"a health system that can set prices with impunity because consumers rarely see them — and rarely shop for discounts"
The story I've heard is that at some point (WW2-ish?) there was some sort of government-induced cap on wages, so employers couldn't compete for employees merely on a cash salary.
So, as an unintended consequence to the original government action, employers started offering health insurance as a non-cash benefit.
(Please correct me if I'm wrong, I am admittedly going on hearsay.)
Here is some history regarding health insurance in the US that backs up that story: http://www.ebri.org/publications/facts/index.cfm?fa=0302fact
Not sure how you fix it, maybe by temporarily making it illegal to allow a company to provide health benefits through insurers to fix this. Employers should only be allowed to give you the money for an individual plan (most startups sometimes do this instead). Employers don't pay your auto insurance, home insurance or other insurance. Maybe a one time convert of employer groups to individual groups managed for risk, then, for privacy, for business, for better health care the individual has that (also probably a back up plan for those in need).
Why should employers know about your health? This is ancient thinking where you stayed with a company forever. It's also a privacy thing. I think it would also combat ageism. It will also make starting companies and competing much easier with less friction. It would also allow employees to more easily go from job to job, when you have an employer plan it is a scary predicament sometimes.
Cost can only be competitive if they are seen, they will be seen if it is moved away from employer provided.
Private healthcare is still perfectly legal and fine, as is private health insurance, if you deem the state services are not suitable for you.
Hospitals should be helping people, not ripping them off >.<
What about the police department? Or the fire department? Or the post office?
Any government is, at its core, socialist. Rather than everyone funding their own private army, the state socialises the cost and provides national defence.
For other parts of society, it may also make sense to have everyone pay in to provide service which is to the public good. Police, fire, postal services are canonical examples.
In most countries, health care is also socialised. As is garbage collection, libraries, and road building.
The question - for most reasonable people - is where do you draw the line? Buses are socialised - what about taxis? Doctors are socialised - what about Lawyers, or accountants?
you mean you can't afford to not _have_ the service? you can certainly be unable to pay!
I understand the theory: People buy insurance; the insurance companies 'police' medical providers and regulate (through the market) the pricing of services.
From the outside it doesn't look like that works. From the outside it looks like very many more (often unneeded) tests are conducted. And it looks like the insurance companies are not squeezing the providers of health care, but are squeezing the patients.
They get paid by employers, but they'd make more profit if the health care they buy is cheaper. Since I regularly hear that prices are cheaper if you negotiate with the doctors it seems that insurance companies are not doing that negotiation.
So, given that they appear to be losing out on some profit, why? Why aren't they pushing the costs down?
Insurance companies figure out what stuff should actually cost, then enter into contracts with providers that says "Hey I know you're still making a decent profit if I only pay you $100 instead of $150, so take $100 and you'll make it up on volume when you become one of my preferred providers."
( (gross_revenue + interest_on_capital) - cost_of_care ) = profit
Hey no, I want to go to Hospital B.