9 ms·

Straight up exploitation of people during their most vulnerable moments.

fredley 9y ago
The free market is a poor model for providing healthcare. In an ideal free market, market forces work to find the optimum price for a product, depending on how much it costs to create the product, and how much people are willing to pay for it. In healthcare, though, how much people are willing to pay for a product is anything, if it's the one thing they need to stay alive, or to reduce chronic pain, etc.
- patrickg_zill 9y ago
  We don't have a free market in healthcare. Easily proved by looking at the artificial barriers to entry, both for products and people.
- pfranz 9y ago
  It sounds like he's talking about a different problem. This is a problem with certification and regulation. What you're talking about is, "I'm bleeding and don't have time to drive to the next city over because it's cheaper." When that hospital purchased its gauze, sutures, and other equipment it wasn't under duress and theoretically could switch suppliers at any time. Being intended for use on or inside a human body, we have higher expectations in quality and consistency. Unfortunately, these certifications can make the barrier to entry too high for good competition. Or they're locked into a supplier for whatever reason.
- deleted 9y ago
  [deleted]
- bluecalm 9y ago
  People are willing to pay anything for food or clothes as well. Still, free (well, at least way more free than in case of healthcare) market works decently, at least when it comes to providing cheap and decent food options. The problem with healthcare is the opposite: there is no free market and it's impossible to compete without huge investment and even then it's sometimes still impossible (patents, long approval periods etc.). The problem is for sure not simple but a lot of basic healthcare services could be a lot cheaper if it was easier to get in.
  - timthelion 9y ago
    When I'm hungry, I'm still able to visit multiple restaurants/ stores to compare prices. But when I'm having a heart attack, do I really have the option to shop around?
    - fennecfoxen 9y ago
      1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? What percentage of health care spending overall are these issues? 2. Have you or someone you know in the United States ever "shopped around" or otherwise prepared in advance for an emergency through the provision of, say, catastrophic health care insurance, which promises to pay for emergency room visits? (Employer coverage can count here.) To the extent that (1) is a small number, this question is a non sequitor. To the extent that (2) is large, even that small number is further mitigated. There are lots of arguments about why it might be better to structure health care as a centrally-planned activity instead of a market-based activity. This isn't one of the good ones.
      - dagw 9y ago
        1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? If just you're counting all issues it's obviously quite few. If you're weighting by potential costs then it's very high. Basically the more expensive and necessary a procedure is the less chance you have to shop around. If I was to break down the costs of all medical procedures I've had over the past 30 years I'd say that almost all of it would be taken up by a single series of emergency surgeries.
      - crusso 9y ago
        If outrageous healthcare costs were only kicking in for life-or-death emergencies then you might have a point. Healthcare costs across the board - except in unregulated, uninsured spheres like plastic surgery, lasik, etc. - are extraordinarily high.
        tertius 9y ago
- duncan_bayne 9y ago
  > The free market is a poor model for providing healthcare. No; a free market has been _proved_ to be good at providing healthcare in the US. What you folks have now is an utterly corrupt cartel.
  - kalleboo 9y ago
    I feel like I'm walking into a trap now, but when was that proven?
    - duncan_bayne 9y ago
      "Friendly societies", back in the day. My understanding is the AMA was formed more or less as a counter to the negotiating power of those societies around pay and conditions.
    - com2kid 9y ago
      > I feel like I'm walking into a trap now, but when was that proven? Any elective procedure. If I want to get laser eye surgery done, the price has dropped to 1/10th of what it was when the procedure first debuted. Likewise for common plastic surgeries. Dental care is also interesting, there is actual competition for many cosmetic procedures, although there is of course a price floor, Dentists compete based on reputation and presentations of previous quality work to justify higher prices. Same thing for eye glasses. Eye glasses range from $50 to $500, insurance distorts this a little bit, but the market is generally quite competitive. If you want hand made frames from a local artists, they are as available as $50 mass produced frames. Likewise many lens materials exist, from $20 plastic lens all the way up to $300+ fancy coated materials with some really cool properties (oleophobic lens coatings!). There is also an interesting market for customer requested lab work. If I want to get basic blood work done, I can walk into clinics that specialize in it and request blood work for a fraction of the price my doctor can order it at! Finally DNA testing is another example where an incredibly complex technological process can now be, quite literally, ordered off of Amazon, and mailed off to a processing center. Meanwhile if I break a toe, I get a giant rubber flat sandal from the doctor that is billed at $200, that same boot can be ordered online for under $30!
- lr4444lr 9y ago
  Health care is a free market? Where?
- tertius 9y ago
  Life threatening ailments are very rare. It is not only those that are off the charts expensive. Negotiation is easier when you have some time to negotiate. Most do.
- duckingtest 9y ago
  There's no free market in healthcare. Healthcare in the US is a guild with state-enforced monopoly. Reasonable prices would defeat the whole point of this. Naturally, it's sold to the public as 'safety' or other BS.
brightball 9y ago
It's not. People don't see the prices. It's whatever the insurance company can be convinced to pay. People don't get to pick their insurance plan either because it's locked into corporate contracts for the employees (for most people). This model happens because the government allows companies to tax deduct the cost of health insurance as a benefit but not individuals...which happened from union demands. When people are totally removed from the cost, people aren't being exploited. Removing people from the cost increases the cost.
- kingkawn 9y ago
  Yes I also believe it is possible to spin a web of the intellect to make this seem like something else than what it is, but all you get from this is the satisfaction of a web well spun, and the exploitation continues.
  - brightball 9y ago
    It's what happens when you hide the price in a supply/demand chart.
  - cookiecaper 9y ago
    It gets tiresome to see accusations of things like "mental gymnastics" and "web of intellect" every time someone attempts to discuss a non-trivial political issue. If we could just snap our fingers and fix all of our problems, we'd have done so by now. Law, politics, and economics are hard, and they sometimes involve considering multiple factors. We shouldn't allow ourselves to be goaded into an unprincipled anti-intellectual stance by people trying to expedite their own solution. Everyone agrees that the economics of health care in the US are bad. I don't know anyone who is happy with this state of affairs. Everyone feels like the other parties are out to screw them. Docs feel that they get fleeced by facilities and insurers, insurers feel that they get fleeced by beneficiaries and providers, etc. I had a medical device manufacturer as a client for a while and they too felt that the industry was unfair to them and that they had to set high prices to try to survive. With so many people in the U.S. receiving their care on differing bases, it's hard to really get a single, strongly-motivated group to coalesce and push some real change through. Every employer negotiates their own contracts; some are good and some are bad, depending on how much your employer cares about benefits and such. Some people have state-provided care through Medicare or Medicaid. Others have to pay private (which is where things get really bad). With everyone's experiences on such a deeply personal issue differing so widely, unification is difficult. Mix in a little political brou-ha-ha and it becomes nearly impossible. I'm sure that fracturing is part of the game by the insidious elements that lie underneath the covers, but it is a reality we must recognize and address legitimately. On top of that, medicine is one of the largest industries in the U.S., and changes to that structure threaten to disrupt the employment of many people. There is no surer way to get a political position dismantled (and its elected purveyors destroyed in the next election cycle) than to threaten the livelihoods of a meaningful portion of the constituency. Changes to the regulatory structures impacting all of this should be carefully considered, and I would hope that we at least run them through the "intellectual paces", as it were. Let's not jump on each other's backs with silly accusations for not acquiescing quickly enough.

The free market is a poor model for providing healthcare. In an ideal free market, market forces work to find the optimum price for a product, depending on how much it costs to create the product, and how much people are willing to pay for it. In healthcare, though, how much people are willing to pay for a product is anything, if it's the one thing they need to stay alive, or to reduce chronic pain, etc.

patrickg_zill 9y ago
We don't have a free market in healthcare. Easily proved by looking at the artificial barriers to entry, both for products and people.
pfranz 9y ago
It sounds like he's talking about a different problem. This is a problem with certification and regulation. What you're talking about is, "I'm bleeding and don't have time to drive to the next city over because it's cheaper." When that hospital purchased its gauze, sutures, and other equipment it wasn't under duress and theoretically could switch suppliers at any time. Being intended for use on or inside a human body, we have higher expectations in quality and consistency. Unfortunately, these certifications can make the barrier to entry too high for good competition. Or they're locked into a supplier for whatever reason.
deleted 9y ago
[deleted]
bluecalm 9y ago
People are willing to pay anything for food or clothes as well. Still, free (well, at least way more free than in case of healthcare) market works decently, at least when it comes to providing cheap and decent food options. The problem with healthcare is the opposite: there is no free market and it's impossible to compete without huge investment and even then it's sometimes still impossible (patents, long approval periods etc.). The problem is for sure not simple but a lot of basic healthcare services could be a lot cheaper if it was easier to get in.
- timthelion 9y ago
  When I'm hungry, I'm still able to visit multiple restaurants/ stores to compare prices. But when I'm having a heart attack, do I really have the option to shop around?
  - fennecfoxen 9y ago
    1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? What percentage of health care spending overall are these issues? 2. Have you or someone you know in the United States ever "shopped around" or otherwise prepared in advance for an emergency through the provision of, say, catastrophic health care insurance, which promises to pay for emergency room visits? (Employer coverage can count here.) To the extent that (1) is a small number, this question is a non sequitor. To the extent that (2) is large, even that small number is further mitigated. There are lots of arguments about why it might be better to structure health care as a centrally-planned activity instead of a market-based activity. This isn't one of the good ones.
    - dagw 9y ago
      1. What percentage of your health issues are "emergency, heart attack RIGHT NOW"-class issues? If just you're counting all issues it's obviously quite few. If you're weighting by potential costs then it's very high. Basically the more expensive and necessary a procedure is the less chance you have to shop around. If I was to break down the costs of all medical procedures I've had over the past 30 years I'd say that almost all of it would be taken up by a single series of emergency surgeries.
    - crusso 9y ago
      If outrageous healthcare costs were only kicking in for life-or-death emergencies then you might have a point. Healthcare costs across the board - except in unregulated, uninsured spheres like plastic surgery, lasik, etc. - are extraordinarily high.
      - tertius 9y ago
duncan_bayne 9y ago
> The free market is a poor model for providing healthcare. No; a free market has been _proved_ to be good at providing healthcare in the US. What you folks have now is an utterly corrupt cartel.
- kalleboo 9y ago
  I feel like I'm walking into a trap now, but when was that proven?
  - duncan_bayne 9y ago
    "Friendly societies", back in the day. My understanding is the AMA was formed more or less as a counter to the negotiating power of those societies around pay and conditions.
  - com2kid 9y ago
    > I feel like I'm walking into a trap now, but when was that proven? Any elective procedure. If I want to get laser eye surgery done, the price has dropped to 1/10th of what it was when the procedure first debuted. Likewise for common plastic surgeries. Dental care is also interesting, there is actual competition for many cosmetic procedures, although there is of course a price floor, Dentists compete based on reputation and presentations of previous quality work to justify higher prices. Same thing for eye glasses. Eye glasses range from $50 to $500, insurance distorts this a little bit, but the market is generally quite competitive. If you want hand made frames from a local artists, they are as available as $50 mass produced frames. Likewise many lens materials exist, from $20 plastic lens all the way up to $300+ fancy coated materials with some really cool properties (oleophobic lens coatings!). There is also an interesting market for customer requested lab work. If I want to get basic blood work done, I can walk into clinics that specialize in it and request blood work for a fraction of the price my doctor can order it at! Finally DNA testing is another example where an incredibly complex technological process can now be, quite literally, ordered off of Amazon, and mailed off to a processing center. Meanwhile if I break a toe, I get a giant rubber flat sandal from the doctor that is billed at $200, that same boot can be ordered online for under $30!
lr4444lr 9y ago
Health care is a free market? Where?
tertius 9y ago
Life threatening ailments are very rare. It is not only those that are off the charts expensive. Negotiation is easier when you have some time to negotiate. Most do.
duckingtest 9y ago
There's no free market in healthcare. Healthcare in the US is a guild with state-enforced monopoly. Reasonable prices would defeat the whole point of this. Naturally, it's sold to the public as 'safety' or other BS.

brightball 9y ago

It's not. People don't see the prices. It's whatever the insurance company can be convinced to pay. People don't get to pick their insurance plan either because it's locked into corporate contracts for the employees (for most people). This model happens because the government allows companies to tax deduct the cost of health insurance as a benefit but not individuals...which happened from union demands. When people are totally removed from the cost, people aren't being exploited. Removing people from the cost increases the cost.

kingkawn 9y ago
Yes I also believe it is possible to spin a web of the intellect to make this seem like something else than what it is, but all you get from this is the satisfaction of a web well spun, and the exploitation continues.
- brightball 9y ago
  It's what happens when you hide the price in a supply/demand chart.
- cookiecaper 9y ago
  It gets tiresome to see accusations of things like "mental gymnastics" and "web of intellect" every time someone attempts to discuss a non-trivial political issue. If we could just snap our fingers and fix all of our problems, we'd have done so by now. Law, politics, and economics are hard, and they sometimes involve considering multiple factors. We shouldn't allow ourselves to be goaded into an unprincipled anti-intellectual stance by people trying to expedite their own solution. Everyone agrees that the economics of health care in the US are bad. I don't know anyone who is happy with this state of affairs. Everyone feels like the other parties are out to screw them. Docs feel that they get fleeced by facilities and insurers, insurers feel that they get fleeced by beneficiaries and providers, etc. I had a medical device manufacturer as a client for a while and they too felt that the industry was unfair to them and that they had to set high prices to try to survive. With so many people in the U.S. receiving their care on differing bases, it's hard to really get a single, strongly-motivated group to coalesce and push some real change through. Every employer negotiates their own contracts; some are good and some are bad, depending on how much your employer cares about benefits and such. Some people have state-provided care through Medicare or Medicaid. Others have to pay private (which is where things get really bad). With everyone's experiences on such a deeply personal issue differing so widely, unification is difficult. Mix in a little political brou-ha-ha and it becomes nearly impossible. I'm sure that fracturing is part of the game by the insidious elements that lie underneath the covers, but it is a reality we must recognize and address legitimately. On top of that, medicine is one of the largest industries in the U.S., and changes to that structure threaten to disrupt the employment of many people. There is no surer way to get a political position dismantled (and its elected purveyors destroyed in the next election cycle) than to threaten the livelihoods of a meaningful portion of the constituency. Changes to the regulatory structures impacting all of this should be carefully considered, and I would hope that we at least run them through the "intellectual paces", as it were. Let's not jump on each other's backs with silly accusations for not acquiescing quickly enough.