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Comment by justaman | Hacker News Reader

Trusting in a private company that must react to market changes is different than trusting in a government that doesn't listen to you anyway.

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If it's employer-chosen, you're not the customer and they're not listening to you either.

Why do you stop there? The chain goes on. Employer will have to listen to the employees or they will be on a lookout for better place to work. It's not uncommon at all for employers to tout benefits as a way to attract new hires.

That only works if you’re in high demand, and your health problems don’t preclude getting a new job. Very few workers can rely on that being true at any point in their lives, much less all the way until retirement.

That is only true for an employee's market.

Your health insurance company listens to you? Mine just constantly tries to wriggle out of paying.

I cannot pick my own health insurance company. My choices are:

- Whatever my employer wants

- Something on the exchange for quadruple the price (particularly without my employer's share of premiums)

How does the market decide when it isn't a competitive market? Why are employers allowed to pick their employee's health insurance? Why are employed people at large companies paying less than employed people at startups?

What is the market, here? What good or service do you get from insurance?

For their real value prop (covering the unlikely need for catastrophic healthcare), you 1. most likely won't ever use it. 2. have no idea how good their service is until you have no other option but to exercise your coverage.

Market-based capitalism works best when consumers can shop around, and take their money elsewhere when the good or service is not a good value. This is absolutely not the case with health insurance.

Meanwhile, medicare is pretty beloved in this country. And the public options in other industrialized nations outperforms US healthcare in most respects for significantly less money.

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