the young pay for the old
"insurance" means there's some chance you're having an adverse event, and a lot of chance you don't
but with medicine, (almost) all of us will get old, and require tons of it
Exactly. Classic insurance is a bet: the insured is betting that something bad will happen (e.g. house burns down), and the insurer is betting that it will be fine.
The problem with health insurance is that the insured will always be correct eventually. The model fundamentally doesn’t work, except if you adjust the parameters of timescale, population, etc. (which tends to be grossly discriminatory except for voluntary behaviors like smoking).
I agree with the point that for high chance, low impact events insurance is less efficient. Follows from the same basic utility theory. Insurance is not costless and costs will start to dominate benefits.
The intergenerational aspects of health insurance are a good point. Inflation and medical-technological progress still make insurance a good solution in my book. You can save for a pension (still looking at most of the Western world for saving too little); it’s harder to save for unknown future costs whose height is dependent on where the medical risk falls.
I can point out that insurance that works is a staple in large parts of the capitalist world, and has been for some 4 centuries.
I’m not arguing against socialisation of medicine per se (though there are obviously worse (UK) and better (Switzerland) models), I’m arguing against using propaganda words for it like “insurance” when it’s anything but.
Every resident is required by law to have health insurance, if you can't afford it, the state will pay it for you.
Insurance companies cannot reject you. There's a limited list of personal characteristics they can use to discriminate on price (I think it's basically just where you live, and your age).
The list of required benefits covered by insurance is also prescribed by the state.
So it's socialized in the sense that "everybody is covered" but the implementation is very "private" i.e. competitive market, which is why I like it, yes.
So like in the US?
First of all, MedicAid and MediCare, are insurers - so basically, if you’re poor (or old), the state pays for your procedures, not for your insurance. That in itself is a massive disruption of the free market (because there’s no competition) and a breeding ground for incompetence and corruption.
In addition, in the US most insurance is paid by the companies, so individuals get much shittier deals. In Switzerland, everyone pays their own.
Finally, in Switzerland the basic services covered by insurance are determined by the state, so there’s no idiotic and, frankly, dangerous concept of “out of network” like in the US.
But I think the market for a mandatory insurance can still have mostly capitalist intent. Competition, private ownership of capital, the functioning of a market.
Health care is the harder example. No perfect system exists AFAIK. Although I do believe that the real socialist Or capitalist solutions fail a lot sooner than the somewhat mixed approaches in this world. That’s also why I keep looking for other insurance markets as examples. The easy examples of functioning markets tell us that something can work. The hard problems are left for humans to solve.