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Libertarians and conservatives believe that health care is or could be a well-functioning market, like buying a refrigerator. But there are many basic differen

Libertarians and conservatives believe that health care is or could be a well-functioning market, like buying a refrigerator. But there are many basic differences. You know when you need a refrigerator, but often are not sure if you need a given test or health treatment. Refrigerators are bought one at a time, but tests and treatments are often whole bundles. Refrigerators of a given brand and model are basically identical, not so health treatments. If you get a bad refrigerator you can exchange it under warranty, a bad health treatment can cause you permanent damage. You can get reliable information on refrigerators from Consumers Reports, not nearly so much for health care. You can generally get along without a refrigerator for a while, taking time to get information before making a decision which one to buy, often that is not the case with important health care. There are many sellers of refrigerators with public prices and lots of price competition, not the case for health care. The prices for refrigerators are standard around the country, not at all the case for health care. The majority of health expenses are in the last few years of life, when people are in poor mental shape to make decisions. You can buy a refrigerator at a reasonable price without insurance, but not individual health treatments. In these and i would guess other ways, a purchaser of health care services is, by the very nature of things, in a far weaker position than a buyer in a normal market. And of course, the health care providers like it that way. Can anyone suggest any other basic differences?

lazaroclapp 10y ago
> Refrigerators of a given brand and model are basically identical, not so health treatments. Heh, wonder if they would take the following compromise: no public healthcare option, but medical patents are hereby abolished. You know, getting the government out of healthcare... Not that I really advocate for this policy, but I mean, libertarians are not ok with being "coerced"[1] to provide medical treatment, but are ok with being "coerced" to not manufacture life saving treatments because someone else owns the IP to them, usually standing on the shoulders of decades of tax funded university research. [1] scare quotes because I believe there is a difference between taking a particular individual and actually forcing them at gunpoint to be a public doctor, and simply taxing people into paying for a public health system that is attractive enough that enough people chose to work for it of their own free will (e.g. the NHS)
deleted 10y ago
[deleted]
danieltillett 10y ago
I was under the impression that under the current US medical system that it is impossible to get a pre-purchase price on a lot of medical care. If you are going into hospital for a knee replacement you can't get anyone to tell you the total bill in advance. One major difference is the actual price paid for a medical service by an insurance company is much lower (often 10%) of the cash price. Another is that the you don't know what the insurance company will cover until months afterwards. None of these apply to normal consumer items where markets work. The most efficient USA healthcare system would probably be to just expand the VA system to cover everyone and put a tax to pay for it.
- ashark 10y ago
  > One major difference is the actual price paid for a medical service by an insurance company is much lower (often 10%) of the cash price. It is often much lower, but it also varies by insurance provider and the specific plan you are on, which can itself (AFAIK) vary depending on when you joined said plan, your group, et c. The hospital can't even guess at a price until they figure out which procedure codes they're going to bill, which itself isn't always clear, then to know what you'll actually pay they have to apply the effects of your specific insurance. It's often quite difficult to get them to do this. Often it will end up being wrong anyway. Bonus: you can't be really really sure your insurance will pay their part until the bill goes out and they do. Sometimes they deny claims. They may be wrong to do so (it's sometimes hard to tell) but even if they are you're in for 100+ hours of work (much of it waiting on hold) to get them to do what they were supposed to.
  - danieltillett 10y ago
    All I can say is I am glad to be Australian. We might have some nasty wildlife, but at least I know that if I am bitten or stung I am not going to end up bankrupt.
baddox 10y ago
I don't have enough certainty to want to take either side here, but wouldn't food make a better analogy than a refrigerator? Food is more similar to healthcare. It's something that you need to purchase regularly and it's vital to your immediate health.
- woodandsteel 10y ago
  Routine health care, like your yearly visit to your doctor, are more like food, but the important, expensive ones like getting cancer, which are the vast majority of health expenses, are occasional and unpredictable, so are more like buying a refrigerator when yours unexpectedly breaks down.

lazaroclapp 10y ago

> Refrigerators of a given brand and model are basically identical, not so health treatments. Heh, wonder if they would take the following compromise: no public healthcare option, but medical patents are hereby abolished. You know, getting the government out of healthcare... Not that I really advocate for this policy, but I mean, libertarians are not ok with being "coerced"[1] to provide medical treatment, but are ok with being "coerced" to not manufacture life saving treatments because someone else owns the IP to them, usually standing on the shoulders of decades of tax funded university research. [1] scare quotes because I believe there is a difference between taking a particular individual and actually forcing them at gunpoint to be a public doctor, and simply taxing people into paying for a public health system that is attractive enough that enough people chose to work for it of their own free will (e.g. the NHS)

deleted 10y ago

[deleted]

danieltillett 10y ago

I was under the impression that under the current US medical system that it is impossible to get a pre-purchase price on a lot of medical care. If you are going into hospital for a knee replacement you can't get anyone to tell you the total bill in advance. One major difference is the actual price paid for a medical service by an insurance company is much lower (often 10%) of the cash price. Another is that the you don't know what the insurance company will cover until months afterwards. None of these apply to normal consumer items where markets work. The most efficient USA healthcare system would probably be to just expand the VA system to cover everyone and put a tax to pay for it.

ashark 10y ago
> One major difference is the actual price paid for a medical service by an insurance company is much lower (often 10%) of the cash price. It is often much lower, but it also varies by insurance provider and the specific plan you are on, which can itself (AFAIK) vary depending on when you joined said plan, your group, et c. The hospital can't even guess at a price until they figure out which procedure codes they're going to bill, which itself isn't always clear, then to know what you'll actually pay they have to apply the effects of your specific insurance. It's often quite difficult to get them to do this. Often it will end up being wrong anyway. Bonus: you can't be really really sure your insurance will pay their part until the bill goes out and they do. Sometimes they deny claims. They may be wrong to do so (it's sometimes hard to tell) but even if they are you're in for 100+ hours of work (much of it waiting on hold) to get them to do what they were supposed to.
- danieltillett 10y ago
  All I can say is I am glad to be Australian. We might have some nasty wildlife, but at least I know that if I am bitten or stung I am not going to end up bankrupt.

baddox 10y ago

I don't have enough certainty to want to take either side here, but wouldn't food make a better analogy than a refrigerator? Food is more similar to healthcare. It's something that you need to purchase regularly and it's vital to your immediate health.

woodandsteel 10y ago
Routine health care, like your yearly visit to your doctor, are more like food, but the important, expensive ones like getting cancer, which are the vast majority of health expenses, are occasional and unpredictable, so are more like buying a refrigerator when yours unexpectedly breaks down.