Is stupidity Invisible?

Insurance is about self interest, in a good way. A large population pays into a fund so that the ones who encounter misfortune are not destroyed. Every person who pays in gets that protection.

Again, paying in taxes for single payer would be better. But we’re not going to get that for a while.

Are you also opposed to car insurance? It’s the same thing.

The issue with the free market plan is what happens to people who can’t pay. I’m not OK with people dying due to poverty. If we keep the idea of subsidies...well, it’s not that different from ACA.

There would still be something like Medicare / Medicaid. No one wants people who can’t afford care to die. The difference here is how much we rely on competition between private services, versus a single unified government plan. The tradeoff here is that single payer gives everyone pretty much the same kinda meh care, whereas a more private system could allow for innovation. Government isn’t really responsible for any of the innovations that have changed our society over the past few centuries. We should create an incentive structure that rewards entrepreneurs who find new ways to cut costs, provide care, and treat conditions.

Medicaid comes after a person is impoverished, though. If we can’t have single payer, I’d stick with subsidies, so that the working poor can afford to live and afford medical care. That might fit into your free enterprise plan; I don’t know.

And single payer countries don’t necessarily have the government providing the care—it just pays for it. I don’t see any conflict between single payer and competition.

In most (US) states you could also post bond with the state instead of paying auto insurance. I'm not sure how it works, though.

https://www.everquote.com/blog/car-insurance/do-you-have-to-have-car-insurance/

I'd rather pay insurance than bet on not being permanently financially ruined by one unfortunate event or dying from not being able to afford medical care.

I wish the costs were lower though, more like a co-op. Of course the insurance companies take a gigantic chunk of it for profit, beyond operating costs. I wonder what percentage of the premiums that is.

ETA: And if you do get a catastrophic illness, sometimes they drop you anyway.

You’re not driving at your own risk. You’re driving at everybody else’s risk.

Re: “And if you do get a catastrophic illness, sometimes they drop you anyway.”

That’s one of those things that the ACA prevents. But we’re all supposed to see the ACA as evil anyway.

CF. I was not arguing with anything you've said. Yes, without insurance, people could definitely just walk off after ruining your life, if they didn't have anything to sue for.

And I certainly didn't say the ACA was "evil," but I have known people who were, in fact, dropped by their insurance company after a certain amount was paid for a serious illness.

So, I do think things could be improved, as mentioned. But that doesn't mean we should just not have insurance at all.

Sorry, I didn’t think that you (“Ma’am”) were arguing against the ACA. But the original poster is.

The ACA is relatively new. Are you sure those people were dropped that recently?

And, yes, we should have insurance—or, in the case of health care, single payer.

I’m not too familiar with how systems like the one in the UK work, but my understanding is that there is generally only one option, and that most people aren’t happy with it. I’m more thinking that there should be baseline care for everyone, with the option to get a better plan instead for anyone who wants one. And in particular the ability for people to just pull out their wallet and pay for it. We don’t really need these middlemen (the insurance companies).

While everyone should have essential care, it is also a fact that many preventative scans and tests are much more common in the US than in other countries. These raise medical costs quite a bit, and are one of the cost areas that makes insurance so unspeakably expensive. We could probably find a more reasonable ground where people pay to get the care that isn’t absolutely essential — to be honest, that’s how most things in life work. Sure there are benefits like subsidized housing but if you want to live in a great place you have to be able to afford it, and I think that’s a fair model so long as we have finite resources, and so long as people have to work to make those finite resources. Technology will change this, and scarily soon.

I don’t think you’re right about the UK—and in any case, there’s no reason why single payer can’t also provide choice and competition.

I’m not a fan of having a minimal standard of care for the poor and more for those who can pay more—that’s likely to result in necessary care being slowly deemed unnecessary. Now, you may just be talking about the things that insurance doesn’t cover now—purely cosmetic surgery on people that don’t have a problem necessitating that surgery, or LASIK for people who could live quite very well wearing glasses, for example. I’m ok with those things remaining patient-pays.

There’s also the situation where withholding medical care costs more than providing it. For example, I see no reason why diabetes supplies should not just be free, period. (Free in the sense that the government pays for them.) No one should have to endanger their health because they can’t afford the test strips or insulin pump that they need, and if they do, the resulting life-threatening conditions will cost far more than preventing them would have.