4 ms·

That quote seems to me to be missing a really important bit, which is that there doesn't seem to be a functioning free market which is a necessary condition to

That quote seems to me to be missing a really important bit, which is that there doesn't seem to be a functioning free market which is a necessary condition to determine the price. (This comment is not aimed at you, it is aimed at the article for supplying such a broken explanation)

sharemywin 10y ago
if a company has a monopoly there isn't by definition a functioning free market.
- ancap 10y ago
  The question therefore is, why does the monopoly exist? You will find that, as _jal has commented, it is not because of some natural phenomenon springing out of a free market.
  - sharemywin 10y ago
    sure it's natural. why would anyone compete if they could carve up a market and make monopoly profits.
    - clarkmoody 10y ago
      Because in a free market, companies cannot keep out competitors. Only through regulatory capture / cooperating with government are monopolies sustained. Even the greatest monopoly of all time -- Standard Oil -- which at its peak had 96% market share was whittled down to 64% by competition by the time the "white knight" regulators had it broken up. And who knows the long-term consequences of empowering the government to determine what is and isn't a monopoly? Well in the case of friendly relationships with well-lobbied corporate interests, there will probably not be any anti-monopoly action forthcoming.
_jal 10y ago
This is very, very important. The drug market is one of the farthest things we have from a free market in the US outside of military weapons. It is just massively dysfunctional due to a combination of special interest lobbying combined with stepwise path-dependency. A huge part of the health care discussion in the US starts from assuming our current system is somehow natural. It isn't. It is an engineered thing, with the engineering performed by in a non-coordinated fashion with incompatible goals by non-experts, piecewise, over a long period of time. Even though I doubt it (healthcare truly is different than most services/goods), a truly free market might even be superior to what we have, in terms of outcomes by patient count. Of course, that would lead to unsightly public corpses, a much different drug industry and a lot of unemployed clerical workers, among other things. And the big, unanswered question remains: why the US is such a special snowflake that what works in various ways in every other first-world country cannot work here. (Aside from the obvious answer.)
- narrowrail 10y ago
  >why the US is such a special snowflake that what works in various ways in every other first-world country cannot work here. I don't care for this argument simply because the US was the first country to throw off monarchical rule. Why the need for homogeneity? Shouldn't we have as many different implementations as possible? Personally, I don't care for centralized power (i.e. Facebook). Didn't Google take a different approach to site ranking than every other search engine? If people want to see what state-level healthcare looks like, check out MA (so-called Romney-care). We had an amendment to the CO state constitution this past election that I voted for, but ultimately failed.
  - Ericson2314 10y ago
    American healthcare isn't a city on a hill, it's a prison in a dump. Save your exceptionalist arguments for something which isn't unbelievably shitty.
  - _jal 10y ago
    > I don't care for this argument simply because the US was the first country to throw off monarchical rule. I'm sorry you don't like it. We have an interesting history, but I do fail to see the relevance of a centuries-old political dispute to the question of modern healthcare policy[0]. > Why the need for homogeneity? This is a strange question. This seems to presuppose that all other first-world countries have identical single-payer or something. The structure of healthcare in the developed world takes many different forms - see [1] for a sampler. All of them work better than what we have, for cheaper. Personally, I'd be fine with any of those models. Or, if you have a new one, please, let's hear it - just about anything is going to be better than what we have[2]. > Shouldn't we have as many different implementations as possible? Unless you want to throw a lot of money and lives away, no. Generally, one experiments with different things in order to find out what works. We have a fairly decent, if not great, idea of things that work and things that don't. A huge swath of "things that don't" probably shouldn't be tried again, because that leads to suffering, death and wasted money. I'm all in favor of refining something that works into something that works better, and we should do that. But we need to get to the "something that works" part, first. > Personally, I don't care for centralized power Good. Me, too, and I think too few people feel that way. Unfortunately, if you're looking for decentralization in healthcare, you're still in the wrong country.[3] Bottom line for me: If, in fact, the U.S. is supposed to be exceptional, supposed to be showing the way, supposed to be a better place, why do we tolerate a sixth of our economy being a shit-pit of waste, misery and dysfunction? [0] For the pedantic, modulo constitutional issues, path-dependence through legal precedent, convincing people that somehow our government/land/people/animating spirit is so magically special that somehow economics, game theory and human nature don't apply to us, etc. [1] https://en.wikipedia.org/wiki/Universal_health_care https://en.wikipedia.org/wiki/Universal_health_care [2] https://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/#767a796e576f https://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthc... [3] http://www.allhealth.org/health-care-consolidation-trends-impact-and-regulation/ http://www.allhealth.org/health-care-consolidation-trends-im...

sharemywin 10y ago

if a company has a monopoly there isn't by definition a functioning free market.

ancap 10y ago
The question therefore is, why does the monopoly exist? You will find that, as _jal has commented, it is not because of some natural phenomenon springing out of a free market.
- sharemywin 10y ago
  sure it's natural. why would anyone compete if they could carve up a market and make monopoly profits.
  - clarkmoody 10y ago
    Because in a free market, companies cannot keep out competitors. Only through regulatory capture / cooperating with government are monopolies sustained. Even the greatest monopoly of all time -- Standard Oil -- which at its peak had 96% market share was whittled down to 64% by competition by the time the "white knight" regulators had it broken up. And who knows the long-term consequences of empowering the government to determine what is and isn't a monopoly? Well in the case of friendly relationships with well-lobbied corporate interests, there will probably not be any anti-monopoly action forthcoming.

_jal 10y ago

This is very, very important. The drug market is one of the farthest things we have from a free market in the US outside of military weapons. It is just massively dysfunctional due to a combination of special interest lobbying combined with stepwise path-dependency. A huge part of the health care discussion in the US starts from assuming our current system is somehow natural. It isn't. It is an engineered thing, with the engineering performed by in a non-coordinated fashion with incompatible goals by non-experts, piecewise, over a long period of time. Even though I doubt it (healthcare truly is different than most services/goods), a truly free market might even be superior to what we have, in terms of outcomes by patient count. Of course, that would lead to unsightly public corpses, a much different drug industry and a lot of unemployed clerical workers, among other things. And the big, unanswered question remains: why the US is such a special snowflake that what works in various ways in every other first-world country cannot work here. (Aside from the obvious answer.)

narrowrail 10y ago
>why the US is such a special snowflake that what works in various ways in every other first-world country cannot work here. I don't care for this argument simply because the US was the first country to throw off monarchical rule. Why the need for homogeneity? Shouldn't we have as many different implementations as possible? Personally, I don't care for centralized power (i.e. Facebook). Didn't Google take a different approach to site ranking than every other search engine? If people want to see what state-level healthcare looks like, check out MA (so-called Romney-care). We had an amendment to the CO state constitution this past election that I voted for, but ultimately failed.
- Ericson2314 10y ago
  American healthcare isn't a city on a hill, it's a prison in a dump. Save your exceptionalist arguments for something which isn't unbelievably shitty.
- _jal 10y ago
  > I don't care for this argument simply because the US was the first country to throw off monarchical rule. I'm sorry you don't like it. We have an interesting history, but I do fail to see the relevance of a centuries-old political dispute to the question of modern healthcare policy[0]. > Why the need for homogeneity? This is a strange question. This seems to presuppose that all other first-world countries have identical single-payer or something. The structure of healthcare in the developed world takes many different forms - see [1] for a sampler. All of them work better than what we have, for cheaper. Personally, I'd be fine with any of those models. Or, if you have a new one, please, let's hear it - just about anything is going to be better than what we have[2]. > Shouldn't we have as many different implementations as possible? Unless you want to throw a lot of money and lives away, no. Generally, one experiments with different things in order to find out what works. We have a fairly decent, if not great, idea of things that work and things that don't. A huge swath of "things that don't" probably shouldn't be tried again, because that leads to suffering, death and wasted money. I'm all in favor of refining something that works into something that works better, and we should do that. But we need to get to the "something that works" part, first. > Personally, I don't care for centralized power Good. Me, too, and I think too few people feel that way. Unfortunately, if you're looking for decentralization in healthcare, you're still in the wrong country.[3] Bottom line for me: If, in fact, the U.S. is supposed to be exceptional, supposed to be showing the way, supposed to be a better place, why do we tolerate a sixth of our economy being a shit-pit of waste, misery and dysfunction? [0] For the pedantic, modulo constitutional issues, path-dependence through legal precedent, convincing people that somehow our government/land/people/animating spirit is so magically special that somehow economics, game theory and human nature don't apply to us, etc. [1] https://en.wikipedia.org/wiki/Universal_health_care https://en.wikipedia.org/wiki/Universal_health_care [2] https://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/#767a796e576f https://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthc... [3] http://www.allhealth.org/health-care-consolidation-trends-impact-and-regulation/ http://www.allhealth.org/health-care-consolidation-trends-im...