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Comment by Vvector | Hacker News Reader

Imagine if we had "food insurance". Your grocery store is "in network", but the butcher sends you a bill because he is out-of-network. No prices on anything, because your insurance carrier has "negotiated" a price for you, which you only find out after the fact.

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Or imagine you had Car Insurance butting in everything including an Oil change and dictating which shop you can use for the oil change. I bet it won't be a $20-$30 oil change anymore and your premiums will be much higher than it already is.

Btw, don't give the Food industry these ideas :). It would suck if we now have "Food Insurance"

That exists, they are called high deductible plans, and people still complain about the high deductibles.

The root problem is the tail end of healthcare is enormously expensive, into the millions of dollars. Insuring a car is a minor expense, max $50k for the vast majority. It is the healthcare, that could require years of therapy and work done by extremely highly qualified people in short supply, using patented medicines, all wrapped up in liability protection, because if someone makes a mistake, you are eligible for up to millions of dollars in damages.

And also, if you are under age 50 and/or healthy, you are not just paying to insure your health in this calendar year, you are paying for healthcare older and/or sicker people are receiving. Health insurance premiums are more similar to a tax than an insurance premium.

That's all true. However it's also true in the rest of the developed world, and while almost all Western European countries have older populations than the US they still manage to spend significantly less as % of GDP with much better median outcomes (of course if we only compare US as a whole, states like Massachusetts are on part or even ahead of most of Europe outcome wise but still at much higher cost)

"Food Insurance" does exist in some places and cases; many colleges charge for "room and board" if you live on-campus, so you're paying for meals even if you don't eat them that day, or at all.

I guess there is also "gym insurance" then, due to people who buy yearly memberships and never go subsidizing the costs for the rest.

My university used to have "X meals per week" plans.

People hated them b/c: - you couldn't use a meal twice in the lunch period e.g. have a late breakfast at 11am and and early dinner at 3pm

- you lost all of your meals at the end of the week

They then switched to "Y meals per semester" and people loved it.

- you could get an extra takeout meal for later (or a friend)

- you could eat three times a day on the weeks you were at school and less if you were away for a trip etc

- they actually released a price for lunch($6) and dinner($11( so you could arbitrage getting a cheap lunch vs buying dinner somewhere else

This is the kind of example where a small change for the “company” greatly increases “customer” happiness.

I feel there’s a ton of room for that in healthcare.

> Or imagine you had Car Insurance butting in everything including an Oil change and dictating which shop you can use for the oil change.

This kind of already exists with insurance and car repair.

If I damage my car, I take it to an approved repair shop and they give me an estimate. It's in the car repair shop's best interest to provide a quick estimate and good repair. If they don't, I can raise the issue with my insurer who might even lose me as a customer. The repair shop would then potentially lose out on repeat business from the insurance company.

Granted, this is a better example of a not-so-free market working vs the "locked in market" of healthcare but I think it's good to provide some counter examples to "it's ALWAYS bad to have insurers with preferred vendors"

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