Our "insurance" sucks because of all the government involvement. Putting government completely in control would solve some problems, but I personally would like to see how things go if we do the opposite and take government out of it completely.
We have done so in the form of government. The whole promote the general welfare bit. The free rider problem is not an issue with publicly funded healthcare.
It is to the extent possible for 330 million people. There are no instances in world history in which people freely organizing as you put it adequately solved the issues of hunger, education, healthcare, etc. for civilizations with more than 5 million people.
People, in the form of their elected officials, can freely decide to impose a publicly funded solution. You’d be free to refuse care in such a system, or to leave. All societies have rules that some people don’t like.
In all seriousness, if those are the only choices then it's not people freely organizing. And this forced "free" organization is NOT the only way to solve these problems, and in fact it isn't really a solution to these problems at all.
what has me pensive is, i think you already know this
Private industry has no prime directive. There is no supreme leader telling them what to do. That's kinda the whole point. Some choose to pursue maximum short term profit at the expense of all else, and some choose to give every penny they earn to the poor and needy, with a whole spectrum in between. Most people in our society are good people, unless they are constantly told they are not, constantly told that they should be afraid of everyone else, or are given too much power over others.
Yes, "insurance" as such has lost its meaning. Its healthcare coverage. Everyone knows that, we just keep calling it "insurance".
Health insurance today is really a collective bargaining organization. You join the UHC club and UHC negotiatates rates with medical providers on club members behalf. Except it doesn't even work very well in that model because it's not run like a club with members having any input really. You also can't easily leave one club if you are unhappy and join another club, and your employer and the government are paying more of the money into the club than you are.
I believe if you propose such a practical experiment HN would be happy to discuss, poke holes, etc. However, most people are fine to look at other countries that have already implemented universal health care well, at a fraction of US prices and say, lets do that. The average American on private insurance already pays more than what such a system would cost. Allowing a private option on top would resolve issues with anyone worried about reduced quality / lack of choice.
https://en.m.wikipedia.org/wiki/File:Life_expectancy_vs_heal...
And what actions do you think companies might take to benefit customers if not for government involvement?
Government gives power to insurance (and to other healthcare related companies, and really to a myriad of other players in other industries) primarily by:
- introducing regulations that make competing with incumbents nearly impossible
- giving tax breaks to favored corporations and behaviors
Why does government do this? Again, because the good people in government have been corrupted by power. The people they give power to help them stay powerful by giving them campaign contributions and other favors. It's a vicious cycle.
I'm not sure how to answer your last question, "what actions do you think companies might take to benefit customers if not for government involvement?" when every corporation does things to benefit it's customers. That's why any and every corporation exists, to benefit it's customers. Customers are anyone that benefits the company. Apple makes great products that benefit their customers without the government telling them to do it. In industries like healthcare in the U.S. right now, we are not the people who are primarily benefitting the corporations. The way things are bought and paid for right now I don't think we benefit health "insurance" companies at all!
That is an incredibly optimistic belief you have about the purpose of corporations. In reality, corporations only have the responsibility to benefit their shareholders.
Making sure your customers are happy and keep giving you business is certainly one route. And I think most companies at least start out this way.
Though it’s funny you use Apple as an example, since they’ve been widely criticized in recent years due to the parasitic App Store practices enabled by their stranglehold over the smartphone industry.
Government does get corrupted by money, but that money ultimately comes from rich corporations. Eliminating government involvement could just make corporations abuse their power in other ways.
Making your customers happy is the only route they have. When governments or other third parties get involved then you and I might no longer be the customer, but I can assure you that the corporation is still serving their customers.
That's the number one problem with our current situation in the US with healthcare. You are not your doctor's customer. You are like, 3 layers away from being his or her customer.
Just look at how Wells Fargo a while back was opening up accounts and charging fees to customers who never authorized it.
Or Purdue Pharma that gave kickbacks to doctors to prescribe opioids and misled the public about how addictive they were.
Or payday loan companies that suck people into vicious cycles of debt. Or the numerous companies that profit from gambling addiction.
Or the big banks that gave out dubious mortgages and lied about risks to investors, which precipitated in a global housing meltdown and recession in 2007.
Or how cigarette companies lied about the dangers of smoking, leading to countless deaths.
Companies will lie, cheat, and scam their way to profits if they have to. Not all of them, and not all of the time, but the endless quest for more money is always corrupting.
Also, you have to understand that public corporations get cash from people buying their products and services and from investors. The investors are therefore just as much their customers as you and I are. Often it feels like investors preferences are given far more deference than your and my preferences. In a free market, we can pay attention to that and make choices accordingly.
Finally, your opioid example is very pertinent to the original topic. You and I were not Purdue Pharmas customers in that scenario. The doctors and insurance companies were. We are just a weird cost of doing business caught in the middle.
The free market works when there is actual competition. If we want a healthy free market, then we need vigorous antitrust action to block mergers and break up companies that get too big.
I also would recommend that government should stop making regulations and tax breaks that favor one company over another. I think that would be even more effective than just antitrust enforcement.