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142 points helloworld | 1 comments | | HN request time: 0.223s | source
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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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tracker1 ◴[] No.12306948[source]
Personally, I would have split the difference... I would have created an NPO insurance corporation that was the default for all government paid access programs (employees, retired va, medicare/aid, state programs backed by federal funding)... this likely would have cost less than was already being paid out, in effect consolidating the management of several government programs as well as opening that corporation up to the states, businesses and individuals.

Following would have been mandated coverage by employers, and from there would probably have been room to cover most of the rest or provide tax incentives to do so.

As it is, when people are paying the entire premium cost directly, they're far more likely to use that resource more, effectively raising costs... the lockin is another negative issue.

Creating a publicly sponsored baseline would establish more competition and as an NPO incentive to drive down pricing. The larger issue is IP surrounding medications and medical equipment. Much of which could be improved by front-loading patent application fees, reducing the approval rates for extension patents, and statutory licensing fees for medications more than 5 years old.

In the end government should encourage competition, with innovation as a side effect instead of trying to encourage innovation by expanding upon misguided protectionist extremism.

But that's my thought on a pragmatic solution that could have worked better with a libertarian mindset.

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gnaritas ◴[] No.12307014[source]
That's not how government works; it's not about pragmatic solutions or logical solutions; it's about what you can get enough people to agree on, which is what Obamacare is, the most enough people could agree on to get it passed. Whatever isn't in there, isn't there because it wouldn't have passed so all Monday morning quarterbacking about what it should have been entirely misses the point about how government works.

Governing is about consensus among ideologically opposed members, not about correctness or efficiency.

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tracker1 ◴[] No.12307106[source]
And the problem is that everyone in congress is trying to push for their own optimal interests, so the compromises are less ideal than a more pragmatic approach that would have the same effect as compromise from all parties. It's not either's ideal, but still better.

If I had the financial independence to run for Congress, I absolutely would.. unfortunately I need to work for a living, and being able to sustain a living while even trying to run isn't something I'd be able to do. Beyond this, running as a Libertarian would be even more difficult.

First, I'm in favor of voting for no incumbents for a few election cycles... from there, I'd love to see actual politicians working to sell pragmatic choices towards consensus instead of the give/take we get today, with the boatloads of pork that come with it.

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1. gnaritas ◴[] No.12307169[source]
> so the compromises are less ideal

Such is the nature of democracy and all design by committee, accept it, it's better than the alternative: dictatorship.

> than a more pragmatic approach

Forcing more pragmatic approaches would require dictatorship and thus is simply not the correct measure to be looking at.

> If I had the financial independence to run for Congress, I absolutely would..

That wouldn't make any difference, there'd still be a committee and the resulting solutions will never be the more pragmatic ones.