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Comment by ffgjgf1 | Hacker News Reader

Or just copy the Swiss system (which is entirely privatized, more so than in the US) if you want to maintain a high degree of direct government involvement in healthcare which exists know you could also copy one of the functioning mixed public/private systems (like the one in the Netherlands). Why try and reinvent the wheel?

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Just need price controls (at least limited ones, and the credible threat of more) plus a good public fall-back option, and strong standards for what health insurance has to cover. That seems to be the minimum (Singapore model). Those elements seem to be the common factors in basically all OECD healthcare systems outside the US. Taking it farther can work, and may even help, but those seem to be the things you have to have (though price controls can also be implicit, via monopsony). “Credible threat of more” for the price controls may not work in places less authoritarian than Singapore, so you may have to swing closer to the price-book model of places like Japan, if not just go single-payer.

Yup. The CBO have in the past even estimated a generic public option as being revenue positive due to replacing ACA subsidies for private insurance plans.

https://www.cbo.gov/budget-options/2013/44890

Single-payer is unlikely in the US for many reasons, if you're interested in the topic though the CBO did a thorough look at all of the different things that would be required for such a system:

https://www.cbo.gov/system/files/2019-05/55150-singlepayer.p...

The amount of pushback we'd see from doctors, nurses, pharmacists and the like if they got paid like they get paid in the rest of the world would be immense.

The Netherlands has a system very similar to the ACA and the Swiss system mandates insurers offer a not-for-profit plan with minimum requirements, as well as offering generous subsidies to those with lower incomes. Both have cost controls though, which the US lacks.

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