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Comment by bluGill | Hacker News Reader

I hate it just as much. "If you like your insurance you can keep it is true" - but I didn't like my insurance and I'm still forced to keep it. I've long said the big mistake is tying health insurance to employment is the problem (it isn't the only problem, but it is a big one). If I take anything else I turn away more than $1000 in subsidies that my employee currently it putting in, and that means as much as I don't like my insurance I cannot use anything else. Of course since the customer of health insurance isn't me but my employer that means they are not responsive to me and my needs.

I'm against socialize health insurance, but what we have today is just as bad though in different ways.

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I've long said the big mistake is tying health insurance to employment is the problem (it isn't the only problem, but it is a big one)

Yes. This is one of those frustrating areas where economists and experts across the political spectrum are in near-unanimous agreement, but anybody who tries to move the system in a sane direction gets attacked for "taking away your insurance". The ACA doubled down on employer mandates, when it should have used the exchanges as an opportunity to get people off employer-based plans.

I'm against socialize health insurance, but what we have today is just as bad

As I've often said, we've managed to combine the worst aspects of both markets and central planning with the benefits of neither.

> The ACA doubled down on employer mandates, when it should have used the exchanges as an opportunity to get people off employer-based plans.

This was the point of the Cadillac tax

The ACA included a public option to remove that tie to employers, but it was removed due to the opposition of Joe Liberman and his insurance company backers.

Joe Liberman and 40 republicans.

$1000 would be on the low side. Employers on average are now subsidizing family coverage by about $17000 per year. Annual increases continue to exceed the rate of inflation. This is obviously unsustainable.

https://www.kff.org/health-costs/report/2023-employer-health...

I'm not allowed to know the real number. There are hints, so I can get close, but even at that, $1000 is a lot of money for almost everyone.

It's $500 - $1000 for a single employee per month and $700 - $2000 with spouses and other dependants if you also subsidize that 50%-100%.

> I've long said the big mistake is tying health insurance to employment is the problem

> I'm against socialize health insurance

You have directly contradicted yourself.

No, health insurance could be like almost any other insurance: bought by the individual, not by his employer or the state.

The ACA is how that was implemented. I can now buy my insurance as an individual.

No you can't. Well if you work for a small company, or don't have a job you can. However anyone working for a company with any size has to come up with the $1000+ per month their employer throws into the company insurance plan that they don't get by going with ACA. So sure you can, but it is so move few can afford so we may as well say you cannot.

Unless the employer offers you the $1000+ per month to opt out and get your own insurance, which quite a few do. Or, as more companies have been doing, just subsidizing your choice of plan through the marketplace so they don't have to think about it.

Well, the other option is to make it possible to affordably purchase insurance directly from carriers without your employer being involved at all. I've always been skeptical that having your employer negotiate for you in these cases is actually more beneficial than a true free market.

Personally, I'd rather we figure out how to have at least some real baseline of public healthcare, but what we have today feels like the worst of both options.

No he didn't. To prove he didn't, for example, look at car and home insurance. Not tied to your employer and not "socialized" either.

Car and home insurance both have a socialized component. Check your policy for an “uninsured driver charge”. Similar concepts exist for home insurance. And we all pay for flood insurance as it’s heavily subsidized by tax dollars.

Uninsured driver protection is not socialized, everyone is just forced to pay for it, the state doesn’t pay it. And this requirement as well as minimum coverages will vary by state, for example, Florida doesn’t mandate it.

And honestly the fact about flood insurance even if it’s true is only an implementation detail.

The point stands: you can have strong insurance markets with multiple private options in a well regulated environment without being tied to your employer or just a public option.

> Uninsured driver protection is not socialized, everyone is just forced to pay for it, the state doesn’t pay it.

Being forced to pay for something to share the cost across a set of people is the definition of socialized. The implementation detail is that it’s shared by all purchasers of insurance as opposed to the population as a whole.

> The point stands: you can have strong insurance markets with multiple private options in a well regulated environment without being tied to your employer or just a public option.

There is no such market for flood insurance.

I don’t think it’s possible to fix the US medical insurance system without banning corporate health plans. It’s the only way to unify the risk pools. Not just removing the tax incentive for corporate plans, I mean banning the concept so that the pools are unified.

> Being forced to pay for something to share the cost across a set of people is the definition of socialized.

For some definition of socialized. I would argue that a transaction between two private entities in which there might be a minimum ceiling for some items is not “socialized”. Even if the minimum ceiling is enforced by the state.

We can argue all day about definitions but at the end of the day nothing is black and white: even if we agree that there’s some “socialized” extent in the private car/home insurance markets I think most would still not say that it is “socialized” in general.

Regarding flood insurance, yes, agreed, there’s no natural law that says that flood insurance must be a profitable business (hello global warming!) so the government steps in.

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