What actually ruined it was Government capping CEO and top officers pay. That lead to perks that were not price controlled to attract talent.
- Housing
- Cars
- Vacation time
- HEALTH INSURANCE
Prior to that health insurance was almost unheard of. Then Unions put it on the table for their workers. Soon healthcare began to rise and insurance companies started to offer it to their clients. Medicare and Medicaid were instituted to help the elderly and indigent.
That is when the cash registers disappeared.
No. Back in the days when I had to file my own claims, I had to pay the provider. The insurance company paid me. If I couldn't afford the whole thing I could pay an estimate of what the insurance wouldn't pay up front (that was the old 80/20 plan), and they'd bill me for the rest. And I'd pay the provider the rest when I received the money from the claim. In that kind of system, the market is still intact.
I don't think health insurance needs to be tied to employment. That's a bad model. I don't see insurance itself as an evil though. It's a valuable product for a lot of people that helps take some uncertainty out of life. If it's a cash register, how will you pay for a long stay in the hospital? Of course it'd be more affordable than it is today. But still expensive.
I would not favor eliminating insurance, and I would not favor prohibiting employers from providing it. But I think some rules need to change to make employment not the #1 way to get insurance, and I certainly think the customer always needs to have the primary role in decision making. Paying the healthcare provider should be a unique transaction between the patient and the provider. Claiming an insured event should be a unique transaction between the insured and the insurance company. What got rid of the cash registers was PPOs. After that I never filed another claim and I was taken out of the loop.