That’s where regulation comes in. In my country it’s mandatory for every citizen to have a base insurance package and it’s mandatory for every insurance company to accept every individual for that same base package, regardless of preexisting conditions. The minimum contents of the base package are determined by the government, the prices and extras are up to the insurance companies to decide. Every calendar year people are allowed to switch to a different insurance company, or make changes to their add-on packages and options, forcing the companies to compete while being able to lock in their clients for a year for some predictiveness. In effect that means that everyone is insured against rare and expensive diseases, while still keeping it relatively affordable, because the pool also includes healthy individuals with extremely low risk profiles. Add-on packages don’t have to follow the same rules, but the base package makes sure that people won’t go into massive debt for being unlucky, which is in my opinion essential for a humane society, no matter how this problem is solved, whether it’s commercial like here, or public like elsewhere. If all is left to the market without regulation, those benefits are lost. Some people might call that freedom, but I disagree.
More directly, yours is a wealth redistribution scheme from parents to elderly non-parents to produce healthy young people at the bottom of the pyramid mostly at their own cost so they can turn around and subsidize people who never raised up this distribution mechanism. An interesting system that is collapsing in much of Europe due to the free rider effect. Why have kids when some other schmuck will foot the bill and the output will lower my insurance premium in what becomes effectively a regressive tax.
Wouldn't it be the kids taking advantage? They fall into non-parents bucket, so yes they are free riders but since they are children I'll forgive them. I don't blame children for not paying their premiums, and since society is about to farm hard on them it's almost a half hearted quid pro quo.
> I doubt anyone in Europe is deciding to not have children based on this factor.
Why so few children in most of Europe then?
Of course they don't. They just know that they can have fleeting fun until 60 and then "somebody" will foot their old age bills. So why have children?
At the same time, people who have children has to pay for themselves, for their children, for their parents but also for "grasshoppers" who only use their country's coffers when in need, while barely contributing anything.
I'm confused by this statement, as the fertility rate in the European Union (1.5 in 2021) is similar to the fertility rate in the US (1.66 in 2021). But yes, countries in Europe do have issues with aging populations, especially when the net immigration is low. It depends on the system how big of an issue it is. For example, in my country the pension system is designed with this in mind, and for a big part people pay for their own pensions instead of for the pensions of the current pensioners. Of course population aging is also a hazard for the economy as a whole, but that's a bit of scope for this discussion, I'd say.
The problem exists in shades in the USA and pretty much everywhere with nation state robust social security that relies in tragedy of the commons of privatizing the lions share of cost of children while socializing the gains ( your health insurance scheme is perfect in scope example I think). The effect is so predictable it's stunning that it's rarely seen as an obvious focus of study.
How does this scheme socialize the gains of children if children don't pay premiums? In my country it's actually free to have children (as there are no hospital and healthcare costs involved for the parents) and having children gets subsidized in various forms (allowances, education, etc). Sure, it's still expensive to have children, but it's expensive to have children in any country. And mind you, there is no country in the world where the per capita healthcare expenditure (private and public combined) is higher than in the US.
Because of the premiums they have to pay, you mean? The premiums are currently about $150 a month, or less if you accept a higher out-of-pocket payment. If you don’t earn much, it’s almost 100% subsidized by the government, which is mostly paid for by people with higher incomes who pay more taxes (in absolute numbers as well as relatively, due to the progressive tax system).
I think one of the most important factors for not having children early is the sky-high housing market, definitely not the healthcare insurance system.
I guess what you're referring to is the long-term benefit of having children, as in: the benefit of having adult children to support you when you're old. Yes, that has been socialized to an extent, which does indeed come with a risk. Maybe I'm too European, but I don't see how a system devoid of public safety nets is superior, though. Everybody benefits from a society that where most people are relative well-off and worry-free, including those that don't need it, and over time it surely needs to adjust to new realities, which is unavoidable.
I think it's achievable with a nation state net but more challenging. Given kids at least up to replacement rates are usually net positive, society will have to economically reflect them as a profit center rather than hogging most of the gains and artificially shunting them as cost center to producers of children.
Although if it were me, well, I'd just leave the kids the hell alone and let them decide who they want to help.
It is not about healthcare, it is about pensions. European social tax is split into multiple separate funds - one goes to support pensions and another to support healthcare, small part also goes to support unemployment benefits.
Pensions is the mechanism that creates an illusion that children are not necessary anymore to support you in your old age if you have "worked enough" - that is the main argument I have heard in support of not having children - but I have worked enough and saved for my pension.
