Comments on y-intercept blog: Anti Universal Coverage Club

Matthias,Good luck on the new job. The HSA account...

2007-07-18T12:12:19.437-06:00

Matthias,

Good luck on the new job. The HSA accounts are a lot like 401Ks. If millions of people switched to this type of account, then we would see a full turn around of health car.

The problem at the moment is that people who use HSAs (which are outside the power structure) end up having to pay more for health care than those inside the system. The last checkup I had cost $350 because I paid cash. A half hour visit with a doctor really shouldn't cost more than $70 or so.

If enough people were using HSAs, then there would be a market to counter to the monopolists.

This is true. A couple of years ago I listened to...

2007-07-17T18:48:46.037-06:00

This is true. A couple of years ago I listened to an orthopedic doctor in the ER rant about the immorality of allowing insurance companies to build and operate hospitals.

I guess I was thinking more about the government players in the system that distort the market.

Matthias' idea about health insurance working like 401k plans has some merit.

BTW, the reason I don't put the monopolies at the ...

2007-07-17T13:25:38.951-06:00

BTW, the reason I don't put the monopolies at the top is that they are relatively new; so it is difficult to determine if they are a cause or manifestation of the problem. Many of the monopolies were assembled as investments by the massive insurance firms.

As someone who is about to move from a job with he...

2007-07-17T13:16:30.938-06:00

As someone who is about to move from a job with heathcare benefits to a contracting position without healthcare, I have to say that I think it would benefit everyone involved if healthcare benefits worked more like a 401k where the employees picked a plan and the empoyer matched the contributions.

In negotiations for my new job, I discovered that the actual cost (to my current employer) of the healthcare benefits I get are worth thousands more than I would pay on my own. They seem "free" to everyone I work with, but that's only because we don't ever see the cost in our paychecks.

As a (soon-to-be) contractor, I can now see those costs, since I'm getting paid the money and then need to find the health insurance myself. Given my condition (mid 20s single male with no history of health issues), I'd rather keep the money, or at least go on a high-deductible HSA-type plan.

You have a very strong argument about the fact tha...

2007-07-17T12:52:11.977-06:00

You have a very strong argument about the fact that insurance is provided by employers. Health insurance is not an asset held by individuals, it is an asset held by employers. Quite frankly, most individuals would not buy the policy given by their employer even if it were offered at the same price.

The reason we feel locked out of health care is because insurance is not an asset that we own, it is something forced on us and that is outside our control.

I suspect that people favor Universal Care because they feel that making it universal and making it something controlled by government would put it into the public domain and make it something they control. However, this sense is simply an illusion. When health care becomes the domain of a centralized government bureaucracy it is even further outside of our control.

The alternative solution is to find a way to transfer ownership of the asset from centralized players back into the hands of individuals. If this were ever done, then it would truly empower the individual, thus empowering the people than could ever be achieved with a centralized bureaucracy.

I think you are not giving the centralized health ...

2007-07-17T08:48:37.177-06:00

I think you are not giving the centralized health care monopolies enough credit for their part in the problem. Although Americans rejected Hillary-care in 1993, the government has steadily been quietly expanding the percentage of the population covered by government health care programs since then. These players substantially distort the market and disrupt the provider-consumer relationship.

I do not necessarily agree that insurance companies are intrinsically bad players in the market. The auto insurance industry, for example, seems to function relatively well for consumers; even though, it creates a buffer between the service provider and the consumer. It works reasonably well because the consumer also has a direct relationship with the insurance provider.

Health insurance companies are problematic because consumers have limited choices and limited chances to influence the health insurance market. Why? Because our tax system rewards employers for providing health insurance. Employers are most interested in keeping health insurance costs down. Quality and flexibility of insurance products are not main concerns. Health insurance providers market to employers. The actual insured individuals have limited options. The employer creates a market-stifling buffer between health insurance providers and their consumers because employers operate from a perspective of different concerns.

If we were to eliminate the tax incentive for employers to provide health insurance in favor of providing the incentive directly to individuals, a more direct relationship between consumers and insurance providers would emerge. New and innovative products focusing on quality and flexibility would emerge, much as they have in the auto insurance industry. (I'm not sure I would actually favor a subsidy for purchasing health insurance, but it might be a compromise required to get legislation passed.)

I don't think insurance companies are all bad. They are just responding to the market conditions in which they find themselves, thanks to government regulation.