3 ms·

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

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.
    - linsomniac 2y ago
      I don't know if I'd call it a mistake... I'm pretty sure the phrase "socialized healthcare" was deliberately selected to help try to demonize the idea, supporting the insurance industry lobbying.
FireBeyond 2y ago
> People don't treat it as insurance against catastrophic events so much as a subscription for ongoing care _People_ don't treat it this way, it IS this way. Health insurance resembles insurance in almost none of the important ways. Picture health insurance models laid on top of your car: Imagine your car gets totaled. Your insurer says, "Hey, we're going to pay out $25K for your vehicle. So you have a $1,000 deductible, so that's $24,000, and then your copay for a total loss is $2,000, so that brings us down to $22,000. For total losses, your coinsurance as your contribution for your vehicle coverage is 20%, which is $5,000, so here's a check for $17,000. But that's only if you're buying a Hyundai, otherwise the vehicle is out of network and you'll get a check for $8,500 instead." (And to be clear, I'm not saying auto insurance is without its own issues and sketchiness, just that it at least conforms to actual "insurance").
- Ajedi32 2y ago
  I think a better analogy to my point would be if making insurance claims for oil changes was considered a normal and accepted practice. But you're right, that's part of the reason we end up with things like copays. My 3rd point above is also responsible for a lot of this.
- mlsu 2y ago
  And your insurance works with a mechanic: How much is this oil change going to cost? -- Can't tell ya. you have insurance though, right? I have Geico. The oil change was $25 last year. Let's just do it, you're telling me it's necessary. -- Great! It'll be done in about 25 minutes. ... -- That'll be $1895.00, I'll send you the bill. But if you take care of it right here, I'll lower the price to $425.00. WHAT!? 425 for an oil change? What a RIP! $125 is all you're getting from me. -- Pleased doing business with you. See you again next year!

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.
  - linsomniac 2y ago
    I don't know if I'd call it a mistake... I'm pretty sure the phrase "socialized healthcare" was deliberately selected to help try to demonize the idea, supporting the insurance industry lobbying.

FireBeyond 2y ago

> People don't treat it as insurance against catastrophic events so much as a subscription for ongoing care _People_ don't treat it this way, it IS this way. Health insurance resembles insurance in almost none of the important ways. Picture health insurance models laid on top of your car: Imagine your car gets totaled. Your insurer says, "Hey, we're going to pay out $25K for your vehicle. So you have a $1,000 deductible, so that's $24,000, and then your copay for a total loss is $2,000, so that brings us down to $22,000. For total losses, your coinsurance as your contribution for your vehicle coverage is 20%, which is $5,000, so here's a check for $17,000. But that's only if you're buying a Hyundai, otherwise the vehicle is out of network and you'll get a check for $8,500 instead." (And to be clear, I'm not saying auto insurance is without its own issues and sketchiness, just that it at least conforms to actual "insurance").

Ajedi32 2y ago
I think a better analogy to my point would be if making insurance claims for oil changes was considered a normal and accepted practice. But you're right, that's part of the reason we end up with things like copays. My 3rd point above is also responsible for a lot of this.
mlsu 2y ago
And your insurance works with a mechanic: How much is this oil change going to cost? -- Can't tell ya. you have insurance though, right? I have Geico. The oil change was $25 last year. Let's just do it, you're telling me it's necessary. -- Great! It'll be done in about 25 minutes. ... -- That'll be $1895.00, I'll send you the bill. But if you take care of it right here, I'll lower the price to $425.00. WHAT!? 425 for an oil change? What a RIP! $125 is all you're getting from me. -- Pleased doing business with you. See you again next year!