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kunaitoday at 1:41 AM1 replyview on HN

These solutions are often proposed as easy fixes but I'm skeptical that they actually will do much to reduce healthcare costs. Healthcare is fundamentally expensive. Not-for-profit hospitals and for-profit hospitals don't really substantively differ in terms of out-of-pocket expenditures for patients; I find it difficult to imagine that forcing insurance companies to be nonprofit would do much to reduce costs.

> large insurance pools that must span age groups and risk groups.

What you describe (community rating) has been tried and it works. But it requires that a lot of young, healthy people enroll, and seniors receive most of the care. In an inverted demographic pyramid like most Western economies have, this is a ticking time bomb, so costs will continue to rise.

> Mandate at least decent minimal coverage standards

I think a better solution is to allow the government to threaten in negotiating prices with companies as Canada does; it greatly reduces rent-seeking behavior by pharmaceutical companies while allowing them to continue earning profits and innovating. (I understand a lot of the complaints against big pharma but they are actually one of the few sectors of the economy that doesn't park their wealth and actually uses it for substantive R&D, despite what the media will tell you, and countless lives have been saved because of pharma company profits)

Essentially the gist of what I'm saying, as someone who has been involved with and studied this industry for the better part of five years, is that it's much more complex than what meets the eye.


Replies

bandramitoday at 1:47 AM

There are a lot of not-for-profit insurance companies and they aren't noticably cheaper, though I'm not in HR and they may well be cheaper for the employer.