Comment by Retric | Hacker News Reader

Comment by Retric | Hacker News Reader

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Netherlands has a mostly public system with heavily subsidized mandatory non-profit insurance under government oversight: Health insurers receive compensation for high risk individuals from the government,[5] and government subsidies pay about 75% of insurance costs. https://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands

Israel also has a public healthcare system in practice. Mandatory participation in 1 of 4 non profit insurance programs looks like private insurance but … https://en.wikipedia.org/wiki/Healthcare_in_Israel For the health tax, wage-earners and the self-employed must pay 3.1% of their monthly salary up to 60% of the average prevailing market wage (appx. NIS 6,300 in 2020), and 5% of anything earned above it.[25] Employers are legally obligated to deduct insurance contributions from their employees' salaries, while the self-employed must arrange payment on their own. Pensioners have contributions deducted from their pensions, as do those receiving unemployment benefits. Those who are not working but have income must pay 5% of their income in health tax, while those who are not working and have no income must pay NIS 104 a month.

Switzerland has a similar system with mandatory participation and non profit insurance programs. https://en.wikipedia.org/wiki/Healthcare_in_Switzerland

Yes health care is very different in every country in the world. There are a 1000 ways to do it well but the US is unique in having insane healthcare costs. Having non profit insurance companies isn't the difference, having mandatory health insurance isn't the difference. It's not that easy to fix.

Each of things individually is lowering healthcare costs. Medical billing is a significant multiplier for US healthcare costs, and going to a highly regulated nonprofit only system would help.

There’s other factors like our obesity rate, but we’re basically intentionally shooting ourselves in the foot when it comes to healthcare costs because cost savings is lost profits for someone else.

The unifying factor of ~all other developed-world systems is price controls, de facto (e.g. government monopsony or [near-]monopoly) or de jure (outright pricing sheets)

Seems like you’re misrepresenting these countries in stating that they “rely” on private insurance (these are countries with public healthcare).

Are you able to point to a completely private system that is insurance based and works well?

Or what do you think public systems that also include private insurance add to the table that is missing from the US market?

In what sense does the Netherlands or Switzerland have public healthcare?

> It's not that easy to fix.

Medicare for everyone seems like an "easy" fix but we have too many red state neanderthals in the US who oppose policies that clearly benefit them claiming "personal responsibility" though they oddly still think schools, police, fire departments, etc. are just fine...

Medicare for everyone fixes the under and uninsured problem. It doesn't fix the cost problem, only moves it from paying private insurance companies to the government. It's true Medicare pays less per procedure but that is not because those procedures are more efficient it's because relies on pricing power. Many hospitals would go out of business or have to layoff a significant amount of their staff if they were exclusively paid Medicare rates.

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