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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 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.
baldfat 9y ago
It eventually is exploitation no matter how you slice it. Doctor's salaries and the money that is made in medical just because it is medical is insane. How much money does a doctor need to make? Why is $400,000+ a year okay when it is bankrupting thousands of people's lives? > which happened from union demands Explain????
- brightball 9y ago
  Well, doctors have to go to school for a very long time, especially to specialize. Then they go through residency programs. In all their general education before practicing on their own tends to be about 10 years more than the average American. Which is 10 years less income and 10 years more of expenses/loans. Most specialties cause doctors to be on call. Working in hospitals creates difficult hours. And with all that we have a shortage of doctors in the US. So, supply, demand, cost, working lifetime to make up those costs, hours, volume of paperwork to deal with insurance, even more for Medicaid, malpractice insurance and now the shift to EMR. Doctors pay is the most justified thing in the medical industry. Until we have an excess supply of doctors that isn't going to change. The other costs in medical are where the story really is. > Explain???? Company provided health care became a standard thing from union demands years ago. Never allowing individuals to tax deduct insurance costs removed insurance from the consumer market, purchased for millions of people without any choice from the employees about who provides it and this became the primary mechanism for paying for health care. Individuals are 2 steps removed from the costs of care, so what do they care if a hospital stay cost $30,000 if $29,000 is covered? That's how your costs rise. Medical costs haven't been even remotely participating in the free market for decades.
  - zxcmx 9y ago
    I find it really interesting that we don't have, for example, a cheaper way of doing front-line health care than teaching people to diagnose every possible ailment. Similarly that that the mechanics of surgery aren't considered a manual skill practicable in a largely assembly line fashion. Apparently, everyone gets artisanal health care, regardless of the level of complication (or not) of their condition. Nothing wrong with doctors at all, but curious that this field above all others is so resistant to the methods of industry which have worked so well to reduce costs in every other field.
scarhill 9y ago
The story of why the US has such a bizarre system of paying for healthcare is more complicated and interesting than just union demands and WW II price controls. Here's a great podcast discussing it: http://www.econtalk.org/archives/2017/06/christy_ford_ch.html http://www.econtalk.org/archives/2017/06/christy_ford_ch.htm...

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.

baldfat 9y ago

It eventually is exploitation no matter how you slice it. Doctor's salaries and the money that is made in medical just because it is medical is insane. How much money does a doctor need to make? Why is $400,000+ a year okay when it is bankrupting thousands of people's lives? > which happened from union demands Explain????

brightball 9y ago
Well, doctors have to go to school for a very long time, especially to specialize. Then they go through residency programs. In all their general education before practicing on their own tends to be about 10 years more than the average American. Which is 10 years less income and 10 years more of expenses/loans. Most specialties cause doctors to be on call. Working in hospitals creates difficult hours. And with all that we have a shortage of doctors in the US. So, supply, demand, cost, working lifetime to make up those costs, hours, volume of paperwork to deal with insurance, even more for Medicaid, malpractice insurance and now the shift to EMR. Doctors pay is the most justified thing in the medical industry. Until we have an excess supply of doctors that isn't going to change. The other costs in medical are where the story really is. > Explain???? Company provided health care became a standard thing from union demands years ago. Never allowing individuals to tax deduct insurance costs removed insurance from the consumer market, purchased for millions of people without any choice from the employees about who provides it and this became the primary mechanism for paying for health care. Individuals are 2 steps removed from the costs of care, so what do they care if a hospital stay cost $30,000 if $29,000 is covered? That's how your costs rise. Medical costs haven't been even remotely participating in the free market for decades.
- zxcmx 9y ago
  I find it really interesting that we don't have, for example, a cheaper way of doing front-line health care than teaching people to diagnose every possible ailment. Similarly that that the mechanics of surgery aren't considered a manual skill practicable in a largely assembly line fashion. Apparently, everyone gets artisanal health care, regardless of the level of complication (or not) of their condition. Nothing wrong with doctors at all, but curious that this field above all others is so resistant to the methods of industry which have worked so well to reduce costs in every other field.

scarhill 9y ago

The story of why the US has such a bizarre system of paying for healthcare is more complicated and interesting than just union demands and WW II price controls. Here's a great podcast discussing it: http://www.econtalk.org/archives/2017/06/christy_ford_ch.html http://www.econtalk.org/archives/2017/06/christy_ford_ch.htm...