table.
  - dragonwriter 2y ago
    > Single-payer plans are often referred to as "socialized healthcare" This is mainly an Americanism which is grounded in a similar mistake about socialism, though in a society which is actually democratic and predominantly working class, a State directed use of resources for a particular public service is at least not-entirely-unrelated to socialism (though if it is a single payer atrangement where the payees are private owners of the means of production actually employing providers of service, it is still not socialism; actually socialized medicine is, for example, where the worker-controlled state controls the hospitals, equipment, and other capital used in providing healthcare, and employs the doctors, nurses, etc. directly), whereas a commercial offering by a private capitalist profit-making entity is... nothing like socialism. > So, can we focus on problems and solutions and not argue about definitions? You are literally attributing a problem specific to capitalism to “socialism” and badly twisting the definition of socialism to do it. That’s not really a sign of being interested in “problems and solutions”, but of being interested in promoting ideological fantasies about capitalism. If you were interested in what works, you'd look at why the problem is unique to the US and what distinguishes the US healthcare system from those of other developed economies.

TheGRS 2y ago

Simplifying the system should be the goal for lawmakers IMO. But that would never really get much traction. Getting care to people who need it has an obvious priority, so we layer more and more complexity over the current system.

User23 2y ago

Capitalism with transfer payments (the Nordic model) and socialism (Union of Soviet Socialist Republics model) are two very different things. Regardless of how we might wish it to be, it's an observable fact that the latter sense is how the word socialized is understood in the USA. And yeah, people rightly object to totalitarian control over their health care, whether it's by a government or a for profit cartel that has managed to achieve a stranglehold on medical payments.