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142 points helloworld | 45 comments | | HN request time: 0.002s | source | bottom
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seibelj ◴[] No.12306806[source]
Can anyone succinctly explain the benefits of having a market for private health insurance companies, rather than a single provider of health insurance (government, aka "public option")? Can a capitalist case be made for their existence? Does the lack of a large private insurance market in countries with government-provided health insurance cause lots of inefficiencies and waste?
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VonGuard ◴[] No.12306849[source]
There is no benefit. The benefit is for the legislatures who passed the law. There was no way that we'd get single payer here in the US because our Congress is very much in the pocket of the health care industry. As such, the markets were a compromise measure enacted by congress to make it easier for people to choose health care. Before Obamacare, it was sort of a black box where only HR people could figure out pricing structures and health care providers didn't really compete in any way with each other.

Obamacare did do some good things that needed to be done, but essentially, everything about it was a bandaid intended to kick this shitty system down the road to the next person who had to deal with it. But hey, at least health care companies can't just turn you down because you have Diabetes or are too fat anymore.

replies(3): >>12306932 #>>12306935 #>>12310096 #
1. eridius ◴[] No.12306932[source]
There's no way that we'd get single payer here because the Republican party has convinced their base that single-payer health care is socialism and that socialism is evil, which leads to the situation where poor people who desperately need health care and can't afford it still oppose single-payer even though they stand to gain the most from it.
replies(8): >>12307005 #>>12307145 #>>12307235 #>>12307241 #>>12308132 #>>12308309 #>>12308651 #>>12310156 #
2. dikaiosune ◴[] No.12307005[source]
Of course, the constituencies which oppose single-payer seem often to be composed of the same people who will vote out anyone who messes with their Social Security, Medicare, or VA benefits.
replies(2): >>12307128 #>>12307373 #
3. Randgalt ◴[] No.12307128[source]
That's an excellent point. Medicare and SSI are equally bad programs that should be phased out.
replies(1): >>12307211 #
4. danielweber ◴[] No.12307145[source]
The situation is not helped when proponents of single-payer say things like "there will be no denial of claims." I think there are things to support about single-payer, but it really, truly, I swear to fucking God, has trade-offs, and since it has been sold as not having any honest trade-offs, we can't actually implement the hard parts of single-player.

http://www.vox.com/2016/1/17/10784528/bernie-sanders-single-...

replies(2): >>12307197 #>>12307418 #
5. VonGuard ◴[] No.12307197[source]
Yes, there are trade-offs. In my opinion, they are worth the switch, and amount to a difference between "choosing which hand to reattach and letting the other go dead," and "No lap-band for you fatty." The latter being the single payer option.

Anyway, in almost all world single payer systems, rich people can still pay for vanity doctors.

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6. VonGuard ◴[] No.12307211{3}[source]
I often wonder if John Galt ever found himself living alone in a room with no one to take care of him in his old age.
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7. im_down_w_otp ◴[] No.12307235[source]
It wasn't Republicans that removed the "Public Option" or the Drug re-importation initiatives from the ACA. FWIW.
replies(2): >>12307549 #>>12308767 #
8. MichaelGG ◴[] No.12307241[source]
And yet the current front runner of that party has been strongly in favour of a single payer system over the years. (Though I'm guessing recently there's a shift away from that, publicly anyways.)
9. nappy-doo ◴[] No.12307294{4}[source]
Who is John Galt? :)
10. tbihl ◴[] No.12307373[source]
The same people: "those barbarians over there," no matter where you're standing.
11. tbihl ◴[] No.12307418[source]
A family friend, who was at the time the chief neurosurgeon of a significant Canadian hospital, pointed out once back in the late 80s, "America will never make single payer work because you won't be able to place a cut off where you stop paying to delay death." And of course it's completely true. The claim that there wouldn't be any "death panels" was of the most damning aspects of the legislative battle, because it proved that no one wanted to let reality in.
replies(1): >>12307521 #
12. vidarh ◴[] No.12307521{3}[source]
Reality, of course, being that the US has death panels: Insurance providers, so the argument was idiotic to begin with.

The difference is that with most socialised systems there are two system in parallel:

A public system whose priorities set based on measured impact, rather than by . E.g. in the UK, a separate agency develops guidance independently that measures how treatments affect "quality adjusted life years".

And a private system, whose priorities are, like in the US, based on how deep your pockets are.

For the vast majority the public system is the only one they use, but about 10% pay for private insurance. In practice this acts like a good indicator:

If takeup goes up it means more patients believe NHS care is slipping and makes them feel they need to "top it up".

If prices goes up (private insurance here is exceedingly cheap, since most providers are based on you going to the NHS first and then referring you privately if you e.g. don't get to see a specialist within X days) it's an indicator the providers see NHS as deteriorating (causing more claims from their customers).

The US could do the same - continue to allow private healthcare, but cover a certain level of treatment via a public system.

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13. ende ◴[] No.12307549[source]
I wonder how many people would trade individual mandate for public option.
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14. ruste ◴[] No.12307688{4}[source]
Except you can sue your insurance provider if they deny you coverage for something that they're obligated to cover. You wouldn't be able to sue the government.

Edit: Let me also add this; when you sign up for health insurance you're entering into a contract with the insurer. They have to be up front about what they're providing and it's your obligation to understand what you're buying. With the government you don't get that. You get whatever the vanilla flavour of healthcare coverage is today. There's no contractual obligation, only whatever the government says is right today. You don't get a guarantee. Because there's no contract you can point to, even if you're legally allowed to sue (and I don't think you are.) you won't have a case to stand on.

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15. vidarh ◴[] No.12307765{5}[source]
Yes you can. In the UK people sue the government, or specially the NHS, over treatment decisions all the time. Including over things like denied coverage of specific drugs etc. (usually when there's no proven benefit from a given drug).

And as I pointed out: If you think they are too strict, then you can pay for a private insurer to cover things the NHS doesn't cover or won't do fast enough for you.

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16. wavefunction ◴[] No.12307820{5}[source]
It's true, Galt was a fictional caricature.
17. maxxxxx ◴[] No.12308132[source]
I am still waiting for the Republicans vote for abolishing Medicare and the VA. Those programs are pure evil and seniors and vets must be liberated from them.
18. st3v3r ◴[] No.12308308{5}[source]
"Except you can sue your insurance provider if they deny you coverage for something that they're obligated to cover. "

With what money? And furthermore, what good will that do if you die before the trial is over?

replies(1): >>12308505 #
19. ecommerceguy ◴[] No.12308309[source]
I think you'll be remiss to find that the majority of insurance company donations go to the Democratic party. Of course poor people have been voting Democrat for over 50 years and they are, for the most part, still poor. Que Einstein quote.
replies(1): >>12309475 #
20. maxerickson ◴[] No.12308332{5}[source]
(successful) Suit against Medicare:

https://www.cms.gov/medicare/medicare-fee-for-service-paymen...

replies(1): >>12308518 #
21. thinkcontext ◴[] No.12308436{5}[source]
> Except you can sue your insurance provider if they deny > you coverage for something that they're obligated to > cover.

There's an enormous information and power imbalance in the health insurance contractual relationship. The large number of medical bankruptcies by people that had health insurance is surely a testament to this fact.

22. ruste ◴[] No.12308505{6}[source]
You can have the procedure done then sue them when they won't pay for what they're contractually obligated to. You don't generally get a hospital bill until the procedure is done.
replies(1): >>12312145 #
23. ruste ◴[] No.12308518{6}[source]
That case was against Medicare contractors. Not Medicare.
replies(2): >>12308532 #>>12310118 #
24. maxerickson ◴[] No.12308532{7}[source]
Jimmo v. Sebelius

The named defendant was the Secretary of Health and Human Services. The suit was over practices followed by Medicare contractors, but it's not like they were operating outside the knowledge of Medicare, they were acting as Medicare had directed them to act. The settlement agreement has Medicare changing the procedures the contractors will follow.

replies(1): >>12312022 #
25. jcbeard ◴[] No.12308651[source]
>which leads to the situation where poor people who desperately >need health care and can't afford it still oppose single-payer >even though they stand to gain the most from it.

I'd think education is the way around this. Start off with a "whats the worst case that could happen" then move to "whats the best that could happen." To me, you can convince people as long as you explain that their not going over a cliff. To me, this argument was never made. All I heard on the news was "it's socialism" or "it's good" but no selling the public on why it was in fact good. In this case, our leaders who were the proponents of single payer failed us. Single payer will happen, it'll just take a bit longer. The commercial healthcare industry is on a path to failure....there is no fixing it for the US. Eventually we'll end up with a system, that likely looks like what Germany/UK have (some mix of public/private).

26. SteveLAnderson ◴[] No.12308767[source]
Well ... you're strictly right, but just like the idiotic provision that forced Congress to give up their employer sponsored insurance and use the exchange instead was forced by the GOP, so to were these provisions dropped due to GOP pressure.

You see, the GOP continually promised, on one hand, to tie the ACA up in legislative hurdles so it couldn't pass, or, on the other hand, vote for it if it met their requirements.

So, foolishly it turned out, the Democrats played ball with the GOP. In the end, the GOP still did everything they could to block it and voted against it en masse.

I think the error was that the Democrats believed the GOP would vote for the bill if they changed it enough. It was naive.

replies(1): >>12308993 #
27. im_down_w_otp ◴[] No.12308993{3}[source]
Um, no. Those provisions were the Democrats negotiating with themselves. At the time the Democrats had the votes to force the issue regardless of the Republican opposition.

It was people like Ben Nelson, Joe Lieberman, and Max Baucus that played a rotating merry-go-round of scapegoats that the Democratic Party used to trump up reasons why they couldn't support more progressive reforms in the healthcare legislation.

Also, it wasn't Republicans that put a WellPoint Executive Lobbyist (Elizabeth Fowler) in charge of writing large portions of the actual legislation and acting as the liaison between the White House and the Senate.

In the end we got a big pageant and self-aggrandizing back-patting session from the Democrats who called it the greatest Democratic legislative accomplishment since the Civil Rights Act... which is ironic considering that the ACA is almost the spitting image of Republican Bob Dole's Heritage Foundation sourced (and AHIP sponsored) reform plan from just a few election cycles prior.

So... the greatest Democratic policy achievement in at least a generation was to pass a Republican policy proposal. Well played Democrats. Well played.

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28. eridius ◴[] No.12309459{4}[source]
A Republican policy proposal that wasn't passed back when it was proposed. Just because the Republicans proposed this first doesn't mean it's a bad idea. We're all human beings and we all have a lot of common ground. Not everything a Republican proposes is automatically hated by Democrats, and not everything a Democrat proposes should be automatically hated by Republicans (I say "should be" because lately the Republican party does seem to reflexively hate everything Democrats propose, even if it was originally a Republican idea like the ACA).
29. eridius ◴[] No.12309475[source]
> I think you'll be remiss to find that the majority of insurance company donations go to the Democratic party.

I'm not sure what you're saying here. Are you saying I'll determine that to be the case if I'm lacking attention, or are you saying that I'm lacking attention and therefore don't know that? I'm also not sure what the point is either way, why the truth or falsehood of this statement is relevant to my comment.

> Of course poor people have been voting Democrat for over 50 years and they are, for the most part, still poor.

This also doesn't make any sense. Nobody said that voting for either party would make you rich. Making health care accessible to the poor doesn't make them less poor, it just gives them health care.

> Que Einstein quote.

What quote?

30. SteveLAnderson ◴[] No.12309615{4}[source]
I agree with your assessment of the legislation.

It's true that Sen. Lieberman, in coordination with Sen. Snowe, threatened a filibuster. At the time, Sen. Lieberman was an independent, not a Democrat. So, it was an independent and a Republican.

I know that's splitting hairs, but these are valid hairs to split.

replies(1): >>12309948 #
31. dredmorbius ◴[] No.12309684{5}[source]
You've got that almost completely backwards, though few people are aware of this (in the United States).

I'm hazy on the details myself, but briefly:

1. Healthcare insurers are covered under ERISA, the Employee Retirement Income Security Act, of 1974. Among the provisions of that act are limitations on the right to sue, under the theory that a retirement fiduciary is an agent of the employees. It's been a long time since I've looked at this, and I don't recall all the specifics, but yes, there are some limitations on suit for lack of coverage.

https://en.m.wikipedia.org/wiki/Employee_Retirement_Income_S...

2. Lawsuits against the government are possible and happen all the time. I'd have to see what specific limitations apply, if any, to Medicare, Medicaid, Disability, and VA care, but you'll find numerous instances of suits:

https://duckduckgo.com/?q=lawsuit+medicare+denial+of+(care%7...

Update, additional info on ERISA and its impact on lawsuits: appeals through the insurer must first be exhausted, but statute of limitations applies whilst lawsuits are blocked: https://www.lawyersandsettlements.com/articles/stock_option/...

32. im_down_w_otp ◴[] No.12309948{5}[source]
He caucused with the Democrats and was only an Independent because he got primaried out of his seat by Ned Lamont, so to stay on the general ticket he switched to being an Independent.

While we're splitting hairs.

Anyway, HN is a place I relish usually being devoid of pointless political conversation, so I'm just going to drop it now and go back to reading about Zippers in Erlang.

33. astronautjones ◴[] No.12310118{7}[source]
... because Medicare contracts out services
34. tn13 ◴[] No.12310156[source]
Pardon my use of words but I think it is foolish not to accept that there are pretty serious trade-offs involved here and there are perfectly legitimate reasons why single payer is a very bad idea. I personally think a single payer system in USA would pretty much resemble Veterans Affairs. Corrupt, inefficient and something that makes consumers profoundly unhappy while taking away a good chunk of your hard earned wealth.
35. tn13 ◴[] No.12310162{4}[source]
I think John Galt would prefer to die than use someone else's money by force to take care of himself. I think that is very honorable.
36. mr_tyzic ◴[] No.12310788{5}[source]
Ayn Rand sure did though.
37. ruste ◴[] No.12312022{8}[source]
Except the very first paragraph states that the reason for the suit was that the contractors were not appropriately following Medicare guidelines.

"...in which the plaintiffs alleged that Medicare contractors were inappropriately applying an “Improvement Standard” in making claims determinations for Medicare coverage involving skilled care..."

replies(1): >>12312438 #
38. dagw ◴[] No.12312145{7}[source]
Will a hospital even perform the procedure if the insurance company has said no and they know the patient will never be able to pay for it?
39. splintercell ◴[] No.12312335{4}[source]
> I often wonder if John Galt ever found himself living alone in a room with no one to take care of him in his old age.

I hope you understand that to Objectivists that sounds like saying "I often wonder if Frederick Douglass ever found himself suffer an accident at work with no master to take care of him because he isn't a slave".

I am sure there are better arguments possible against objectivist position, but the one you made is rather naive one.

40. maxerickson ◴[] No.12312438{9}[source]
I read that as mealy-mouthed cover for future questions about Medicare expanding coverage unilaterally, but I would agree that is pretty subjective.
41. danielweber ◴[] No.12313060{6}[source]
In Hillary Clinton's proposed health care plan in 1993, no, you weren't allowed to sue. You could get an appeal from a Board, but that's it. The proposed legislation explicitly said there could be no other review.

Note that this is a very good cost containment strategy. Note also that this can probably not reduce patient outcomes at all. Note also that it is extremely unpopular.

42. danielweber ◴[] No.12313103{3}[source]
> and amount to a difference between "choosing which hand to reattach and letting the other go dead," and "No lap-band for you fatty."

No, it tends to be a lot of care that isn't worth the cost that gets denied. This is very different from what an American expects, which is that everything they "need" (or what their doctor says they should do) ought to be covered.

The lap-band often passes, because it can be a relatively low-cost way to add a bunch of QALYs to a patient's life.

NB: I think having care decided on a cost-basis is a pretty good approach, at least to start from, but it is immensely unpopular in the US. On both sides of the aisle.

> Anyway, in almost all world single payer systems, rich people can still pay for vanity doctors.

Often. Not always. In Canada only recently could a doctor offer the same services the government offered, and that was against the will of the legislature. Their supreme court had to rule on it. https://en.wikipedia.org/wiki/Chaoulli_v_Quebec_(AG)

43. danielweber ◴[] No.12313208{3}[source]
You can't get rid of the individual mandate without completely destroying the whole law.

It's the unpopular part of the law. But pretty much anything that works is going to have some unpopular component that needs to be swallowed in order for the whole thing to work.

When Republicans talk about getting rid of the individual mandate, it's because they are, in actuality, trying to kill the law. When Democrats talk about it, I really don't know what's going through their heads. Leftist wonks like Krugman or Klein keep on telling them exactly why it's needed.

replies(1): >>12322185 #
44. ende ◴[] No.12322185{4}[source]
Sure, but not really what I meant. Adding public option and subtracting individual mandate would basically be a step towards having single payer with secondary private market.
replies(1): >>12322244 #
45. dragonwriter ◴[] No.12322244{5}[source]
> Adding public option and subtracting individual mandate would basically be a step towards having single payer with secondary private market.

I don't see how it would be, unless by "subtracting individual mandate" you mean "replacing an individual mandate backed with a fee/tax/penalty for failure to comply with a universal tax, an option to select a private option with the tax refunded as a subsidy, and a default of using the public option if no private option is selected". Which, really, is retaining the individual mandate, but making it impossible to break rather than penalizing breaking it.