Good article in general but such a misleading headline and framing. The problem, as described in the article's body, is employer-provided health insurance, not private healthcare.
private healthcare is getting more and more expensive due to private prices available to bulk insurers but not for private person
even if this is not completely deliberate, effect is that you are "serf of whomever pays your insurance" or go bankrupt the moment you have any kind of emergency
in europe some private healthcare providers are showing their colors from different perspective, they outright refuse or cancel private contracts when you are above certain age
using what money? Most people get their money from their employer.
The distinction in the US before 2011 is that couldn’t buy health insurance as an individual, hence it was a benefit dependent upon being employed. Post 2011, health insurance became attainable without an employer.
ACA made it so anyone can get it, with standardized metal levels to make comparing plans possible, and out of pocket maximums and the inability to use health risks to deny insurance coverage to ensure one can actually buy and use it as long as premiums were paid. There were even generous tax credits to help pay the premiums.
Obviously, it is still very expensive, but the situation is far different than pre-2011. There would have been no “bank a few million at a tech company and be financially independent at 40” people without ACA.
https://www.census.gov/data/tables/time-series/demo/health-i...
Even now, when I write health insurance, I mean "ACA complaint health insurance", because the limitations in other kinds of products labeled "health insurance" are useless to the point of not being worth discussing.
> The distinction in the US before 2011 is that couldn’t buy health insurance as an individual, hence it was a benefit dependent upon being employed. Post 2011, health insurance became attainable without an employer.
More than 30 million people had individual health insurance in 2010. If it were useless, 30 million people would not have paid $5k - $10k per year for it out of their own pocket.
That's why in normal countries public healthcare is a thing and it competes with the private healthcare sector, forcing it to offer relatively affordable premium services.
Individuals are the one with huge tax benefits under the ACA. Last year, the government paid 73% of my health insurance premiums as a tax credit.
So even if you could get a tax break for buying your own health insurance, you'd still have to give up a bunch of free money from your employer in order to take advantage of that, which isn't realistic.
It's funny that he (accurately) quotes the Cato Institute as being opposed to employer-provided health insurance... and then implies that the sole alternative is the NHS. Um, I'm pretty sure that's not what the libertarian Cato Institute was suggesting!
Employer health care may have bad externalities, but it has the extremely important (but... maybe invisible to the median libertarian) property that it constitutes collective bargaining. You can force insurers to cover folks they wouldn't want to otherwise by bringing more customers (employees) to the table.
It's so weird that even now, with the ACA having been proved out over decades, that we have to have these weird free market arguments. It didn't work, guys. It's not a good that works well in an efficient market sense.
I would say that the ACA is on the free market-ish side of the design space: individuals purchasing (subsidized) insurance from private companies.
Yeah, so... my question stands: name one you're thinking of, even if you qualify that it isn't an "endorsement". I contend there isn't one and you're fooling yourself.
* Medicare in the US (single-payer, private providers)
* Medicare Advantage in the US (government provides capitated payments to competing private companies, which then do all the administration work)
* The Singaporean system (complicated, but revolves around mandatory payments to HSAs)
etc.
Now you're saying I'm wrong because there are other socialized forms than NHS that work too. Well, OK! I submit. Use one of those.
100% untrue. There were affordable catastrophic coverage plans available, and many were made illegal by the ACA and the requirement to provide boutique services for "free" (i.e., forced to pay for even if you don't use).
Not for anyone who needed them! If you were already sick, you would die poor without coverage. Are we really continuing to have this discussion?[1]
The market failed in this case. We all know it.
[1] Just to short circuit: you'll want to deflect to a non-economic discussion of whose "fault" it was that they were stuck with a pre-existing condition. But my point is: who cares? There was a product and a consumer which could not be exchanged at a reasonable price in an unregulated environment. And that's bad regardless of fault (doubly or triply so because it's a really important product).
The word you're looking for is "convince," not "force." This whole discussion is replete with misuses of words like "free" and "force," and it's a little worrying.
I'm also curious (since this is closely related) whether you favor the tax break to employer health insurance. You wanna talk about my woke focus on words, well well, take "externality." I'm not familiar with these bad externalities of the institution of employer provided insurance of itself, but I can see negatives from the tax break. Namely, by subsidizing my employer's health plan, my private health insurance purchasing power is effectively nerfed. Bit of a stretch to call that external.
The current situation is even worse than it might seem: Employers must provide the same plan options to all employees. A high-earner might prefer a more premium plan over a barbones, catastrophic coverage-only plan while a low-earner at the same company might prefer the extra cash in their pocket. Even if some of the cost of the premium plans is forwarded to the employee the cost to the employer is still higher and they must price that case into their calculation of the overall comp package. The market is more competitive, by definition for high-earners. So the employer will offer plans that cater to them. But this cost still impacts the comp package of the low earner. For many years this dynamic has eaten up most raises to take home pay got low income earners. See: https://www.econtalk.org/mark-warshawsky-on-compensation-hea...