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Your employer shouldn't have anything to do with your health care; the majority of economists across the political spectrum would agree. Single payer is not the

Your employer shouldn't have anything to do with your health care; the majority of economists across the political spectrum would agree. Single payer is not the only alternative to that. There are people who can't afford enough food, so we give them either food stamps or cash rather than trying to make it free for everyone.

sidlls 10y ago
The margins and economic incentives in medical care are very different from those in food and housing. It's of limited use to compare solutions in these two spaces.
- oconnor663 10y ago
  "Medical care" is a broad category though. Of course emergency medicine will never work like food. But I wonder what percentage of spending, say, goes to things that are closer to food than to emergency medicine?
  - sidlls 10y ago
    Almost none of the spending in medicine is analogous to spending on food. The closest would be things like regular checkups. For just about everything else the goal of payers is to minimize usage of the product they sell, not maximize it. In food, grocers are (roughly speaking, here) analogous to insurers and food is analogous to care utilization. Grocers want to maximize sales of food at the best price possible: they make more money by moving their product. Insurers want to minimize utilization: they make less money by "moving" their product. In the case of food, the grocers' and buyers' incentives are aligned: people need food, and grocers want to provide it. In the case of medicine, this isn't the case: people need care, and the access providers don't want to provide it.
    - oconnor663 10y ago
      Caveat: I have no idea what I'm talking about. It makes sense to me that an insurer would never be a good analogy for a grocery store, but that problem seems specific to the insurance model, rather than to medicine itself. That's more what I meant to ask about. If we imagine that hospitals and patients work like grocery stores and their customers, a few obvious problems come up: - Healthcare is too complicated for patients to make informed choices. - Emergency medicine is too urgent for patients to have much choice anyway. - Demand for care is unevenly and unfairly distributed, because of conditions people are born with. So I guess my question is, how much of medicine (in terms of dollars) hits those problems? Cancer treatment seems to hit at least two out of three. But on the other hand, a lot of dentistry seems not to.
- quickben 10y ago
  That's why countries regulate it. So you don't have "incentives" where care should be provided.
  - icebraining 10y ago
    So you don't have "incentives" Of course you have incentives. Hospital administrators want to cut costs, doctors want to redirect patients to their private offices, suppliers want to increase profits (and will offer kickbacks to doctors and administrators), etc. If you have humans, you have incentives. Regulation can change some, but not eliminate them.

sidlls 10y ago

The margins and economic incentives in medical care are very different from those in food and housing. It's of limited use to compare solutions in these two spaces.

oconnor663 10y ago
"Medical care" is a broad category though. Of course emergency medicine will never work like food. But I wonder what percentage of spending, say, goes to things that are closer to food than to emergency medicine?
- sidlls 10y ago
  Almost none of the spending in medicine is analogous to spending on food. The closest would be things like regular checkups. For just about everything else the goal of payers is to minimize usage of the product they sell, not maximize it. In food, grocers are (roughly speaking, here) analogous to insurers and food is analogous to care utilization. Grocers want to maximize sales of food at the best price possible: they make more money by moving their product. Insurers want to minimize utilization: they make less money by "moving" their product. In the case of food, the grocers' and buyers' incentives are aligned: people need food, and grocers want to provide it. In the case of medicine, this isn't the case: people need care, and the access providers don't want to provide it.
  - oconnor663 10y ago
    Caveat: I have no idea what I'm talking about. It makes sense to me that an insurer would never be a good analogy for a grocery store, but that problem seems specific to the insurance model, rather than to medicine itself. That's more what I meant to ask about. If we imagine that hospitals and patients work like grocery stores and their customers, a few obvious problems come up: - Healthcare is too complicated for patients to make informed choices. - Emergency medicine is too urgent for patients to have much choice anyway. - Demand for care is unevenly and unfairly distributed, because of conditions people are born with. So I guess my question is, how much of medicine (in terms of dollars) hits those problems? Cancer treatment seems to hit at least two out of three. But on the other hand, a lot of dentistry seems not to.
quickben 10y ago
That's why countries regulate it. So you don't have "incentives" where care should be provided.
- icebraining 10y ago
  So you don't have "incentives" Of course you have incentives. Hospital administrators want to cut costs, doctors want to redirect patients to their private offices, suppliers want to increase profits (and will offer kickbacks to doctors and administrators), etc. If you have humans, you have incentives. Regulation can change some, but not eliminate them.