Comment by csa
> You could zero out every dollar American insurers make and not materially alter consumer health care economics; their share of the health care pie is almost literally a rounding error.
What are you implying with this comment?
I generally enjoy reading your comments, as they provide some interesting and often unique insight.
But this one…
Either it’s something I don’t understand, or it has the potential to be incredibly misleading in its implications.
The impact of American insurers on direct costs, indirect costs, and opportunity costs of healthcare is much more than a rounding error. The incentives amongst various actors, with insurers in the middle, are massively misaligned. I’m sure you know this.
Ask patio11 about insurance in Japan. It’s incredibly affordable, it’s quite good, and there are both public and private options. It’s not perfect by any means, but I miss the healthcare options in terms of both cost and quality that I had in Japan.
I think people mistake me for saying that the American status quo is acceptable. It isn't. We overpay (and overprescribe) wildly above peer countries. It's very bad. The only point I'm making here is that the two most common villains in these narratives --- insurers and pharma companies --- mathematically account for only a small portion of spending. Insurers in particular act as sin-eaters for the providers, who dwarf them in size.