[vec]

This works reasonably well for things like vision care because they're entirely opt-in. Patients who aren't satisfied with the prices they're being quoted can realistically choose to keep wearing glasses instead.

No one in their right mind is going to decide that the going rate for chemotherapy is a little steep right now so they're going to sit with the cancer for a year or two and see if the prices come down.

[krupan]

So think of it in terms of food then. We don't have "food insurance," yet food is a short-term need and it works pretty darn well as a free market.

[vec]

A) We do have socialized food insurance. That's literally what EBT is.

B) I'm not going to wake up in the morning to discover that my expected annual food costs have suddenly increased by four or five orders of magnitude. There is no budget-conscious version of a lot of non-emergency, but still lifesaving, medical care.

[krupan]

A) we do not have universal single payer food. Some welfare for the poor yes.

B) that's because food is a free market

[vec]

A) Right. We have universal single payer food insurance, also known as taxpayer funded welfare for the poor. We're in essence covered by, and paying premiums to, a mandatory State-run insurance policy such that if we ever can't afford the minimum necessary food to survive the State will (at least in theory) step in and buy it for us from the open market.

B) Let me rephrase. I'm not going to wake up one day to find that my required daily calorie intake has increased by multiple orders of magnitude. There are very few household budgets that could reasonably be expected to absorb such a shock, no matter how efficiently the market for those calories functions.

[krupan]

A) and it works like insurance in that most of us don't ever need it, but it's there just in case. Also, it does not regulate prices, providers, etc.

B) Again, yes, we need health insurance for rare surprises just like we get fire insurance, auto collision insurance, etc. in case of those rare occurrences. We do not need insurance for medical treatments that everyone gets. We just need to plan ahead financially for those, just like we do for food, clothing, housing, etc. Preparing ahead of time for known expenses is not insurance. If everyone's house burned down a few times each year fire insurance would not work, you would instead just factor that in to the cost of living.

[vec]

As I understand it, we have a relatively small number of people with serious or chronic illnesses whose normal, predictable healthcare expenses will drastically and permanently outstrip their realistic ability to pay. The only way they will ever be able to receive treatment is on someone else's dime, one way or another. And because everyone involved knows they're going to cost more to treat than they can pay then no sane insurer will willingly cover them if they have a choice in the matter.

As far as I can tell the main difference between the socialized food insurance we already have and the socialized medical insurance I'd like us to have is that subsistence level food costs are uniformly low for everyone whereas subsistence level medical costs vary wildly from person to person.