[Taikonerd]

> You are extremely close to arriving at the solution, which is medicare for all. Cover everyone, then almost noone uses the insurance except when they need it

Most Medicare recipients do get supplementary private insurance though? It's called "Medigap."

Medicare pays for 80% of patients' costs, but even the remaining 20% is a lot. (You get a $100,000 procedure -- you're on the hook for $20,000.) That's why people get Medigap coverage.

[mekdoonggi]

By "the insurance" I was referring to Medicare. I'm a working, healthy person and rarely use healthcare outside of preventative care. You could raise my Medicare taxes by hundreds monthly and still be less than what I pay for private insurance.

In a Medicare-for-all scenario, the individual price of a given procedure doesn't need to be so high, because the reimbursement is guaranteed. Right now, the "list" price of the procedure has to be high to subsidize the uninsured and Medicaid who lose money.

I'm sure there are single payer health insurance countries in which people still purchase insurance, which should inspire debate about the universal insurance cost-sharing.

Regardless, the only viable solution in the US is a single payer insurance model.

[SoftTalker]

Your private insurance isn't there (ideally) to pay for your preventative care, which you can easily pay for out of pocket. It's there to pay for the low-probability but very expensive scenarios, such as cancer, major accident/injury, etc. that would otherwise bankrupt you.

[mekdoonggi]

I understand how insurance is supposed to work. The problem is that private insurance captures all of the value I pay in during my working life, and doesn't have to pick up the tab when I inevitably get old and sick.

To use car insurance as an example, it would be like if we had a government program for cars over 150k miles. You have to pay for both private and government insurance. The private company collects more money than the government, but the government pays for all the expensive stuff because that's when cars break down. It's completely pointless.

If you want a medicare-for-all scheme where working people have a higher cost-share than children/retirees, fine, that's reasonable. Having private companies rake in profits from a system that has no business being a profit enterprise is insane.

[SoftTalker]

The value is that it is there. Most insurance isn't used, or ever pays back what you paid into it. That's the point; that's how it's a viable product. There's no way to insure old, sick people, that's why the government does it. It would be like selling automobile insurance only to drunk drivers, or selling homeowners insurance to people whose houses are already on fire.

[mekdoonggi]

There's a way to insure old, sick people (who were once young and healthy) and it's how every other developed nation does so at lower cost. How is it lower cost? the profits from the young and sick don't get shoveled to private corporations for performing the exact same function at higher cost.

[LorenPechtel]

Paying for the preventative is because it's been demonstrated that doing so reduces costs overall. The amount involved isn't all that much, it's not the driver of the costs.