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> I very much like free market. But here, the final consumer is not in a position to bargain prices when getting sick, which is a pre-requisite for a free marke

> I very much like free market. But here, the final consumer is not in a position to bargain prices when getting sick, which is a pre-requisite for a free market to function. Single-payer system works way better in that very particular industry, because both parties can now effectively negotiate. I am sorry but you don't like Free market. That's like saying "I love Hillary Clinton and I am totally with her, but I think Trump would be a better President than Hillary in every way because he is not dying". My friend describes this as a 'Sales Pitch argument' where you claim to support your opponent's position, but you actually don't. "I am all for Gays to be able to freely marry, but we gotta make sure that the kids they adopt aren't going to abusive homes because statistics say that kids raised by gay and lesbian couples don't do so well". > the final consumer is not in a position to bargain prices when getting sick, which is a pre-requisite for a free market to function. I don't know from where does this kind of faulty thinking originates. Lemme show you why it is faulty: The final consumer of food is not in position to bargain prices when he is hungry, which is a pre-requisite for free market to function. Therefore a single payer food system works better than a private food system. The final consumer of a gun is not in a position to bargain prices when his home is invaded, which is a pre-requisite for a free market to function. Therefore a single payer gun system works better than private market for guns. The problem is, you're not suppose to look for food only when you get hungry, or buy a gun precisely when you're getting invaded, you're suppose to do these things BEFORE you actually need them. And just like food (which you need daily multiple times) you buy in chunk. The whole system of food acquisition works out perfectly fine. Your rest of the comment is more to the point, and the way things are in America are antithetical to a free market in healthcare and pharma industry.

snowwrestler 10y ago
I agree with this, and I'll add that the system we have now actively prevents me from trying to apply price sensitivity. I have a chronic illness that requires me to take medicine every day; some prescription, some not. For the prescription medicine I get a prescription from my doctor. It does not tell me the price of the drug, nor does it tell me whether there is a generic available, or another brand-name drug with similar effect. Even if I ask, the doctor typically has no idea how much the various drugs cost, and which are less expensive. They just say "your insurance will cover this." I take it to the pharmacy. None of the pharmacies advertise their prices for this drug, so I have no reason to choose one over another. I fill the prescription and go to checkout. The price will be different depending on which tier the drug is on at my insurance company, the copay for that drug, or whether I've yet satisfied my deductible. The only way to predict these things in advance is to read through dozens of pages of dense literature from my insurance provider. And by the way, I have no choice in insurance provider because my employer only offers one. For the non-prescription medicine, the price is clearly marked in every store, and generics are clearly identified and merchandised right alongside the brand name. I have great opportunity to choose where and what to buy. And, no surprise, these are way cheaper than the prescription drugs. Keep in mind that my need for, and usage of, these drugs is exactly the same. But the price is radically different depending on whether they come to through the clarity of the market or the opacity of the current health insurance system.
Nursie 10y ago
So you think that people should stock up on meds before they get sick? It's not an invalid argument to say you think markets are great excwpt where the preconditions for a well functioning market are not met. Many people think they are not met when it comes to healthcare, hence most of the developed world having socialised medical systems. The US is a weird outlier in that respect.
- snowwrestler 10y ago
  A huge amount (the majority, I believe) of health care costs in the U.S. are spent treating chronic illnesses. Chronic illnesses are like hunger--you know you have it, and you know you will need regular treatment for it. Buying medicine in advance is how chronic illnesses are treated. Medical emergencies are a popular counter-argument to the idea of greater market clarity in health care, but the reality is that most people encounter the medical system in non-emergency situations. They have the opportunity to shop around for these--but often don't, because they don't have the information or incentive to do so. As for emergencies or unexpected costs--that is what insurance is properly for.
soundwave106 10y ago
The problem is that people would have a lot of trouble swallowing some of the consequences of a true free market on medical care. From "patient dumping" cases (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305897/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305897/) to the very real possibility that a medication with horrible consequences will be put on the market (ala a Thalidomide -- https://en.wikipedia.org/wiki/Thalidomide https://en.wikipedia.org/wiki/Thalidomide), it is clear that some regulations are needed for moral and practical reasons in health care that would run against the spirit of free markets. Part of that is that there is a very significant barrier in obtaining the knowledge needed in order for a consumer to be truly "informed", as medicine and chemistry etc. are hard subjects. Another problem is that a sick patient in need of medical emergency by definition is not going to be in the best place to make an informed decision -- and it's not like you always can chose things beforehand (example: what if you have a medical emergency while traveling?). So I don't think the gun / food comparisons are directly comparable, personally. That being said, it is entirely possible to design a system that introduces plenty of competitive opportunities while keeping the above in mind. Personally, I think many single payer systems in the world are actually more free-market-friendly than the United States, in that there's provisions for competition from either/or private insurance and private health care facilities! Capitalism / free markets lose many of their advantages if they turn into monopolies that are able to strong-arm competition away with legislation... this pretty much is the situation with American pharmaceuticals, I'm afraid.
decaysackparity 10y ago
> The final consumer of food is not in position to bargain prices when he is hungry, which is a pre-requisite for free market to function. You are ignoring the fact that consumers can pick from a plethora of food options. When you have sickness A the ONLY option you have is medicine X (take this medicine or you die), where is the market force to drive down the price? That isn't free market
- splintercell 10y ago
  > When you have sickness A the ONLY option you have is medicine X (take this medicine or you die), where is the market force to drive down the price? That isn't free market Sure, but if a country suffers famine, do people (and you) suggest single payer food system?
  - decaysackparity 10y ago
    > if a country suffers famine, do people (and you) suggest single payer food system? Yes! The government (payer) gets the food it needs to feed its people or...?
mattmanser 10y ago
Your logic's completely wrong. The gun + food arguments don't work at all. A lot of drugs are patented, which means they aren't operating in a free-market. I can, however, choose any gun or any food. And how can you know what disease you're going to get before it happens? Should I stock up on all possible diseases just in case?
bisRepetita 10y ago
Clarifying. Yes, I am in favor of free market, free entrepreneurship, and competition in most industries. E.g.: I favor free market for food, as opposed to Govt fixing food prices... and it seems to be very efficient, much better than Poland in the 80s!! In a few limited industries, such as healthcare, I am much less in favor. >you're suppose to do these things BEFORE you actually need them Exactly. I paid full price in a single-payer system, not subsidized by anyone, where prices have been negotiated in advance, and it is a lot less costly. I paid even less than the co-pay in the US! I am insured here, so my insurance takes the rest, but it's super expensive for them. And therefore for me in my premium. The magnitude of the difference is insane, but it makes sense given the dynamics of that industry. Hence calling for a different system, just for that industry: it shows to be a more effective in many developed countries.
- splintercell 10y ago
  See you seem to think that when you say "I favor free market for food but not in healthcare", you're saying "I favor eating Chinese food today but last week I ate mostly Turkish food". Or "I don't drink coffee on the days I have to make a big presentation". Whereas saying what you're saying is more akin to "I believe in science and reason as far as Christian god is considered, but in China I believe in Budda as the supreme deity". My point is, that there is a reason why Free Market works, and government controlled economies don't. If you hold that model consistently you will find the reason why American healthcare system is so messy, and not that somehow govt controlled healthcare system works. If govt controlled healthcare works, then govt controlled everything and anything could work. > I paid full price in a single-payer system, not subsidized by anyone, where prices have been negotiated in advance, and it is a lot less costly. Are you claiming that something fundamentally in free market which prevents you from doing that here?
  - bisRepetita 10y ago
    Reading you, I feel you believe free market is some sort of God that cannot ever be contested, and everything should be the same/consistent. The real world is way more complex. Healthcare is not like food. >if govt controlled healthcare works, then govt controlled everything and anything could work. Absolutely not: we have enough examples showing the opposite. Govt-controlled food prices usually does not work, and bargaining drug prices betwen a state and private companies actually does, in many countries!! Free market is a tool, very efficient to serve the people in most cases. But if that tool does not work very well for the people of the Unites States in a particular industry, why not change the rule in that industry? Afraid of entering of world of complexity where free market is not the only, systematic solution? Reality is diverse, even if it's annoying intellectually.

snowwrestler 10y ago

I agree with this, and I'll add that the system we have now actively prevents me from trying to apply price sensitivity. I have a chronic illness that requires me to take medicine every day; some prescription, some not. For the prescription medicine I get a prescription from my doctor. It does not tell me the price of the drug, nor does it tell me whether there is a generic available, or another brand-name drug with similar effect. Even if I ask, the doctor typically has no idea how much the various drugs cost, and which are less expensive. They just say "your insurance will cover this." I take it to the pharmacy. None of the pharmacies advertise their prices for this drug, so I have no reason to choose one over another. I fill the prescription and go to checkout. The price will be different depending on which tier the drug is on at my insurance company, the copay for that drug, or whether I've yet satisfied my deductible. The only way to predict these things in advance is to read through dozens of pages of dense literature from my insurance provider. And by the way, I have no choice in insurance provider because my employer only offers one. For the non-prescription medicine, the price is clearly marked in every store, and generics are clearly identified and merchandised right alongside the brand name. I have great opportunity to choose where and what to buy. And, no surprise, these are way cheaper than the prescription drugs. Keep in mind that my need for, and usage of, these drugs is exactly the same. But the price is radically different depending on whether they come to through the clarity of the market or the opacity of the current health insurance system.

Nursie 10y ago

So you think that people should stock up on meds before they get sick? It's not an invalid argument to say you think markets are great excwpt where the preconditions for a well functioning market are not met. Many people think they are not met when it comes to healthcare, hence most of the developed world having socialised medical systems. The US is a weird outlier in that respect.

snowwrestler 10y ago
A huge amount (the majority, I believe) of health care costs in the U.S. are spent treating chronic illnesses. Chronic illnesses are like hunger--you know you have it, and you know you will need regular treatment for it. Buying medicine in advance is how chronic illnesses are treated. Medical emergencies are a popular counter-argument to the idea of greater market clarity in health care, but the reality is that most people encounter the medical system in non-emergency situations. They have the opportunity to shop around for these--but often don't, because they don't have the information or incentive to do so. As for emergencies or unexpected costs--that is what insurance is properly for.

soundwave106 10y ago

The problem is that people would have a lot of trouble swallowing some of the consequences of a true free market on medical care. From "patient dumping" cases (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305897/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305897/) to the very real possibility that a medication with horrible consequences will be put on the market (ala a Thalidomide -- https://en.wikipedia.org/wiki/Thalidomide https://en.wikipedia.org/wiki/Thalidomide), it is clear that some regulations are needed for moral and practical reasons in health care that would run against the spirit of free markets. Part of that is that there is a very significant barrier in obtaining the knowledge needed in order for a consumer to be truly "informed", as medicine and chemistry etc. are hard subjects. Another problem is that a sick patient in need of medical emergency by definition is not going to be in the best place to make an informed decision -- and it's not like you always can chose things beforehand (example: what if you have a medical emergency while traveling?). So I don't think the gun / food comparisons are directly comparable, personally. That being said, it is entirely possible to design a system that introduces plenty of competitive opportunities while keeping the above in mind. Personally, I think many single payer systems in the world are actually more free-market-friendly than the United States, in that there's provisions for competition from either/or private insurance and private health care facilities! Capitalism / free markets lose many of their advantages if they turn into monopolies that are able to strong-arm competition away with legislation... this pretty much is the situation with American pharmaceuticals, I'm afraid.

decaysackparity 10y ago

> The final consumer of food is not in position to bargain prices when he is hungry, which is a pre-requisite for free market to function. You are ignoring the fact that consumers can pick from a plethora of food options. When you have sickness A the ONLY option you have is medicine X (take this medicine or you die), where is the market force to drive down the price? That isn't free market

splintercell 10y ago
> When you have sickness A the ONLY option you have is medicine X (take this medicine or you die), where is the market force to drive down the price? That isn't free market Sure, but if a country suffers famine, do people (and you) suggest single payer food system?
- decaysackparity 10y ago
  > if a country suffers famine, do people (and you) suggest single payer food system? Yes! The government (payer) gets the food it needs to feed its people or...?

mattmanser 10y ago

Your logic's completely wrong. The gun + food arguments don't work at all. A lot of drugs are patented, which means they aren't operating in a free-market. I can, however, choose any gun or any food. And how can you know what disease you're going to get before it happens? Should I stock up on all possible diseases just in case?

bisRepetita 10y ago

Clarifying. Yes, I am in favor of free market, free entrepreneurship, and competition in most industries. E.g.: I favor free market for food, as opposed to Govt fixing food prices... and it seems to be very efficient, much better than Poland in the 80s!! In a few limited industries, such as healthcare, I am much less in favor. >you're suppose to do these things BEFORE you actually need them Exactly. I paid full price in a single-payer system, not subsidized by anyone, where prices have been negotiated in advance, and it is a lot less costly. I paid even less than the co-pay in the US! I am insured here, so my insurance takes the rest, but it's super expensive for them. And therefore for me in my premium. The magnitude of the difference is insane, but it makes sense given the dynamics of that industry. Hence calling for a different system, just for that industry: it shows to be a more effective in many developed countries.

splintercell 10y ago
See you seem to think that when you say "I favor free market for food but not in healthcare", you're saying "I favor eating Chinese food today but last week I ate mostly Turkish food". Or "I don't drink coffee on the days I have to make a big presentation". Whereas saying what you're saying is more akin to "I believe in science and reason as far as Christian god is considered, but in China I believe in Budda as the supreme deity". My point is, that there is a reason why Free Market works, and government controlled economies don't. If you hold that model consistently you will find the reason why American healthcare system is so messy, and not that somehow govt controlled healthcare system works. If govt controlled healthcare works, then govt controlled everything and anything could work. > I paid full price in a single-payer system, not subsidized by anyone, where prices have been negotiated in advance, and it is a lot less costly. Are you claiming that something fundamentally in free market which prevents you from doing that here?
- bisRepetita 10y ago
  Reading you, I feel you believe free market is some sort of God that cannot ever be contested, and everything should be the same/consistent. The real world is way more complex. Healthcare is not like food. >if govt controlled healthcare works, then govt controlled everything and anything could work. Absolutely not: we have enough examples showing the opposite. Govt-controlled food prices usually does not work, and bargaining drug prices betwen a state and private companies actually does, in many countries!! Free market is a tool, very efficient to serve the people in most cases. But if that tool does not work very well for the people of the Unites States in a particular industry, why not change the rule in that industry? Afraid of entering of world of complexity where free market is not the only, systematic solution? Reality is diverse, even if it's annoying intellectually.