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142 points helloworld | 2 comments | | HN request time: 0.449s | 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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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.

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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.
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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-...

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1. 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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2. danielweber ◴[] No.12313103[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)