[vkou]

> Which is to say don't propose something until you understand the unintended side effects. You can get your desired result but while making everything worse.

I think the American experiment in trying to provide market health care has demonstrated that you can, in fact, have a 'free' market for healthcare, while making almost everything about that healthcare worse.

[bluGill]

The american way is not a free market. The employer tax break on health insurance is a significant manipulation.

[vkou]

A constant 30% discount on employer insurance via tax breaks does not explain the ludicrous growth in hospital bills over the last 4 decades.

Your vision benefits enjoy similar tax breaks, but I've yet to see an optometrist try to bill someone without benefits $800 for a vision exam, or $4,000 for a pair of glasses.

Its not the tax break. It's something else.

[bluGill]

Insurance companies benefit from all those tricks: medical care billing is too complex to understand unless you have a full time team of people to understand it. Insurance companies have this team and you don't.

Vision doesn't work that way because enough people don't have basic vision care that they won't stand for the complexity.

[vkou]

So, the problem is that medical billing can be made too complicated for the free market to work - not the flat ~30% tax break?

[bluGill]

NO, the problem is medical billing was allowed to become too complicated, and it is very hard to unwind that situation.

I'll contend (though of course there is no way to prove this) that if we hadn't had the advantage to company provided insurance the complex billing wouldn't have developed in the first place.