Comment by cmrdporcupine | Hacker News Reader

Comment by cmrdporcupine | Hacker News Reader

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There are many problems with our Canadian system, it's certainly not perfect. And single payer is not the only way to approach this problem. But I'm overall happy with its compromises in our system. Like any economic resource, it's rationed. But it's rationed, generally, on the basis of need. And that "from each according to their abilities to each according to their needs" philosophy may be the ideological curse on it that will prevent it from ever having adoption in the US with its virulent anti-communist past. It would never happen in Canada now, it was a product of the 1960s and early 70s and the way things were then. And it's consistently under threat from its ideological foes here, even if it's immensely popular among the Canadian public.

What boggles my mind about the US system is the blatant way it makes working people dependant on employment for health coverage. In a way it's a form of feudalism, tying people physically to their employment.

>In a way it's a form of feudalism, tying people physically to their employment.

uhh, what? Is employment in general "a form of feudalism" because people depend on it to fund their basic needs?

People can quit their job, and then meet their needs using their savings (if they have any), or welfare. The same is not true for health insurance.

They can't get health insurance on healthcare.gov?

There are two options after losing your job. Cobra or healthcare.gov.

Cobra will allow you to keep your current plan, for my family that would have been ~$800 per month.

Healthcare.gov rates are based on your income, or what it was, or what you expect it to be. Which for me was ~$700.

So there is no way to get affordable insurance to cover the gap in employment in a way that preserves cash reserves.

>So there is no way to get affordable insurance to cover the gap in employment in a way that preserves cash reserves.

I fail to see how it's any different than "there is no way to get affordable housing/food to cover the gap in employment in a way that preserves cash reserves". I suppose you could argue that with housing/food your costs stay the same regardless of your employment status, but from a finance perspective it's still the same. There's no difference between losing a $6000/month paycheck and losing a $5500/month paycheck and $500/month in insurance subsidies.

You're contradicting yourself by claiming it's tied to employment and then saying you can buy it for a price.

It's one or the other.

Or you can claim the price makes it effectively tied to employment.

I agree the cultural ties it has to employment ought to end, but that's a peculiarity of the american system, not a fundamental feature of a private healthcare system.

I dont know if the Canadian, the British or even the German model are the best. But what is clear to me is that for profit insurance is a system that doesn't make sense. There should be a way to align the interests of both the organisation providing the service as and the individual using/paying for it. In the American model these two are completely opposite, which doesn't make sense in an inelastic market.

Maybe if that system had VERY strong economic regulations (like, the government would set prices for everything and let private carers compete in "value added".)

Absolutely. If the NHS and National Insurance weren't already invented I'm positive they would never be implemented today. I mean can you imagine someone like Clem Atlee in power today?

>In a way it's a form of feudalism, tying people physically to their employment.

This is a feature, as far as major companies and lobbying organizations are concerned. It's a major reason behind the resistance to universal healthcare because the duress of losing health insurance is the only way some companies keep their employees.

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