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There are a lot of reasons health insurance is way too expensive, but one of them is that many individuals are shielded from the true price because it's provided through their employer. This essentially removes downward price pressure from individuals.

Having insurance tied to employment is bad for workers. It makes switching jobs far more difficult and stressful, and makes losing your job that much more of an issue.



Yes, I agree having insurance tied to employment is bad for workers. The conclusion is "therefore M4A", not "therefore everyone should buy their own insurance on a public exchange, paying half as much as their rent". You can use COBRA to stay on your job's health insurance when you leave it, which is not notably more expensive than the public exchange plans.

The insurance market model for healthcare coverage is such a fractally broken failure that if you're still stuck on the stage of twisting some knobs and adjusting some levers in the hope that second-order market effects will improve things then there really is just nothing that will convince you to move on.


Normally people create downward pressure on prices by not buying the product when it becomes overpriced. However with healthcare there is a captive market. Are you not going to get a cast put on a broken leg because the doctor wants to charge too much? Are you going to just opt out of cancer treatments and die?

Healthcare is an area where market forces are inherently perverted because people often don't have a choice of not buying the service. This is why every sensible country uses a socialized system instead. Not only does it provide better service, but without the perverse market incentives and multiple layers of middlemen infesting the system it is much less expensive.


You still have a choice between competing hospitals / doctors in a system where prices are not inflated for insurances' catalogues.


That would be true iff prices were disclosed upfront and the pricing model was clear. I had a hospital experience recently where the surgeon provided one bill, the hospital a second, and the anesthesiologist a third.

Only the surgeon's pricing was available ahead of time. The hospital provided an invoice at the time of surgery, marked as "SUBJECT TO CHANGE". The anesthesiologist himself didn't know how much his services would cost.

Three weeks later, we're still watching invoices and insurance claims roll in.

Medical tourism is a direct testament to inflated charges as a systematic problem. Finding a hospital with non-inflated costs requires crossing international borders.


The best time to shop around for the best deal is after you've been hit by a car and are having trouble breathing.




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