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by seanmcdirmid 443 days ago
I thought the ACA was based on the Swiss system of mandatory insurance? The heritage foundation copied the Swiss, Romney took that proposal to Mass, and Obama thought going with a Conservative initiated plan would make it more bipartisan (it didn’t, but mainly because republicans hated Obama).
1 comments
tomp 443 days ago
Definitely not.

IMO the most distinct parts of the Swiss health insurance system is that (1) copay is obligatory but limited (i.e. healthcare isn’t free but it’s not expensive either), and (2) it’s individual, companies cannot pay for it, so there’s no US-like extreme benefit of having a good job.

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rahkiin 442 days ago
In the Netherlands we have those two as well, but it is also regulated: - the cheapest plan must not cost more than 115 eur (dont know exactly), and it has mandatory coverage (‘basisverzekering’) - there is a maximum copay of 850eur per year (‘eigen risico’) - some services are not allowed to have copay - low income people can have extra subsidies to pay for insurance - insurance is mandatory - insurance is a personal thing, not a work-thing. Your work absollutely knows nothing about your health insurance

Due to the regulations it is not a big run to the bottom

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seanmcdirmid 443 days ago
Yes, having lived in Switzerland I experienced that, and it was the personal buy rather than having group plans was the feature missing from the ACA the most.
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waveBidder 443 days ago
aca di. implement a market, it's just that most people buy through their job, because if that's legal you obviously want to be part of a larger bargaining pool for buying.
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seanmcdirmid 442 days ago
Group plans suck away cream of crop risk pools. People with good stable high paying jobs tend to be a lot healthier than people working part time crap jobs or working in the trades for themselves.

It isn’t really bargaining power of the pool, but the risk assessment of the pool you are in. Being in a hodge lodge personal pool means you are sharing risk with people who will have more expenses. That’s why Switzerland throws everyone into the same pool, so no crème low risk can be siphoned away.

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