“While what you say regarding consumers not being fully informed is true - it does not *need* to be true.”

Can you elaborate on this point? My understanding is if consumer is detached from the price of the treatment, and insurer operates on percentage margins, then by covering new and expensive treatments they are able to push overall costs up and by doing so increase their profit in absolute numbers without increasing efficiency of profit extraction. The only downward pressure is consumers having to pay higher insurance premiums, but with employer paying most of it, pressure is very minimal.

In traditional sense market would operate along the following decision-making lines – Treatment A(expensive) and Treatment B(affordable) are available. If I pay directly and I can’t afford treatment A, then I will go with treatment B. This puts market pressure on Treatment A to lower price to better compete with Treatment B. This is not how the system currently operates – Treatment A is picked every time, insurers pass the cost to employer who absorbs it into labor costs, and individual consumer has very little say in going with Treatment B. In turn, if employer wants to lower coverage costs, they go with an insurance plan that covers fewer conditions, has higher deductible or lower lifetime max; but if this cheaper plan covers a specific condition, they still go with a Treatment A.

This is why I think employer-sponsored insurance-pool health care is a dysfunctional system. Single payer system would be better. So is everyone paying out of pocket (and influencing prices via market forces) with only major conditions requiring insurance.

---

“Also, you have not "demonstrated" that such a system contains cost. You have made that assertion, but have made no inroads in modeling such a scenario where that occurs. Large scale systems where this style of intervention has been implemented have failed without exception.”

This is not a falsifiable argument, as such it is invalid. See: No True Scotsman fallacy.

If I bring up examples of any other First World country, you will claim (and have in the past) that scale is too small. If I bring up other US-based cases, such as VA or Active Military health care, you will claim it is too different.

Formally: ‘US health care’ is not ‘Other health care’ for all healthcare that is not ‘Other health care’ is not falsifiable as defined.

---

I am not denying that R&D will be affected. While I don’t think effects will be as drastic as you propose, I don’t want to focus our debate on this, and will concede that it will be reduced and leave it ‘reduced’ unspecified.

‘Silver lining’ of my plans is that under single payer employers will be largely free from providing health insurance, as such normalizing labor costs over part and full time. It will also lower overall employment costs, assuming that US is not an outlier and health care costs under single-payer drop to around 10%GDP observed in every other single-payer country. Additionally it will allow greater labor mobility, lessening ‘bennies lock-in’ and will afford more business creation, freeing individuals from concerns of finding individual health coverage.

[Linked Image]