[anonymoushn]

I came here to say just this. In the United States, though, we use "Insurance" to refer to a very expensive form of prepaid health plan. We keep costs up by making laws that prevent employees from knowing how much their prepaid health plan costs. Just in case people might want to react to the high costs by not purchasing a plan, in the near future everyone in the U.S. will be required by law to purchase a prepaid health plan.

[tptacek]

It's the nature of the social contract that we give up certain freedoms to gain the benefits of society; that's what contracts do: they bind us.

It's not hard to make a list of "freedoms" we're mostly happy that people give up: the "freedom" to drive 100mph through school zones, the "freedom" to sell patent medicines with Pfizer branding on it, the "freedom" to set tire fires on our lawns. Those "freedoms" are respectively outweighed by the cost of collisions, of medical fraud, and of toxic and repulsive clouds of smoke.

When societies adopt single-payer health care systems, they're expressing a judgement that the "freedom" to take individual control over how to finance health care at the lowest possible price is outweighed by the cost to society of the uncertainty of health care costs.

And, setting aside principle for a moment, your health & well being is in fact one of the most important uncertainties in your life. You could be hit by a bus tomorrow, or stricken with a disease that outstrips your ability to pay for care. With the exception of a tiny, tiny fraction of people in society, nobody can truly provide an assurance of their ability to provide for their own care. So, to bring the principle back into the picture: if you're ideologically opposed to single-payer or socialized or mandated health insurance, it would seem that you must also support the idea that people who can't pay for their care must be denied care.

There's a wide variety of pragmatic objections to single-payer insurance, many of which are probably valid. But if we're going to bring "freedom" and "choice" into the picture --- ideology, in other words --- we should be clear about what the tradeoffs are.

[bunderbunder]

I think what the grandparent was actually referring to was the system in the USA where people get group insurance through their employer.

Setting aside the question of market vs. socialized health care, it doesn't take much observation to realize that this is a very bad system. It both sweeps costs under the carpet and removes consumer choice from the equation, thereby severely reducing the extent to which health insurance companies must compete on both cost and quality of service.

Think your company's group plan is too expensive? Well, you're free to drop out of it if you want. Of course, the money they were spending on your health insurance won't get added to your salary when you do, so ultimately whatever you find will end up being even more expensive.

Pissed off because your health insurance company screwed you over? Well, you've got pretty much the same "my way or the highway" option.

What a lot of folks fail to realize is, just because we don't have a socialized system doesn't mean we have a market system. What we actually have is a bastard system that offers the benefits of neither, plus some downsides that are uniquely its own.

[sunsu]

Freedom and choice cannot be broadly lumped into "ideology". Freedom and choice are integral parts of how markets function. To completely remove freedom and choice from the healthcare debate means that there should be ONE BEST solution. The reason why I value my freedom to make my own decisions about health care is because I do not think that a universal single payer system is the ONE BEST solution.

[tptacek]

That's a pragmatic objection and probably a valid one, but note that the concern is explicitly mitigated by the idea of a market for private health insurance with "guaranteed issue"; the catch with guaranteed issue is that it requires a mandate to work.

[anonymoushn]

A single-payer health care system would be excellent. I eagerly await its implementation in the United States.

[yuhong]

They did limit the profit of the health care providers which happened to reduced lobbying.

[yuhong]

Sorry, health insurance providers.