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It's an obvious outcome though. Cheaper insurance can be had by excluding anyone with a chronic or serious condition. Healthy people will flock to it. Their rat

It's an obvious outcome though. Cheaper insurance can be had by excluding anyone with a chronic or serious condition. Healthy people will flock to it. Their rates will drop. The rates for the non-healthy will thus go up, and effectively be unaffordable for most; the same reason you cannot get home insurance in a fire prone area. It's not that it is expensive -- you literally cannot get it (unless Government backs it, e.g. same as our current insurance). The destitute in health will indeed get some charity. But unless people willingly donate to the same level they are paying for insurance today, it will be strictly less. Yes, "insurance" as such has lost its meaning. Its healthcare coverage. Everyone knows that, we just keep calling it "insurance".

krupan 2y ago
Insurance is supposed to be for rare and expensive occurances. Fires (in most places), windstorms, car accidents, etc. It's essentially a bank account that a large number of people put money into and only a few people ever withdraw from. So yes, you are correct that it doesn't work to have fire insurance in fire prone areas, or to cover medical care for people that are chronically sick. It's not that insurance companies are evil, it just doesn't fit the insurance model. A different solution is needed. One that we could come up with if we had some freedom to experiment with. Health insurance today is really a collective bargaining organization. You join the UHC club and UHC negotiatates rates with medical providers on club members behalf. Except it doesn't even work very well in that model because it's not run like a club with members having any input really. You also can't easily leave one club if you are unhappy and join another club, and your employer and the government are paying more of the money into the club than you are.
- cloverich 2y ago
  > A different solution is needed. One that we could come up with if we had some freedom to experiment with. I believe if you propose such a practical experiment HN would be happy to discuss, poke holes, etc. However, most people are fine to look at other countries that have already implemented universal health care well, at a fraction of US prices and say, lets do that. The average American on private insurance already pays more than what such a system would cost. Allowing a private option on top would resolve issues with anyone worried about reduced quality / lack of choice.

krupan 2y ago

Insurance is supposed to be for rare and expensive occurances. Fires (in most places), windstorms, car accidents, etc. It's essentially a bank account that a large number of people put money into and only a few people ever withdraw from. So yes, you are correct that it doesn't work to have fire insurance in fire prone areas, or to cover medical care for people that are chronically sick. It's not that insurance companies are evil, it just doesn't fit the insurance model. A different solution is needed. One that we could come up with if we had some freedom to experiment with. Health insurance today is really a collective bargaining organization. You join the UHC club and UHC negotiatates rates with medical providers on club members behalf. Except it doesn't even work very well in that model because it's not run like a club with members having any input really. You also can't easily leave one club if you are unhappy and join another club, and your employer and the government are paying more of the money into the club than you are.

cloverich 2y ago
> A different solution is needed. One that we could come up with if we had some freedom to experiment with. I believe if you propose such a practical experiment HN would be happy to discuss, poke holes, etc. However, most people are fine to look at other countries that have already implemented universal health care well, at a fraction of US prices and say, lets do that. The average American on private insurance already pays more than what such a system would cost. Allowing a private option on top would resolve issues with anyone worried about reduced quality / lack of choice.