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This whole situation could get solved with two swift changes in the law: - Employer provided healthcare is now illegal (with exceptions for the military). - H

This whole situation could get solved with two swift changes in the law: - Employer provided healthcare is now illegal (with exceptions for the military). - Healthcare discounts are now illegal. Insurance and cash-in-hand individuals pay exactly the same rate. These changes would be quite painful in the short term. In fact there would be a queue of people arguing why this was a horrible idea (the "I got mine" group). However in the long term this makes health insurance more similar to auto-insurance (car insurance). People can actually shop around, insurers have to compete for individual's business, and if people want to forgo insurance or go with a smaller insurer (new business!) then they can. Plus insurers and individuals will now both work together to bring hospital care costs down (they're on the same "side"). But people are too short sighted to see what a massive leap forward this would be. It is the very definition of a healthy capitalist market. But their thinking about insurance and how it "should" work is just so muddied with what has been done up until now. Employer insurance in particular is a massive problem - due to the lock-in (both between employees and their employer's insurance company AND between the employee and employer). It really hurts innovation, startups, and growth in America today. Healthcare discounts hurt people without insurance AND make the insurance sector uncompetitive. It is impossible to start a new insurance scheme now because you cannot get big enough discounts to be competitive.

AndyNemmity 14y ago
What about all the people without car insurance even under this program? This would be even worse in your situation.
- UnoriginalGuy 14y ago
  I don't understand what you mean at all. Prices for cash-in-hand individuals would be a lot lower under this scheme. Insurance covers the same costs cash-in-hand individuals pay, so no matter how many people do or do not have insurance the costs remain roughly the same.
aneth4 14y ago
"It is the very definition of a healthy capitalist market." I didn't realize heavy handed, unnecessary regulation bound to cause massive market distortions was "healthy" for capitalism. Employer health insurance is the current method of distributing risk among a larger group, and any prohibition would simply be circumvented by other types of group health insurance and reimbursements. Making discounts illegal is a ridiculous restraint on capitalism. Imagine if wholesalers and retails could not discount for marketing, loyalty, or quantity. Ridiculous. The only thing that should be regulated is the transparency of pricing and services. Consumers simply won't accept paying 5 times the price if they are aware, but they may be willing to pay 20% more to avoid the hassle of insurance. That's "healthy capitalism" - not your complex regulatory scheme. The thought of enforcement of what you suggest is mind-boggling. Illegal to provide your employees with health insurance? Bonkers.
- UnoriginalGuy 14y ago
  > I didn't realize heavy handed, unnecessary regulation bound to cause massive market distortions was "healthy" for capitalism. So the current market where two or three insurers basically control an entire state is healthier? > Employer health insurance is the current method of distributing risk among a larger group, and any prohibition would simply be circumvented by other types of group health insurance and reimbursements. In English? > Making discounts illegal is a ridiculous restraint on capitalism. So when businesses subvert capitalism that is a-ok because they are part of the system. But when the government subverts capitalism to actually make the market more competitive that is wrong? > Imagine if wholesalers and retails could not discount for marketing, loyalty, or quantity. A lot of wholesalers don't. They sell at a set price. Doesn't matter if you buy 50 or 5,000. They still seem to be in business. > The only thing that should be regulated is the transparency of pricing and services. What's the point in that when you have no choice in insurance provider? > That's "healthy capitalism" - not your complex regulatory scheme. A "scheme" I can describe in two lines is "complex?" Obama care was how many thousands of pages, remind me... If you cannot understand what I am suggesting then I propose that the issue isn't with my "complex" scheme but with your comprehension. > Illegal to provide your employees with health insurance? Bonkers. ... Just like it is "bonkers" to imagine not providing them with auto-insurance, right? And I don't mean auto-insurance for their company car. I mean auto-insurance for their private car. It makes about as much logical sense as insuring someone's private body/person.
pdx 14y ago
Of course, this would be incredibly easy to defeat in the public forum (see other's comments below), but I really like it. This system of having no price visibility, coupled with prices being arbitrarily lower or higher for different payers, is a recipe for inefficiency, opportunism, and fraud. Anything that forces us away from that path is a long term good.
sliverstorm 14y ago
Healthcare discounts are now illegal Hooray, outlaw negotiation! What could possibly go wrong with that!
- UnoriginalGuy 14y ago
  Consumer choice is more powerful than negotiation. If one hospital charges the end user twice as much as another then people simply won't go there, and doctors won't refer people there. I would say that now everyone gets to be part of the fight for cheaper prices rather than just the insurers as it is today.
- aneth4 14y ago
  We need something for all the TSA employees when they leave our airports. They can stand around in hospitals making sure nobody gets a deal.
Shivetya 14y ago
At one time I would have loved to shop for my insurance, but government prevents that, see the McCarran-Ferguson Act of 1945. I would dare say that a good portion of our out of control health care costs are because of government intervention, another good part is separating the end user from directly paying for it.
dougk16 14y ago
I'm not sure I fully grasp your argument, but if health insurance becomes anything like car insurance, then at best it's just a slightly lesser evil. I've been paying car insurance for about 15 years, at $120 a month, which is about $21,600 paid in so far, and I haven't used it once. The one time I got into a minor fender bender, I just gave the guy some cash and parted ways. If I reported it, then my rates would go up and the insurance company would eventually make back whatever they paid out anyway. Over my lifetime, I'll have given them perhaps upwards of $100,000...for what? It's not worth it to pay so much to have peace of mind against some hypothetical horrible accident. I would much rather a more government-backed system, where the government tallies all the automobile-related accident costs at the end of the year and foots the public the bill.
- fr0sty 14y ago
  > I would much rather a more government-backed system, where the government tallies all the automobile-related accident costs at the end of the year and foots the public the bill. This is pure Moral Hazard. If any cost you may incur is diluted over a pool of over 100,000,000 other people what do you care that you smash up someone elses car? Every $1,000,000 of damage costs you less than a penny. And if you put your car in a ditch the government (read: other people) will buy you a new one and you don't pay a dime...
  - dougk16 14y ago
    The same risks exist with the system in place now (insurance fraud), and will exist with really any system. The mechanisms for mitigating these risks seem rather obvious. If someone runs their car into a ditch, you do some reasonable investigation to see if it was legitimate. If someone continuously gets into suspicious accidents, they're on their own and have to pay private insurance or stop driving. Edit: not to mention the health risks of purposely smashing up your car :)
- maxerickson 14y ago
  Basic liability insurance (for auto) is more like $500 a year. That's more or less the mandated part of the coverage. I don't really care to see the government insure expensive cars and the assets of the wealthy (expensive cars and asset protection are the big drivers of expensive insurance).

AndyNemmity 14y ago

What about all the people without car insurance even under this program? This would be even worse in your situation.

UnoriginalGuy 14y ago
I don't understand what you mean at all. Prices for cash-in-hand individuals would be a lot lower under this scheme. Insurance covers the same costs cash-in-hand individuals pay, so no matter how many people do or do not have insurance the costs remain roughly the same.

aneth4 14y ago

"It is the very definition of a healthy capitalist market." I didn't realize heavy handed, unnecessary regulation bound to cause massive market distortions was "healthy" for capitalism. Employer health insurance is the current method of distributing risk among a larger group, and any prohibition would simply be circumvented by other types of group health insurance and reimbursements. Making discounts illegal is a ridiculous restraint on capitalism. Imagine if wholesalers and retails could not discount for marketing, loyalty, or quantity. Ridiculous. The only thing that should be regulated is the transparency of pricing and services. Consumers simply won't accept paying 5 times the price if they are aware, but they may be willing to pay 20% more to avoid the hassle of insurance. That's "healthy capitalism" - not your complex regulatory scheme. The thought of enforcement of what you suggest is mind-boggling. Illegal to provide your employees with health insurance? Bonkers.

UnoriginalGuy 14y ago
> I didn't realize heavy handed, unnecessary regulation bound to cause massive market distortions was "healthy" for capitalism. So the current market where two or three insurers basically control an entire state is healthier? > Employer health insurance is the current method of distributing risk among a larger group, and any prohibition would simply be circumvented by other types of group health insurance and reimbursements. In English? > Making discounts illegal is a ridiculous restraint on capitalism. So when businesses subvert capitalism that is a-ok because they are part of the system. But when the government subverts capitalism to actually make the market more competitive that is wrong? > Imagine if wholesalers and retails could not discount for marketing, loyalty, or quantity. A lot of wholesalers don't. They sell at a set price. Doesn't matter if you buy 50 or 5,000. They still seem to be in business. > The only thing that should be regulated is the transparency of pricing and services. What's the point in that when you have no choice in insurance provider? > That's "healthy capitalism" - not your complex regulatory scheme. A "scheme" I can describe in two lines is "complex?" Obama care was how many thousands of pages, remind me... If you cannot understand what I am suggesting then I propose that the issue isn't with my "complex" scheme but with your comprehension. > Illegal to provide your employees with health insurance? Bonkers. ... Just like it is "bonkers" to imagine not providing them with auto-insurance, right? And I don't mean auto-insurance for their company car. I mean auto-insurance for their private car. It makes about as much logical sense as insuring someone's private body/person.

pdx 14y ago

Of course, this would be incredibly easy to defeat in the public forum (see other's comments below), but I really like it. This system of having no price visibility, coupled with prices being arbitrarily lower or higher for different payers, is a recipe for inefficiency, opportunism, and fraud. Anything that forces us away from that path is a long term good.

sliverstorm 14y ago

Healthcare discounts are now illegal Hooray, outlaw negotiation! What could possibly go wrong with that!

UnoriginalGuy 14y ago
Consumer choice is more powerful than negotiation. If one hospital charges the end user twice as much as another then people simply won't go there, and doctors won't refer people there. I would say that now everyone gets to be part of the fight for cheaper prices rather than just the insurers as it is today.
aneth4 14y ago
We need something for all the TSA employees when they leave our airports. They can stand around in hospitals making sure nobody gets a deal.

Shivetya 14y ago

At one time I would have loved to shop for my insurance, but government prevents that, see the McCarran-Ferguson Act of 1945. I would dare say that a good portion of our out of control health care costs are because of government intervention, another good part is separating the end user from directly paying for it.

dougk16 14y ago

I'm not sure I fully grasp your argument, but if health insurance becomes anything like car insurance, then at best it's just a slightly lesser evil. I've been paying car insurance for about 15 years, at $120 a month, which is about $21,600 paid in so far, and I haven't used it once. The one time I got into a minor fender bender, I just gave the guy some cash and parted ways. If I reported it, then my rates would go up and the insurance company would eventually make back whatever they paid out anyway. Over my lifetime, I'll have given them perhaps upwards of $100,000...for what? It's not worth it to pay so much to have peace of mind against some hypothetical horrible accident. I would much rather a more government-backed system, where the government tallies all the automobile-related accident costs at the end of the year and foots the public the bill.

fr0sty 14y ago
> I would much rather a more government-backed system, where the government tallies all the automobile-related accident costs at the end of the year and foots the public the bill. This is pure Moral Hazard. If any cost you may incur is diluted over a pool of over 100,000,000 other people what do you care that you smash up someone elses car? Every $1,000,000 of damage costs you less than a penny. And if you put your car in a ditch the government (read: other people) will buy you a new one and you don't pay a dime...
- dougk16 14y ago
  The same risks exist with the system in place now (insurance fraud), and will exist with really any system. The mechanisms for mitigating these risks seem rather obvious. If someone runs their car into a ditch, you do some reasonable investigation to see if it was legitimate. If someone continuously gets into suspicious accidents, they're on their own and have to pay private insurance or stop driving. Edit: not to mention the health risks of purposely smashing up your car :)
maxerickson 14y ago
Basic liability insurance (for auto) is more like $500 a year. That's more or less the mandated part of the coverage. I don't really care to see the government insure expensive cars and the assets of the wealthy (expensive cars and asset protection are the big drivers of expensive insurance).