[TheRealDunkirk]

What a joke. The only thing that would lower the costs would be to increase the competition, but the government has allowed merger after merger after merger (in health insurance, and in providers, just like everything else lately), taking away more and more pressure to compete.

Why is every other ad on TV for one of the car insurance companies? Competition, which drives down price. The way to fix US health care is to create a market environment where I can buy health insurance like I can buy car insurance. It's too regionally regulated now. Make the market national. Make it possible for a young, unmarried man to buy into a group policy with other young, unmarried men (with zero benefits for maternity or female-specific illnesses), and let the market sort it out.

Tying insurance to employment has got to be one of the most BALLER moves of Capitalism the world has ever seen. I mean, how much harder could you force your employees to bend over than to tie their literal life and health to working for the company?

GET MY EMPLOYER OUT OF MY FUCKING INSURANCE. People say there's no money for nationalized healthcare. Bullshit. We're already paying it. Give me the money that my company is paying on my behalf -- about $20,000/year -- and let me combine that with my portion -- about $8,000 -- and let me go buy a plan that makes sense for me on the open market.

Do these 2 things, and the market would sort this out in a New York minute.

[andrewlgood]

To be clear, I agree we should eliminate the deduction for employer paid health care.

For historical reference, employer-paid insurance only became prevalent in the US during/after World War II as a way to compete for labor after the government implemented wage controls. When the wage controls were lifted, people had become used to the benefit of employer-paid health care and it stuck.

My sense is the US will never move to the model you describe with young men creating a buying group for very specific policies. Society is simply not going to accept extreme differences in premiums for young, healthy people vs much older, less healthy people.

[CarlosEscobedo]

i think the main difference is if i have car insurance A and get into an accident they send me to body shop A, or at worst i go to body shop and send insurance the bill. If i need to see one of the 15 dentist in my area and there 100s of dental insurances there is no guarantee they take my insurance. When i switched dental insurance to another big regional one, my current dentist didn't accept that insurance, so now im paying out of pocket or finding a new dentist.

[JamesBarney]

Health insurance merges help drive down costs.

Provider merges drive up costs.

Health insurance is the buyer of medical care, so when they are monopsony (buyer side monopoly) they drive down costs.

[andrewlgood]

They also reduce choice and supply. They get to decide who gets what treatments. The death panel analogies sound ominous, but at the end of the day they are accurate. Someone has to decide what will be covered. For most people, if it is not covered, it won't be done.