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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

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.

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.