Hacker News Reader

At one time I would have loved to shop for my insurance, but government prevents that, see the McCarran-Ferguson Act of 1945.

I would dare say that a good portion of our out of control health care costs are because of government intervention, another good part is separating the end user from directly paying for it.

"It is the very definition of a healthy capitalist market."

I didn't realize heavy handed, unnecessary regulation bound to cause massive market distortions was "healthy" for capitalism.

Employer health insurance is the current method of distributing risk among a larger group, and any prohibition would simply be circumvented by other types of group health insurance and reimbursements.

Making discounts illegal is a ridiculous restraint on capitalism. Imagine if wholesalers and retails could not discount for marketing, loyalty, or quantity. Ridiculous.

The only thing that should be regulated is the transparency of pricing and services. Consumers simply won't accept paying 5 times the price if they are aware, but they may be willing to pay 20% more to avoid the hassle of insurance. That's "healthy capitalism" - not your complex regulatory scheme. The thought of enforcement of what you suggest is mind-boggling. Illegal to provide your employees with health insurance? Bonkers.

> I didn't realize heavy handed, unnecessary regulation bound to cause massive market distortions was "healthy" for capitalism.

So the current market where two or three insurers basically control an entire state is healthier?

> Employer health insurance is the current method of distributing risk among a larger group, and any prohibition would simply be circumvented by other types of group health insurance and reimbursements.

In English?

> Making discounts illegal is a ridiculous restraint on capitalism.

So when businesses subvert capitalism that is a-ok because they are part of the system. But when the government subverts capitalism to actually make the market more competitive that is wrong?

> Imagine if wholesalers and retails could not discount for marketing, loyalty, or quantity.

A lot of wholesalers don't. They sell at a set price. Doesn't matter if you buy 50 or 5,000. They still seem to be in business.

> The only thing that should be regulated is the transparency of pricing and services.

What's the point in that when you have no choice in insurance provider?

> That's "healthy capitalism" - not your complex regulatory scheme.

A "scheme" I can describe in two lines is "complex?" Obama care was how many thousands of pages, remind me... If you cannot understand what I am suggesting then I propose that the issue isn't with my "complex" scheme but with your comprehension.

> Illegal to provide your employees with health insurance? Bonkers.

... Just like it is "bonkers" to imagine not providing them with auto-insurance, right?

And I don't mean auto-insurance for their company car. I mean auto-insurance for their private car.

It makes about as much logical sense as insuring someone's private body/person.

I'd take these points on one by one if that weren't just a rat hole.

Based on your responses, I think you need to spend some time gaining a basic understanding of the meaning of "free market," "market distortion," and how markets develop and adapt to their environment. You seem to imply you want capitalism and free markets, yet your suggestions and reasoning is ideologically incompatible with that goal, and nothing I say or do in this forum is going to bring you to a better understanding.

Of course, this would be incredibly easy to defeat in the public forum (see other's comments below), but I really like it.

This system of having no price visibility, coupled with prices being arbitrarily lower or higher for different payers, is a recipe for inefficiency, opportunism, and fraud. Anything that forces us away from that path is a long term good.

Healthcare discounts are now illegal

Hooray, outlaw negotiation! What could possibly go wrong with that!

Consumer choice is more powerful than negotiation. If one hospital charges the end user twice as much as another then people simply won't go there, and doctors won't refer people there.

I would say that now everyone gets to be part of the fight for cheaper prices rather than just the insurers as it is today.

We need something for all the TSA employees when they leave our airports. They can stand around in hospitals making sure nobody gets a deal.

I'm not sure I fully grasp your argument, but if health insurance becomes anything like car insurance, then at best it's just a slightly lesser evil. I've been paying car insurance for about 15 years, at $120 a month, which is about $21,600 paid in so far, and I haven't used it once. The one time I got into a minor fender bender, I just gave the guy some cash and parted ways. If I reported it, then my rates would go up and the insurance company would eventually make back whatever they paid out anyway. Over my lifetime, I'll have given them perhaps upwards of $100,000...for what? It's not worth it to pay so much to have peace of mind against some hypothetical horrible accident.

I would much rather a more government-backed system, where the government tallies all the automobile-related accident costs at the end of the year and foots the public the bill.

Basic liability insurance (for auto) is more like $500 a year. That's more or less the mandated part of the coverage.

I don't really care to see the government insure expensive cars and the assets of the wealthy (expensive cars and asset protection are the big drivers of expensive insurance).

$500 * 50 years is still $25,000 over a lifetime. I feel safe in saying that that number doesn't come anywhere close to the damages that an average person actually causes. And besides, I paid about that much when living in the midwest for a stint, but around an east coast city you'll be lucky to get that price for half a year.

My master plan could similarly relate population density to accountability.

You have a good point about "luxury" assets (and certainly there would be many special cases like this to account for), but I'm not really talking about government insurance per se, because it's based on actual damages. If no car accidents happened in a year, nobody would pay any money.

I have more than the legal minimum of liability insurance, live in an East coast state and pay less than $600 year. I do have a fairly clear record.

People that carry collision are doing so because someone made it a condition of a loan or because they are worried about the cost of losing a vehicle. I don't see any reason to bring the government into those situations.

Fair enough. I ran an orange light a few years ago and my insurance costs went up by 150%. While the $500/year price tag may be what's on paper, I find that it isn't the reality for most people.

It isn't so much bringing the government in, as just using them as the non-profit middle man to tally all the car-related damage costs, then foot the bill to the public. If someone wanted to opt out and use private insurance, they would be free to do so.

Obviously this will never happen in the USA, but it would be an interesting social experiment for a smaller country perhaps.

In some states you can self-insure your car if you have the cash.

Awesome...didn't know that! Self-insurance seems like a reasonable compromise to what I'm talking about.

It's a great option so long as you are comfortable having ca. $50,000 of your own money on the line every time you get behind the wheel.

I'm in no way willing to make that wager though...

With the current system, you're not even wagering that $50,000...you're throwing it out the window. Unless you believe you'll cause >= $50,000 of car-related damage over your lifetime.

Also, and this is the bigger piece of having auto insurance vs being self-insured, if you hit somebody else and kill them, you may be in for a wrongful death suit and personally liable for all of those expenses, or even medical bills if the person survives it. Those bills can easily jump into the hundreds of thousands of dollars.

> I would much rather a more government-backed system, where the government tallies all the automobile-related accident costs at the end of the year and foots the public the bill.

This is pure Moral Hazard. If any cost you may incur is diluted over a pool of over 100,000,000 other people what do you care that you smash up someone elses car? Every $1,000,000 of damage costs you less than a penny. And if you put your car in a ditch the government (read: other people) will buy you a new one and you don't pay a dime...

The same risks exist with the system in place now (insurance fraud), and will exist with really any system. The mechanisms for mitigating these risks seem rather obvious. If someone runs their car into a ditch, you do some reasonable investigation to see if it was legitimate. If someone continuously gets into suspicious accidents, they're on their own and have to pay private insurance or stop driving.

Edit: not to mention the health risks of purposely smashing up your car :)

What about all the people without car insurance even under this program? This would be even worse in your situation.

I don't understand what you mean at all.

Prices for cash-in-hand individuals would be a lot lower under this scheme.

Insurance covers the same costs cash-in-hand individuals pay, so no matter how many people do or do not have insurance the costs remain roughly the same.