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0 pointsnradov9y ago0 comments

Asking everyone to pay into a shared risk pool is not gouging. That's simply the nature of insurance. We're going to have to pay for people with pre-existing conditions one way or another, whether it's structured as a tax, penalty, or insurance premium.

Certainly there is some waste, fraud, and abuse in the healthcare system which could be cut. But ultimately the only way to significantly cut costs would be to ration care. It's a hard issue and no one likes to talk about it.

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5 comments · 2 top-level

sampo9y ago· 2 in thread

> But ultimately the only way to significantly cut costs would be to ration care.

As far as I know, Western European countries spend about half (per capita) on health care as what USA spends. I don't know if US health care is that much better. And if it's not, then in theory there is a way to get the same results cheaper.

jquery9y ago

My experience with the USA healthcare system has been utterly phenomenal. Almost no waits for procedures of any kind, top-tier care. My last hospital stay was 5 days with many lab tests and two ER visits and an ambulance ride preceding it. Out of pocket I paid $100, $50 of which was later refunded to me.

Parts of the ACA are necessary but I can't help but feeling, based on the price increases, the Act itself is horribly inefficient. We didn't increase the supply, we just increased the demand for a product which is very inelastic, resulting in skyrocketing premiums. A reform must involve increasing the supply of care.

nradovOP9y ago

Sure if we ration care intelligently based on maximizing QALYs per dollar or something then we can get roughly equivalent results (on a total population basis) for much less money. But that means we have to put a price on human life, and for emotional reasons most people don't like to do that.

maxerickson9y ago· 1 in thread

It's the nature of universal insurance with no lifetime limits.

In terms of insurance, it's perfectly possible to write healthy young people a significantly cheaper policy that has limits and is no longer available as they age. It's probably pretty stupid for the young people to opt for that policy, but whatever.

cmdrfred9y ago

What is interesting is the really expensive portion of insuring individuals is already essentially single payer. When people age most of them end up on medicare and the majority of health expenses happen in the weeks and months prior to your death.

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