The Derp
Gold Member
- Apr 12, 2017
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- #241
Oligopolies do not happen without some sort of help from government, and that help comes in the form of regulation 9 times out of 10. I am familiar with the cable/internet oligopoly, and they co-opted government to make themselves the gatekeepers of cable/fios/broadband lines. They have successfully pulled the ladder up, so that no competition can survive without them. The problem isn’t that these companies are too big to fail, it is that they’ve stomped out any new/better/cheaper and more practical competition. People have this false perception in their minds that the big players buy out politicians to remove regulation out of their way, so they can cut corners and make a few extra bucks. This is not the case, they push for more regulation very often, even though it may hurt them in the short run. But they play a longer game, and they know that if they add more and more corners for smaller companies to transverse, those smaller companies have a much harder time working their way up. They need teams of expensive lawyers that the big companies already have in place and can afford. And if the smaller competition inadvertently cuts one of the many corners, they can immediately hop on them, call in the g-man and create a very expensive problem for the competition. I cannot think of a oligopoly or monopoly that got there without some sort of help (usually a lot of help) from the government. It’s theoretically possible, but highly improbable if a small guy can come in at any time and do it faster/cheaper/better etc. What usually stops the small guy is regulation, and keeping compliant with them. It’s pretty telling when 60% of the cost of a new house goes into keeping compliant with regulation, not the land, not the building materials, not payroll, equipment, maintenance, etc. but keeping compliance.
So why wouldn't insurance companies also co-opt government? They practically already have. In fact, health care lobbying is the #1 sector of all lobbying, and if we are just looking at purely health services/insurance/HMO's, they represent about 19% of all health care lobbying contributions. So they carry significant influence and weight. So what you're saying is nice and sounds good, but the realities are that it's not realistic nor would there be any protections against insurers becoming too big to fail. What is to stop an insurer from using its weight to buy out/merge/consolidate with other insurers? That's not a regulation thing at all. Regulations weren't the reason banks merged, greed and a desire to increase market share would. So what's to stop a handful of 3-5 insurance companies from buying up all the smaller ones, and crowding the market share? Nothing. You're scapegoating the wrong thing (regulation) for a problem that exists beyond it.
So how do you intend to freeze insurance lobbyists out of the lawmaking? Are you saying that we should have public campaign finance so that lobbyists no longer existed?
You're also missing the entire point; all we are talking about is who reimburses your provider after they treat you. It's not even a part of health care that is germane to health care delivery. It's a transaction that happens after the fact. And to this day, not one person has been able to make the case that a private insurer does that administration cheaper, more efficiently, or just plain better than Medicare. And if you are going to remove state boundaries so insurance companies can become massive oligopolies, why not just enroll everyone in Medicare since it already operates across all 50 states, runs administrative overhead of 1% of its entire budget, would result in the lowest possible risk pool, and has the second-highest patient satisfaction rating after veterans' care?
nd yes, Switzerland does have universal care, but universal means all have to have it. Which is pretty much what we have now. They still have a much freer system than we do. It’s basically a lot like our car insurance laws, which are if the vehicle is on the road, it needs insurance. I’m not a fan of a universal system, but that is an area I can comprismise on...as long as we are freeing up the system, and we don’t have these gatekeeper dinosaur corps that should have been extinct long ago, had there been real competition.
No, not universal care, universal coverage. And it relies on a system where everyone is covered. And no, we don't have that system now. In fact, the system we currently have still excludes 25,000,000 people.
Also, by letting insurance sell across state lines, you're making the case for more federalism; because the roadblocks to selling across state lines that currently exist are each state's individual regulations of health insurance. So in order to do what you want, all those state regulations would have to be overruled by federal ones. And I don't know a single conservative who thinks that federal authority trumps state authority, particularly on health care and commerce. You're the ones saying that those powers aren't reserved for federal authority, yet here you are arguing for federal authority. So arguing for this broken concept is fucking hilarious when it comes from a right-winger or Conservative.
Finally, many states already allow insurance from out of state. The state I live in, GA, is one of those states. But insurers still don't offer plans from out of state despite being allowed to. Why? Simple; GA's state regulations on insurance would make the administrative burden of conforming to those standards too great to overcome.