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Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by djsumdog on Tuesday January 30, 2018 @11:51AM (#16266791)
This is what was talked about in the book "Redefining Health Care." The employer based model is totally broken.

What you're describing is more open capitalism in health care where everyone is on an open playing field. I use to really believe in this at one point years ago, even when working in Health Insurance.

Today, I'm not even for this compromise. I think it should be taken out of our taxes in single payer. Insurance would still be contracted out to those private insurers (cause America). We might even be able to create a system where people chose which insurance provider they use, but it should be payed for by taxes .. it's there for everyone and everyone pays the same proportion of income and everyone gets the same level of coverage. If something is in short supply, then it's going to need a needs based + lottery system (just like organ transplants currently).

For profit and _non-for-profit_ (not to be confused with non-profits; most health care companies are non-for-profits which is a weird legal area) have no place when it comes to public welfare services. People don't pay individually for private security/police. We don't pay for fire. We don't pay a fee to visit a city park (and I'm against fee based national parks actually). The general good should be paid for equally by everyone to their abilities.

Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by jedberg on Tuesday January 30, 2018 @12:38PM (#16267164)
> People don't pay individually for private security/police. We don't pay for fire.

Sure they do. Rich people hire private security all the time. Heck, not-rich people do it too. Like your local Chuck E Cheese who hires a security guard on Friday night.

Same with fire protection. There are plenty of private fire protection companies.

Everyone gets those basic services paid for out of their taxes, but some people want more than basic service, and there is nothing wrong with that.

The OPs system would work great and you could modify it simply enough to account for your system too -- everyone pays a health tax, which is then redistributed as an HSA payment to every American, setting a base level of funding.

I'm actually a big fan of single payer, but not because of the social impacts, only because of the ease of administration aspects. But if you did OPs system and made sure everyone could participate, it would probably work just as well, because there would need to basically be a health payment cleaning house to make it work.

Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by TillE on Tuesday January 30, 2018 @01:46PM (#16267792)
Germany is one of very few countries with a robust public insurance scheme which also allows private insurance, but I wouldn't expect that to last too much longer - there's a growing consensus (57.6% in a recent poll) around the idea that receiving faster or better care because you can pay more is fundamentally unfair.

People need the health care that they need. Unless we're talking about small things like your own private bed in a hospital, there's no room in a just society for a "basic service" which does not provide the best possible care.

Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by philwelch on Tuesday January 30, 2018 @07:17PM (#16270293)
So, for example: should the government provide free LASIK for everyone who wants it, or should they make it outright illegal to even pay for LASIK out of pocket? What about vasectomies? Abortions? What if it's something my doctor and I agree would be a good course of treatment, but the health care bureaucrats don't agree with?
Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by ascorbic on Tuesday January 30, 2018 @05:11PM (#16269569)
The UK has similar. Single payer rather than public insurance, but people can buy private insurance if they want. It's certainly a small minority who do: it's largely a perk for some senior jobs, along with the BMW. It's relatively cheap (around £50/month for a non-smoker in their 30s), because all of the basic stuff is already covered by the NHS. The private insurance is mostly about getting shorter waiting times for elective surgery, and maybe a nice room.
Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by jedberg on Tuesday January 30, 2018 @03:02PM (#16268494)
> there's no room in a just society for a "basic service" which does not provide the best possible care.

Unfortunately health care is still a finite resource, and you can't give everyone the best care. You either give some the best care and everyone else good care, or you give everyone pretty good care, but no one gets the best care.

Each has its merits, but my personal feeling is if no one gets "the best care", then we as a society will forget how to give such care, and medical innovation will become stagnant.

There is a reason that the health systems with at least some private participation (USA, France, Germany) also have the most innovation. We need a balance so there can still be a motive for innovation.

Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by gbacon on Wednesday January 31, 2018 @03:16PM (#16277136)
If everyone is super, then no one is.
Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by disprove on Wednesday January 31, 2018 @01:39PM (#16276287)
> receiving faster or better care because you can pay more is fundamentally unfair

It's considered fair exactly the for reasons you have mentioned: you pay more for a premium product.

> there's no room in a just society for a "basic service" which does not provide the best possible care.

A regulated market that denies individual differences and enforces the same salary for different talents is incompatible with a "just society". In this case, healthcare workers with above-average talent would emigrate to a country where they can get a fair salary.

If you are worried about fairness, please consider the other side, the healthcare professional who provides the service.

Patients who pay basic fees are not entitled for the "best possible care". The provider of the "best possible care" can raise the price anytime. There is no economic justification for price rigging.

Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by conanbatt on Wednesday January 31, 2018 @03:29AM (#16272390)
> (57.6% in a recent poll) around the idea that receiving faster or better care because you can pay more is fundamentally unfair.

Gross.

Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by gbacon on Wednesday January 31, 2018 @03:06PM (#16277075)
… the idea that receiving faster or better care because you can pay more is fundamentally unfair.

Is it unfair because it’s health care specifically or because of something else? Premium service offerings abound: priority mail delivery; first class passage; reddit gold; ongoing memberships or subscriptions to movie theaters, golf courses, publications, and podcasts; “freemium” model web services, and Amazon Prime.

… there's no room in a just society for a "basic service" which does not provide the best possible care.

Basic service and best possible care are at different ends of the spectrum for whatever good or service we’re talking about. What did you mean by this remark?

Re:Amazon, Berkshire, JPMorgan to Create Healthcare Company by whataretensors on Tuesday January 30, 2018 @03:00PM (#16268465)
Tieing insurance to employers is yet another way to limit class mobility. Want to start a company? Better be young, healthy, and lucky.

It's also a huge reason people don't want transparent health records, even in the cases where it would help automate discovery and prevention of disease.

I don't think state-based healthcare is the correct abstraction either. It involves dealing with a central organization that is too big to fail. What happens when they screw something up? What do corrupt regulations look like when lives are at stake?