> there isn't a whole lot of money to be made for corporations lowering the cost of healtcare.

I don't know if that's true. There are a lot of companies that would save money if healthcare was cheaper -- pretty much every company in America is a health-care consumer. It's just that benefits are diffuse and the downsides of lower-cost health care are concentrated.

I think large companies love it the way it is. Healthcare being so tightly bound to employment makes it more difficult for employees to leave, which probably has a dampening affect on salaries. I haven't had to deal with it in a while, but getting healthcare for a small company ~10 years ago was a nightmare.

It wasn't too bad for us. We provide gold level healthcare for our employees (~20 FTEs). Companies like Zenefits (yes yes I know) and others have made it a lot simpler to get started.

Guessing you’re a tech company employing educated young single (low risk) workers?

Things look very different in other industries... not everyone gets the same price...

>>tech company

Nope.

>>not everyone gets the same price

I don't care about the price. I pay for insurance for my employees because it is the right thing to do.

The comment I am referring to is the nightmare of the setup, not the cost to me for providing the healthcare. And many middleware insurance navigators make it easy to provide it (at least for me).

As far as how much it costs me, whatever.

large firms would lose talent to smaller firms.

Then the smaller firms could be acquired. As it is, because of the slowing new-company generation, large firms have been getting fewer and fewer options. Small firms can take risks to create new products and processes which can then be acquired and taken up and expanded by large companies. Generally its much more difficult for a large company to do that creation part in-house. So insufficient small firms end up affecting the large-firm capability in the end.

Unfortunately this type of long term benefit for the large corporation doesn't affect the next quarterly report and is ignored in favor of more short term gains.

Productivity gains seem to be dropping and one theory is that companies are getting larger, but aren't able to pickup efficiency/new value generation boosts from acquisitions like they once were able to (at an economy wide scale, not talking about the acquisitions of any specific company or even sectors here). It is difficult to make any certain conclusions here though. But if true, they will have to care sooner or later.

Minor compared to the cost of funding health care

Exactly. Huge corporations would LOVE to push their health insurance costs to the taxpayers.

Maybe, but they LOVE the huge competitive advantage it gives them over smaller and more nimble firms nipping at their market share, because it's very onerous for small businesses to competitively offer health benefits.

I think they're afraid some of the cost would be dumped onto them.

I don't know about that. If your employer were to pay you more and you were to use your salary to buy health insurance, you'd be bumped into a higher tax bracket and you'd be using post tax money to buy the insurance.

It's not a long term benefit because the government should be able to lower taxes given the increased revenue, but you'd never look past the short term (and the government would never lower taxes).

Isn't YCs research arm looking into healthcare?

I think this is a bit of a just-so story. Rebuttals:

* There are top-tier progressive think-tanks that write favorably about single-payer; EPI is an example.

* Single-payer is ideologically anathema to conservatives and libertarians, so a majority of think tanks are going to be constitutionally incapable of proposing plans.

* For the past 8 years or so, progressives have been working to support the health care victory they already achieved in the ACA, which has been under continuous assault since the GOP regained control of the legislature. It would be weird to see them endorsing a new health care system (and, in the process, conceding defeat on the ACA).

>>Single-payer is ideologically anathema to libertarians

For Libertarians (LP), maybe. There are plenty of libertarians who see initiatives like single-payer and UBI as the only way to reduce graft and overspending of the federal government, knowing that pure elimination is impossible.

Can you really be a libertarian, even with a small 'l', and support single-payer?

Yes, if you combine it with reducing absurd controls of the industry. Libertarians tend to be angry about the fact that Americans cannot buy medicine abroad, that medical schools are absurdly regulated, coupling insurance with jobs, and so forth. Single-payer + those reforms are well within a reasonable libertarian platform.

https://www.google.com/search?q=libertarians+who+support+sin...

I'm not an expert on libertarianism, but I looked at the first results from that search and it seems like some libertarians support some form of single-payer but purely as a political compromise, which I assume is what you were referring to. It still doesn't jibe with the ideology, but they seem to think that certain forms of single-payer might be better than what exists now.

Yeah, pretty much. I used to be a libertarian and know a lot of people who are, and many regard it as a reasonable compromise and a strict upgrade over the nonsense we have now.

Not really. Advocates of any ideology can compromise their ideals pragmatically, but libertarians explicitly cannot countenance single-payer as an end state. The idea of a government-run monopoly on health care is directly contrary to libertarianism.

Which is what you see when you read posts from libertarians about single-payer. Single-payer as a compromise, and only if accompanied by such a radical deregulation of medicine that "single-payer" is really just an economic subsidy for consumers on a private marketplace. That's a coherent (if, to me, terrifying) plan, but it's not what mainstream policy thinkers mean by single-payer!

Again: I'm not saying a libertarian can't accept single-payer as a temporary compromise (even for very long definitions of "temporary"). But if you find single-payer attractive, you're an economic liberal.

People don't throw the word "monopsony" around as much, so people aren't as afraid of them.

ACA is structurally designed to be a stepping stone to a more rational system. I don't think you'll find a lot of ACA boosters who think healthcare in the US is a solved problem because of it.

It's not a stepping-stone towards single-payer.

>there isn't a whole lot of money to be made for corporations lowering the cost of healtcare.

There is a whole lot of money to be made by special interests in giving people free heathcare at the taxpayers expense. It means massively increasing government spending afterall, and that gives those with political control more resources to divvy up. And there's an enormous amount of advocacy for single payer. It also does not reduce costs.

Wow. That's really disturbing actually...The layers of power and control are so mind bogglingly intricate. Eric Schmidt just demonstrated how finely tuned and detailed power actually is today. To know of a single paper and effectively flip a switch to shut it down. The Google of 'do no evil' is certainly dead. Where does this leave us in changing these things? What options are there for gaining momentum for real change when all the powers that be fight against it?

> why things like single payer don't have the intellectual backing of rigorous white papers and advocacy

I dont understand why Gates or Buffett who have made comments supporting single payer systems dont fund such think tanks who will "educate" the public about single payer.