I figure they all will. And I figure they’ll then start competing against each other.
Imagine you own an insurance company, and I own an insurance company, and five other people own five other insurance companies. And now imagine we’ve each set up shop in the same state. What happens next?
I quite agree that it’s a good idea – though I don’t follow you on how “to control costs” doesn’t count when you’re concluding that “it won’t solve any of the problems”.
I believe this graph makes clear the identities of the partiers and the cleanup crew.
My abstract political philosophy is based on the same thing as your abstract political philosophy, which is what I think is best for all members of society. I don’t see why your philosophy carries any more weight than mine.
Bullshit.
The free market is not going to make sure the local cancer patient can get treatment without going into bankruptcy.
No free market company is bidding to pay for her care. No free market ever will. The free market will let her drop dead.
Gleefully.
The problem is the free market.
My husband was hit by a car last Feb. He had three broken bones. And hours and hours and hours and hours of my fucking time chasing after the fucking assholes who run our “free market based health care system” just get them to pony up the bills that were their goddamned fucking responsibility.
I finally cleared the last of the goddamned fucking bills last month.
I estimate that between myself and my husband we spent over a hundred fucking hours of our time and nearly trashed our credit rating just to get the fucking assholes who have never once failed to collect on the premium my husband’s employer pays health care (and the goddamned bills we pay ON TIME each fucking month) to finally do their fucking job and not fob off thousands of dollars on our heads that they were legally responsible for.
Scream to death all you want about “government bureaucracy” but I swear to god that I never fucking seen so much goddamned paperwork as I have in the aftermath when dealing with the fucking private sector after his accident.
Fuck the free market and health care. The two are the worst goddamned marriage ever wet dreamed up by some schmuck at Aetna or United Wellpoint and Senator he bought.
Fuck every single goddamned asshole who ever lobbied for it. I hope all of you choke to death while some asshole from the private sector sits there deciding whether you live or die and caring more about his third house or his bizzillion dollar raise than your actual life.
Single payer is the only goddamned rational response to American health care.
My husband may lose his job in the next few months because of budget cuts.
I am halfway towards immigrating to Canada at this point just not to have to deal with this nonsense.
Our health care system is run by greedy, heartless, delusion incompetents who literally do not care if any of us die on the streets just as long as they have a few more pennies to put in their pockets.
Fuck every single fucking human being who fails to understand that.
You don’t understand the nature of the insurance industry. I’ll explain more below.
If you haven’t gotten rid of the anti-trust exemption they price fix and fuck everyone.
Okay, what you need to understand about the insurance industry:
[ul]
[li]It is not profitable to pay someone’s health care costs.[/li][li]It is profitable to collect premiums.[/li][li]To be profitable you need to collect premiums and pay out as little as possible.[/li][li]Once someone gets sick (say with diabetes) it is not worth offering them insurance, because they will use more health care than their premium covers.[/li][li]Because of the above, if a group of insurers are in a state with no regulations, they will not offer insurance to people who have been sick or have chronic problems.[/li][li]They will boot people when they reach arbitrary limits.[/li][li]They will say no to expensive treatments based on their whim (remember that there are very few regulations in our hypothetical.)[/li][li]They will attempt to use complex legal language and long forms to confuse clients about the nature of their business.[/li][/ul]
It won’t lead to an end of pre-existing conditions, it won’t make it affordable for more than a small sliver of additional members and it won’t make them stop dumping sick people when they become unprofitable. It will lower costs slightly. And that’s good, but it isn’t everything by a longshot.
In other words, you are expressing a blindly ideological catchphrase:
That is both wrong and evidence of massive ignorance on the subject. Your declaration is an utterance of faith, not an intelligent argument.
Maybe I’m misunderstanding you: are you laboring under the delusion that the free market is in effect now? Are you hypothesizing that the marriage would be the worst ever, or that it’s currently here?
My claim is that monopolistic behavior is the problem; as Lobohan just pointed out, my claim is that antitrust efforts would be terrific.
And so, too, is our auto-insurance system, I suppose? And so is our grocery-store system, perhaps – and likewise for bookbinders and boatbuilders and so on, with hotel chains and fast-food franchises and thus and such competing against one another on a level playing field, all keeping each other honest so long as the government steps in to ensure truth in advertising and prevent collusion and enforce contracts and et cetera.
What makes health insurance so different, I wonder? Or is it merely the tip of a spear?
There is no free market. There will be no free market. A free market is a boon to consumers. It will not happen. Corporations hate competition and take great pains to make sure it does not occur.
You’re being a bit dim at the moment. Possibly it’s the hour?
You suggested getting rid of the anti-trust immunity, and stated that doing so is a good idea. I replied by saying that I quite agree that it’s a good idea. And you now reply to me by – er, constructing a response around how they’ll fuck everyone unless we get rid of the anti-trust exemption.
You don’t need to lecture me on that point. You don’t need to win me over on it. We’re on the same side when it comes to how that piece of government interference with free-market forces is the problem.
All of which, I suppose, applies to auto insurance, and homeowner’s insurance, and malpractice insurance, and life insurance, and so on. Are you railing against them as well?
So deal with that point separately, if it’s a goal worth meddling in the free market for; some goals are, after all. And do likewise, one by one, for each remaining item on the list, if each item deserves that governmental interference. Not everyone can afford a house; should we allow the free market to supply houses to those who can buy them, or should we combat homelessness by attempting to give houses to everyone? Maybe we should. Maybe not. Make the case for any given piece of interference; maybe you’ll propose something else as foolish as the antitrust exemption, or maybe you’ll propose something sensible.
I don’t rule out the latter possibility; I’m not obsessed with a blindly ideological catchphrase. I merely believe this happens to be a case where the market (a) hasn’t been given a shot, and (b) should be, in hopes that it’ll shake out as well as other across-state-lines insurance competitions have. If it doesn’t, then by all means suggest new government interference – but why declare it a failure before you see what happens when consenting adults are free to make voluntary decisions?
No, I’m open to running the experiment and seeing how it shakes out. I admit to a presumption that market forces will leave health insurance looking a lot like auto insurance or homeowner’s insurance, but I freely admit that it could shake out badly; to my mind, you’re the one declaring the experiment a failure before we even run it.
Is that how you feel about every industry in this country, or just health insurance?
What is “evidence,” Alex?
Can you honestly not tell the difference between wants and needs? A house is a want. Health care is a need.
Unless your mother is a fucking moron doing an unassisted home birth you will need health care the moment you draw your first breath. You will continue to need access to health care for the rest of your life if you are an average human being.
The question is are we going to join the civilized world and have decisions made about health care in a rational way that is cost effective and benefits everyone . . or will we continue to leave things in the hands of free market idiots bent on nothing more than profit?
Well, that’s – not exactly what I’d say to a homeless person, but it’s an interesting dividing line. Of course, you’re shifting the ground a bit here; the issue isn’t really health care, but health insurance, right? We of course open the doors of our emergency rooms to people who can’t pay – starting “the moment you draw your first breath” and all that – precisely because we recognize that health care is the sort of thing people need; we’d rather have mothers and fathers pay the way for their babies, but we of course tax people who can afford it to provide medical assistance for those who can’t. If you can afford an insurance policy, we’ll bill them; if you can’t, we’ll bill the taxpayers.
If your appendix bursts, we’ll treat you. If you’ve bought an insurance policy, we’ll treat you and bill your insurer. If you haven’t, we’ll treat you and bill you. If there’s no such insurer and you can’t pay the bill, we’ll treat you and something something dark side something something complete.
An interesting argument, to be sure, for putting it in the hands of idiots who aren’t even bent on proft. Of course, well over 80% of those who have policies are currently satisfied with them, but perhaps they’re the idiots. It’s all a rich tapestry, I guess.
Sounds good to me. It’d be nice if the government went about formalizing this sentiment into a kind of universal health care plan. Expanding the plan to include preventive care instead of just emergency care might even help reduce the burden on taxpayers, since lack of the former can easily turn into need for the latter.
. . . and at each step there’d be less of an incentive to buy insurance, which would presumably affect their remaining policies in profound ways. And if that’s the ultimate goal, then by all means push it – but expect resistance from that 80+% I was just talking about in the post you’re quoting, since there’s a reason why Obama so carefully prefaces his many remarks on the subject by emphasizing that if you’re happy with your current policy you’ll be able to keep it.
That reason, of course, is that the Dems don’t want to stir up that resistance; the resistance they’re already facing is very nearly too much to overcome. So they want to craft a plan that leaves the status quo intact except for the stuff it’s meant to fix, since the alternative lacks mainstream enthusiasm or even support.
Most, not all. Oil, power companies, health care, medical, sports.
I grew up when we had competition. Not completely, but some. I remember gas station price wars. They used to give out classes or stamps to get your business. They pumped your gas and checked your oil. Is that what you get at your service station?
I never had problems with health insurance when I was young. But of course I never used it. I am 66 and don’t see a doctor very much now. I have Medicare and they send me emails telling me what tests I have available. Why? They have an interest in keeping me healthy. Strange idea isn’t it. If they were making profit off me, their interest would be to keep me from using the system and would want to deny coverage and payment.
Which idea is more humane? Which one is more ethical?
We are wrapped up in a system that is degrading and wrong. If you want to change jobs, there is a risk. If you get sick or get in an accident while you are waiting to get covered in your new job, you are dead meat. If you want to go back to school ,you have to worry about health care. If you get sick , they may dig out some excuse not to pay. They have refused people for teenage acne medicines . They can give you a huge form to fill out. They will pour over it looking for a way out of paying. Make an omission or a mistake and they can deny you. What the hell kind of system is that?
No, you’re just not quick enough to grok what I’m sayin’. Because of that blind, stupid ideology you spout off instead of thinking.
The anti-trust exemption isn’t a sure thing. I hope it is, and it’s looking good at this hour, but I have my fears that the outright evil actions of the Republicans in the senate may win the day. But yes, it would be very much worse if the anti-trust is still in place. It will still be outright horrifying however.
The free market doesn’t work for health insurance. The drivers are wrong.
No it doesn’t apply to those things. Adverse selection doesn’t apply to those things. Only sick people *need *health insurance. The sicker they are the more they cost the company. Home insurance isn’t the same thing at all. A home insurance policy has a set payout. It is statistically a safe bet for insurance companies. A health insurance policy can involve a 3 million dollar set of treatments randomly one day.
Okay, follow along:
If you want to remove pre-existing conditions you need a mandate. Because if you want insurance to cover everyone you need as many people in the risk pool as possible.
If you have a mandate you need subsidies for the poor. Because if you don’t the poor can’t pay for the mandated coverage.
Guess what? That’s pretty much the Senate plan.
No. And you’re fucking stupid for bringing it up. Thanks.
No. And you’re fucking stupid for bringing it up. Thanks.
No, we shouldn’t. You’re being fucking stupid.
The Senate bill is much more sensible than your bullshit, childish, ideological statement of faith.
Oh, my bad. 
I’ve already explained why the across-state-lines is stupid. Unless you want to have strong federal regulations. Like enforcing that insurance companies can’t deny based on pre-existing conditions.
But if you want to get rid of pre-existing conditions you need a mandate. And if you want a mandate you need subsides. Which puts you back with the Senate bill.
Because we know what would happen. Just because you don’t want to believe it is hardly a reason to make a stupid, self-destructive maneuver.
Home owner’s insurance isn’t the same. As I mentioned above.
And how will either of the bills before the House or the Senate change this?
Yes, I know; you’ve said it, I’ve said it, you’ve now said it again, I’ll now say it again: that bit of governmental interference with the free market makes things worse. It’s a wretched abomination. We’re on the same page with regard to this point; if you like, we can each keep mentioning it in every post.
So you say – but we haven’t given it a try. Instead of competition, we’ve had monopolistic behavior fostered by the antitrust exemption and barriers to selling across state lines – and it’s that wretched abomination, rather than a free market, which has only led to upwards of 80% of folks being satisfied with their policies. You agree that governmental interference has made things worse, but want to assume more governmental interference is the solution. I agree that governmental interference has made things worse, and want to assume less governmental interference is the solution.
I want to see whether the free market works first. You don’t.
And, in your proposed system, ‘the sicker they are, the more they cost the country’.
So let’s hit the taxpayers with it instead. I get it.
No, we could just keep the existing system and authorize government compensation for insurance companies who accept high-risk people at the same price as low-risk ones. Er, if we do want insurance to cover everyone. Maybe the population is okay topping out at only covering 95%-99% of the people. I don’t know. Maybe we should find out.
I believe in politics as the art of the possible. I believe the Senate bill doesn’t have the support to pass. I believe there is support for killing the wretched abomination we both agree makes things worse. I believe there’s support for killing the restrictions on sales across state lines. I believe there’s even support for a universal health-insurance plan that isn’t the one currently under discussion. I believe the polls will back me up, and I believe the politicians will take the polls very seriously:
That’s exactly how I’d put it. I’m quoting you out of context, but it’s a fine way to phrase it here, too.
I
And, again, I have nothing against strong federal regulations on across-state-lines competition. By all means, keep rehashing our violent agreement.
An uncompetitive one that gets special favors from the government.