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Comment by girvo | Hacker News Reader

Kind of defeats the whole "free market" thing, doesn't it?

It isn't really a free market though, it is a fixed market. If it was true free market it would be individual to service, that is why prices are all over the place. We just need to return to individual health care plans, paid for by employees individually (or give them cash health benefits). If your employer paid your auto insurance we'd have the same problem.

Not sure how you fix it, maybe by temporarily making it illegal to allow a company to provide health benefits through insurers to fix this. Employers should only be allowed to give you the money for an individual plan (most startups sometimes do this instead). Employers don't pay your auto insurance, home insurance or other insurance. Maybe a one time convert of employer groups to individual groups managed for risk, then, for privacy, for business, for better health care the individual has that (also probably a back up plan for those in need).

Why should employers know about your health? This is ancient thinking where you stayed with a company forever. It's also a privacy thing. I think it would also combat ageism. It will also make starting companies and competing much easier with less friction. It would also allow employees to more easily go from job to job, when you have an employer plan it is a scary predicament sometimes.

Cost can only be competitive if they are seen, they will be seen if it is moved away from employer provided.

Or how about have national healthcare? Like every other decent country on this planet?

Possibly, but you can't make that leap directly, people/industries don't move that fast. First step is move away from company provided, I am sure there would be renewed interest for it in many against it now, or some workable private and public system where prices are known, more direct.

Only after we have explored every other possible solution. This is America, and no socialism is possible; unless you are a homeland security contractor.

What the hell? State provided healthcare = Socialism?! That's bullshit.

What about the police department? Or the fire department? Or the post office?

Yes, those are all socialist. That's not a bad thing.

Any government is, at its core, socialist. Rather than everyone funding their own private army, the state socialises the cost and provides national defence.

For other parts of society, it may also make sense to have everyone pay in to provide service which is to the public good. Police, fire, postal services are canonical examples.

In most countries, health care is also socialised. As is garbage collection, libraries, and road building.

The question - for most reasonable people - is where do you draw the line? Buses are socialised - what about taxis? Doctors are socialised - what about Lawyers, or accountants?

Careful there. A lot of countries have quasi private/public systems with law-enforced mandates. For example, Switzerland.

Describe "national healthcare". I see people who like to bitch about the US throwing this term around a lot, but what do you mean by it? One single, state-organized health care provider that gets funded 100% by other taxes or a flat-fee contribution that is the same for everybody? State-set price controls? Price controls on what - costs of procedure or insurance plan? What about coverage of those plans, determined by the state?

State organized and owned healthcare. You pay for it as a taxpayer and don't have to worry about going bankrupt because of a disease that can happen to anybody. For an example, the UK's NHS.

Private healthcare is still perfectly legal and fine, as is private health insurance, if you deem the state services are not suitable for you.

Hospitals should be helping people, not ripping them off >.<

You don't even have to make it illegal for your employer to pay your insurance premium, just take away the tax deduction and watch how fast your employer stops paying.

I suspect they still would provide it, because it would be a competitive advantage. I get better rates on health insurance through my employer than I could get on my own, presumably because the average working person is cheaper to care for than the average person. So, my company (and most companies) would still find an advantage in hiring if they offered health care. (I'm assuming above that you're talking about taking away the employee tax advantage for this insurance (the avoidance of personal income tax on it). It occurs to me at the end of my reply that you might consider treating it as a non-business expense and that the company would have to pay corporate income tax on the money they use to buy health insurance. I agree that doing that is a big hammer, but it also seems like a terrible idea. If the company has a legitimate business purpose in spending its money that way, namely to better compete for employees, then it's a legitimate business expense, IMO. Trying to enforce social change via the tax code rarely results in precisely the "clean" outcome that people lobbying for those changes intend, or purport to intend.)

No captive market can ever be a free market. And everything health-related is a captive market, because you can't afford not to pay for the service.

> because you can't afford not to pay for the service.

you mean you can't afford to not _have_ the service? you can certainly be unable to pay!

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