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by ggrrhh_ta 1379 days ago
Fortunately, life-threatening, chronic, bankruptcy-inducing, rare-and-disabling conditions represent a relatively small portion of the total healthcare spending (removing the most widespread chronic conditions). Those are also the least profitable things to insure (require a constant and sustained spending to maintain the knowledge/capability and fund research even if underutilized) if we want to ensure that any human can get reasonable access to those treatments regardless of their wealth. For this reason, countries like Switzerland or Germany maintain a "healthy" public (with lots of adjectives) healthcare system alongside.
1 comments

This is where you might be out of your element, it seems. Life-threatening / chronic / bankruptcy-inducing conditions do not represent a "relatively small" — at least in the US, 90% of health expenditure is on chronic health conditions (https://www.cdc.gov/chronicdisease/about/costs/index.htm) — this includes heart disease, stroke, cancer, and diabetes. I work in the industry and this comports with what I see on the ground as well.

In Switzerland (and also the Netherlands), the vast majority of this is covered by private health insurance, not via any sort of public health insurance. That's what sets Switzerland and the Netherlands apart from other peer developed countries, and they have results to show for it.

Regarding rare conditions, we agree — even the US has a public healthcare system alongside which covers rare conditions (e.g. end stage renal disease). US's Medicare Advantage system of private individual health insurance for senior citizens (with Original Medicare as a public option) is also a proven model with results to show for it. The CBO expects that by 2032, 61% of health insurance expenditure for senior citizens will be by the private sector (https://www.kff.org/medicare/issue-brief/medicare-advantage-...).