"When one person in a typical mid-large group insurance plan (of the sort available to contractor "guilds" today) gets cancer, premiums for the group do not shoot up."
I didn't say they did. I said 10-person startup. And, regardless of the existence of an "exchange" or not, policies of that size will still be meted out case-by-case, and those little start-ups will get squeezed, especially if they have someone on board with a pre-existing condition.
There's no getting around that problem unless each state acts as a group insurance pool. You will ALWAYS run into the small business, part-timer, or self-employed worker problem. Full stop. No arguments.
"it turns out... you agree with me."
Let's get this out of the way from square one: I don't agree. At all. In principle or in general. I may agree in some finer details, but my ultimate pie-in-the-sky wish for America is for us to implement a mandatory system in which every man, woman, and child, regardless of age or infirmity can get covered for a nominal price, unless they are a religious or conscientious objector and chooses to opt-out, but must themselves still pay, like we do with defense.
"I disagreed with you that what we need is the Department of Health and Human Services to set prices for health care by fiat."
And, I disagreed that the free market cannot correct what is here _in practice_. Not some theoretical America where we didn't have a glacially large government or a sedentary populace with 50 Million uninsured that didn't eat Cheetos and Mountain Dew for dinner. I'm talking about the reality of the situation and how it will take more than EMR and telemedicine changes to close that 50 Million (and counting) gap, though I do agree that technology can play a non-trivial role in cutting administrative costs.
See, I have wiggle room and patience for negotiation.
"Please stop writing like this on HN."
You, I can see, don't.