[tptacek]

This is a concern that could be addressed by providing guaranteed issue and a mandate for high-deductible health insurance, and then leaving it to the market to resolve the financing of everything below that high deductible.

That system is in fact not too far from what we're trending towards in the US.

[chernevik]

I don't see how you can say that. We're currently headed towards comprehensive insurance whose holders pay very little out of pocket. Consumers will have no incentive to limit consumption or make cost / quality tradeoffs, and none to police providers for cost.

And "guaranteed issue" is never _insurance_, it's cost sharing. Because it takes the known costs of some individuals and spreads them to others. It is a mandated subsidy. Doing it through "insurance" introduces opacity into the system, which obscures from the electorate the costs of the choices they're making, and reduces accountability throughout the entire system.

[tptacek]

Employees at many large companies today already have the option of high-deductible insurance; scaling the new, as-yet-unimplemented guaranteed issue system "back" to require a mandate only for high-deductible insurance (and thus guaranteed issue only for high-deductible insurance) would not be a major change.

You are articulating the "moral hazard" concern with universal health insurance. I am recognizing moral hazard, and saying that it can be addressed in a universal system simply by setting the threshold that the system pays out at a higher number.

[chernevik]

I'm not talking about moral hazard.