[Spivak]

Why do you say that? Take insurance in its most basic form: a company does its best to determine how much money they're likely going to pay out over the lifetime of a policy and spreads that cost out for their customer who is then insulated from unexpected expenses or non-uniform cost schedules. It seems perfectly suited to medicine.

Insurance doesn't solve the problem of a population where the total cost of care is more then they can collectively afford or when an individual's treatment has known costs higher than what they can afford but nobody has a good answer for that.

Insuring everyone from birth can be a solution for the individual but not the population.

[Eridrus]

Insurance works when you incur a lot of one time costs, it works much worse when you start incurring a lot of expenses over a long period of time. Ideally you could buy insurance that would cover all of your long term costs once you contracted some disease, but this doesn't exist in the US. And doubly doesn't exist when you realise that there are a bunch of forces incentivizing people to get their insurance from an employer.

[Spivak]

> you could buy insurance that would cover all of your long term costs once you contracted some disease

Kind of defeats the point if you're using it to cover known future costs. Insurance can really only insulate you against risk, it's not free money.

[Eridrus]

But at the earlier point in time, when people are buying insurance, these are unknown future costs.

And this is the whole problem, insurers don't want to pay those costs because that would increase the premiums they need to charge, making them uncompetitive (and then you're into the realm of behavioural economics), but what people actually want is something that can insure against spending on chronic diseases, which accounts for 90% of the spending on healthcare in the US.

And IMO, to the extent that insurance doesn't cover chronic conditions, it is a bad model for healthcare.