[keerthiko]

Just another among 10s of reasons why healthcare shouldn't be left to the market. Lining up capitalist incentives with public health is incredibly hard -- the people who need more expensive treatment more badly are almost always the people who are less capable of affording it, for evident reasons: being invalid made them unable to work, being in poor conditions in the first place led to their health conditions, it's all a vicious cycle.

It's fine to have subsidized higher tier insurance as an employee benefit, but basic coverage should be part of normal social security, or, in an ideal universe (or nordic country), something that hospitals don't even bill for because a few billion from taxes could go into the healthcare industry instead of military or roads.

[WillPostForFood]

Interesting to note though, employer provided health insurance is a direct outcome of govt policy:

Most insurance in the first half of the 20th century was bought privately, but few people wanted it. In 1942, with so many eligible workers diverted to military service, the nation was facing a severe labor shortage. Economists feared that businesses would keep raising salaries to compete for workers, and that inflation would spiral out of control as the country came out of the Depression. To prevent this, President Roosevelt signed Executive Order 9250, establishing the Office of Economic Stabilization. This froze wages. Businesses were not allowed to raise pay to attract workers. Businesses were smart, though, and instead they began to use benefits to compete. Specifically, to offer more, and more generous, health care insurance. Then, in 1943, the Internal Revenue Service decided that employer-based health insurance should be exempt from taxation. This made it cheaper to get health insurance through a job than by other means.

https://www.nytimes.com/2017/09/05/upshot/the-real-reason-th...

[d357r0y3r]

Rarely discussed but yeah, that's how employee provided health insurance became a thing. It makes no more sense than company-provided housing or groceries or life insurance. You're already at risk of being let go by the employer at any time. Why tack on more risk by trusting the employer to take care of important insurance coverage?

The answer in 1942 would have been, "don't subsidize employer-based health insurance." The answer in 1962 would be have been, "remove the subsidies and let God sort it out." The answer is 2018 is...well, kind of like replacing the engine mid-flight. An entire tumor-like system has grown around various market incentives and it can't just be 'removed' without putting the host at serious risk.

It's kind of a shame it turned out this way because it's given insurance a bad name, unfairly IMO. Insurance is actually something that the market handles reasonably well and it's a product worth buying depending on the situation. Catastrophic insurance can be (and, to some degree, is) fairly priced.

There are many health-related services that make no sense to be covered by insurance, though. Doctor visits, routine procedures, pregnancy - it doesn't make sense to insure oneself against any of those events. Rather, they should either be paid for out of pocket or a single payer system if you like.

[dragonwriter]

> The answer is 2018 is...well, kind of like replacing the engine mid-flight. An entire tumor-like system has grown around various market incentives and it can't just be 'removed' without putting the host at serious risk.

Sure it can; the ACA marketplaces were the first step. If they hadn't been systematically undermined, the next step after they were established and stable would be shifting tax incentives to avoid favouring employer-based insurance, and the final step would be removing employer mandates and maintaining the individual mandate.

The problem is that it's not a cancer, it's an active parasite that protects itself against the host.

[mmirate]

> The answer in 1962 would be have been, "remove the subsidies and let God sort it out."

Aside from the pointless religious bit, that answer is still the correct one today.

Indeed, if any policy question is answerable via "remove the subsidies" then that answer is the correct one.

"Too big to fail" really means "too big", period.

[jacquesm]

There is this thing called lobbying. The fact that the government mandates something does not automatically mean that it is good. It could be but it does not have to be.

[WillPostForFood]

I've heard of lobbying, and didn't suggest government mandates are good (or not). What I thought was is interesting is that at least initially, it was an unintended consequence, nor the result of a mandate or lobbying.

[thaumasiotes]

> President Roosevelt signed Executive Order 9250, establishing the Office of Economic Stabilization. This froze wages. Businesses were not allowed to raise pay to attract workers.

Tangent: from where does the president draw the authority to do this?