I'll take a stab at it. This is just an effort for public discussion because I actually want socialized medicine, so I'm not really espousing the following. Innovation is one advantage to a profit motive, but it isn't the only one. Capitalist markets are excellent at managing risk -- pricing who faces risks and finding offtakers who can bear that risk most efficiently. The profit motive is also excellent at proactively finding efficiency to reduce costs, which can yield greater market share and more profits. So, individuals are facing risks (financial ruin resulting from health problems), and the insurance layer is trading that risk for some cost certainty for the individual. The insurance company takes that risk itself, but can then hedge its risks with its other customer contracts, its vendor contracts, and with financial instruments. Then, as manager of this value chain, it can find efficiencies to do this exercise better than an unmotivated middleman would. Finally, because insurance is a market-driven enterprise, they are making forward-looking decisions and taking that forecasting risk (which comes with a risk adder on their profits). A government agency trying to fulfill the same function could give individuals that trade of risk for some cost certainty. And it can take some of the same risk hedging strategies. But when it tries to force vendors to pick up its risk, they're accused of abusing their monopsony. And far from finding efficiency (if they ever wanted to), they'd get mired in red tape as politicians find advantage in making rules about how and from whom they can procure. And maybe most importantly (to me, because my industry is like this), this agency will be backward-looking about their costs, recovering from ratepayers what had been spent (with no profits!), instead of being forward-looking and taking risk that revenues might not equal expenses.
@Invisible Fan You didn't mention how Lina Khan has already sued to break up the PBM cartel alongside filed numerous mergers to block Healthcare consolidation. The current FTC has stopped more hospital mergers than any other admin in history. They also stopped UHC and Cigna acquisitions so they couldn't become bigger Weird how none of the Bernie bros in this thread have no idea what's already happening
I think we should break up BIG MEDICINE it's more like BIG MEDICINE and BIG INSURANCE (Like we separate out BIG PHARMA) Rocket River
