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Comment by dboreham | Hacker News Reader

And this is why you can't have a system where people can opt out of paying for healthcare.

I suspect that the parent does in fact pay for any healthcare that they need or that their kids need. They just aren't buying insurance because the price of the insurance far outweighs their normal spending.

This is the real problem with health insurance is that it covers relatively routine and non emergency healthcare services where you can ship around and have market forces encourage people to find efficiency.

I understand the "if I'm dying from a car crash I can't shop around" argument and I agree. But that's very different than shopping for a family doc you like for the half dozen times a year you or your family will need to see someone for a strep test and maybe antibiotics.

> And this is why you can't have a system where people can opt out of paying for healthcare.

We do pay for our healthcare. We don't pay for health insurance. I get the general point you're making and I'm not trying to be pedantic, but I do think it's important to distinguish between the two in order to have a productive exchange.

But you wouldn't pay for your healthcare if you had a major event that cost $500k+. The rest of us would be left holding the bag.

I don't think you're doing anything wrong, but I do think we need a system everyone is a part of paying for, via health insurance mandate, single payer, etc.

Or we let people opt out completely, to where a family like yours just wouldn't receive care if you can't pay for it, but I don't think this is the world we want to live in.

And how many zeros does that justify tacking onto realistic fair-market pricing on meds and procedures to force people to "opt in"?

The value you get from the health care system isn't just from the services they provide when/if you need them.

It's from the system existing and being ready to help you.

We're not talking about widgets, onions, haircuts, or pork bellies here. You can't opt out of the system existing. And you can't opt out of the horrific consequences if the system doesn't exist.

So it's a bit silly to talk about health care like it's something that has a free market.

I work at a hospital, so should I get better rates than everyone who doesn't, since I'm helping keep that system ready?

Whatever it takes to keep you from leaving your post.

You can if not every actor in your system is trying to gouge the others ...

The ACA has specific language that limits insurance company profits to a percentage of gross costs of care.

It’s in their interests to have the provider costs be as high as possible as it directly limits their own profits.

To put it another way, when the private equity that bought your local doctor’s office raises their prices, your insurance company wins.

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