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Comment by zaptheimpaler | Hacker News Reader

Yeah this would overall be good, but not short-term.

Once consumers are directly exposed to the shit show that is insurance and pre-existing conditions and zero price transparency, and they have no collective negotiation power as they do when a company purchases, they will revolt and it will force a change.

There are a few people who cannot get insurance individually thanks to pre-existing conditions. They can only get insurance via employers group plans. Short-term a few of these people go bankrupt or die, but whats a few deaths in service of a good ideology?

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> There are a few people who cannot get insurance individually thanks to pre-existing conditions.

Denying insurance due to pre-existing conditions is currently prohibited unless the Affordable Care Act is repealed.

https://www.hhs.gov/healthcare/about-the-aca/pre-existing-co...

I agree with your other points though ("directly exposed to the shit show that is insurance"): removing employer provided health insurance would speed up the current system's collapse and push us to single payer at ludicrous speed. There would be no other option palatable.

> and push us to single payer at ludicrous speed. There would be no other option palatable.

Considering how many people are against any kind of collective payment for health and how many protections Republicans are happy to sacrifice... is it really the only option? It could just go worse with few people getting any kind of insurance. (Enough to keep the system profitable, but not necessarily helpful)

> Considering how many people are against any kind of collective payment for health

There is more support for single payer than you might have been led to believe.

"Currently, 60% say the federal government is responsible for ensuring health care coverage for all Americans, while 39% say this is not the government’s responsibility. These views are unchanged from January, but the share saying health coverage is a government responsibility remains at its highest level in nearly a decade."

"Even among those who say the federal government is not responsible for ensuring Americans have health care coverage, there is little public appetite for government withdrawing entirely from involvement in health care coverage. Among the public, 33% say that health care coverage is not the government’s responsibility, but that programs like Medicare and Medicaid should be continued; just 5% of Americans say the government should not be involved at all in providing health insurance."

Emphasis mine.

http://www.pewresearch.org/fact-tank/2017/06/23/public-suppo...

EDIT: HN throttling, sorry for editing this instead of replying.

@nerfhammer:

That doesn't mean you don't try.

yea, but any specific plan that is put forward will go through an absolutely endless relentless well-practiced vilification process and many people will end up believing that the bill is intended to the do opposite of whatever it actually does, largely only to get people to listen to radio ads.

I think there's a huge difference between "federal government is responsible" and specifically single payer solution. There's more ways fed gov could be involved.

I think if the healthcare and education cost situation gets much worse, there's going to be a big drain of people who have the means to move to more civilized societies. Or maybe thats just a personal bias because that's what I keep edging closer to in contemplation. Tech salaries are better in the US than say Europe, but if that all taken out by healthcare, while adding all sorts of bankruptcy risk and poor standards of care then there's little point gambling.

Not trying to be snarky - serious question: if you feel that way, what's stopping you? I've often contemplated what I would do if the US leans further left, and sadly, there aren't a lot of other places to go where I can have guns, freedom of speech (although in a lot of places people have been protesting against that lately, because they believe it should only apply to speech that's not horrible), and a private-business dominated economy. Looking in the other direction, there are a ton of places where you can get super-tight gun laws, a huge welfare state, and a government dominated economy ... so why not pick one and go?

Gun laws? Who said anything about gun laws. I actually think we should take a much different approach than silly bans, like maybe geographic analysis of dealer sales vs permits/ownership records to identify illegal sales.

I'm talking financial analysis and quality of life.

>> There are a few people who cannot get insurance individually thanks to pre-existing conditions

It's allot more than a few. Insurance companies consider a single night in a hospital a pre-existing condition.

Not all of them. I had individual coverage from Anthem for a while, before Obamacare, and it was all fine, and yes we had some routine medical issues in our history.

What insurance companies want to avoid is people who go without insurance until they are sick, and then want everything covered. As long as you don't have gaps in coverage, pre-existing conditions are not a huge showstopper at least in my individual experience.

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