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>Price transparency is the number 1 hurdle facing American healthcare. How are you supposed to fix a cost problem if you don't know what anything costs? Worse y

>Price transparency is the number 1 hurdle facing American healthcare. How are you supposed to fix a cost problem if you don't know what anything costs? Worse yet, how can there be a market for a service if there are no prices??? Less than 10% of healthcare expenditures are emergencies, that leaves a lot of room for shopping around. Price transparency is a band-aid on the real problem: we've corrupted the market with EMTLA. Since hospitals can't turn you away other people have to pick up that tab. Maybe what we should be asking ourselves is why we want healthcare to be a market at all? We have the capability to remove wealth from the equation of health entirely so why not?

rconti 9y ago
Is EMTLA (had to google it, Emergency Medical Treatment and Labor Act) really the problem? Eg, do the costs of covering this "free" treatment make up the majority of hospital bills we get charged? If our prices are 2-4x other countries, I have a hard time believing that the "real" problem is emergency services for those without coverage. My wife works in a trauma center so I'm well aware of how much they do for the uninsured (along with what they do NOT do for them), but I have a hard time believing the scale is an order of magnitude.
- frgtpsswrdlame 9y ago
  What I mean to say is that there is an original sin in our marketplace and that sin in EMTLA. Our society doesn't really like the idea of the sick and poor dying just outside the ER's doors (like in a truly free market) so we have EMTLA to make sure that doesn't happen. It's also reflective of America's cultural attitudes towards death and the amount of money that is spent buying our loved ones just one more month, week, day. All of which is to say that generally we seem quite uncomfortable with the idea of someone else being able to afford more "life" than we can. So maybe we should just toss the idea of marketizing our healthcare entirely.
lend000 9y ago
> We have the capability to remove wealth from the equation of health entirely so why not? Do we? I think the world needs at least one private healthcare market powerhouse to drive the advancement of medicine -- right now, it's mostly the US. If you are content with the current state of medicine, then yes, we can shut off the progress valve and more equitably distribute the healthcare technology we have now. Quality of providers will likely decay over time as well, once the incentives are gone. However, even this is easier said than done. Or we can address how cheap most healthcare expenses ought to be (in terms of cost to administer / raw materials + manufacturing + R&D (much of which was done decades ago, for common medicine)), and ask why are they not? Well, the reasons are pretty blatant. We have a combination of oppressive occupational licensing (it is too difficult to become a practicing doctor -- $$$ and decades of time), FDA-imposed pharmaceutical monopolies, inability to opt-in to experimental treatment (which also means malpractice insurance is always a major expense), artificial demand via Medicare and Medicaid (which artificially pump up the prices of all things they cover, especially drugs, and because they only apply to part of the population, they distort the market even more than universal health care would), overly broad and long-lasting IP law (patents, specifically), amongst others. I think a more free healthcare system would advance faster, save lives, and be cheaper. We have one of the most government distorted healthcare economies in a world, including compared to countries with universal health care systems. As an aside, re: the cost to become a doctor via Medical school, that is part of our expensive US education system, which is expensive for similar reasons (tuition prices are highly correlated with financial aid grants and federal student loan availability). So basically, the common worldview that we need more government intervention is garbage. We just need government intervention in the right places (and nowhere else), preventing fraud and holding criminals liable.
- frgtpsswrdlame 9y ago
  >Do we? I think the world needs at least one private healthcare market powerhouse to drive the advancement of medicine -- right now, it's mostly the US. 1/3 of the research in the US is already publically funded, there's no reason that amount couldn't be increased and there's no reason why other governments couldn't also drive up public investment. >I think a more free healthcare system would advance faster, save lives, and be cheaper. We have one of the most government distorted healthcare economies in a world, including compared to countries with universal health care systems. But your system isn't more free. Universal healthcare is obviously the most free system. >So basically, the common worldview that we need more government intervention is garbage. We just need government intervention in the right places (and nowhere else), preventing fraud and holding criminals liable. Why would we keep twisting and twisting this market? And where does the strange confidence come from that we just have to tweak it like this and then it'll all work? We have examples of well functioning healthcare systems. They're universal.

rconti 9y ago

Is EMTLA (had to google it, Emergency Medical Treatment and Labor Act) really the problem? Eg, do the costs of covering this "free" treatment make up the majority of hospital bills we get charged? If our prices are 2-4x other countries, I have a hard time believing that the "real" problem is emergency services for those without coverage. My wife works in a trauma center so I'm well aware of how much they do for the uninsured (along with what they do NOT do for them), but I have a hard time believing the scale is an order of magnitude.

frgtpsswrdlame 9y ago
What I mean to say is that there is an original sin in our marketplace and that sin in EMTLA. Our society doesn't really like the idea of the sick and poor dying just outside the ER's doors (like in a truly free market) so we have EMTLA to make sure that doesn't happen. It's also reflective of America's cultural attitudes towards death and the amount of money that is spent buying our loved ones just one more month, week, day. All of which is to say that generally we seem quite uncomfortable with the idea of someone else being able to afford more "life" than we can. So maybe we should just toss the idea of marketizing our healthcare entirely.

lend000 9y ago

> We have the capability to remove wealth from the equation of health entirely so why not? Do we? I think the world needs at least one private healthcare market powerhouse to drive the advancement of medicine -- right now, it's mostly the US. If you are content with the current state of medicine, then yes, we can shut off the progress valve and more equitably distribute the healthcare technology we have now. Quality of providers will likely decay over time as well, once the incentives are gone. However, even this is easier said than done. Or we can address how cheap most healthcare expenses ought to be (in terms of cost to administer / raw materials + manufacturing + R&D (much of which was done decades ago, for common medicine)), and ask why are they not? Well, the reasons are pretty blatant. We have a combination of oppressive occupational licensing (it is too difficult to become a practicing doctor -- $$$ and decades of time), FDA-imposed pharmaceutical monopolies, inability to opt-in to experimental treatment (which also means malpractice insurance is always a major expense), artificial demand via Medicare and Medicaid (which artificially pump up the prices of all things they cover, especially drugs, and because they only apply to part of the population, they distort the market even more than universal health care would), overly broad and long-lasting IP law (patents, specifically), amongst others. I think a more free healthcare system would advance faster, save lives, and be cheaper. We have one of the most government distorted healthcare economies in a world, including compared to countries with universal health care systems. As an aside, re: the cost to become a doctor via Medical school, that is part of our expensive US education system, which is expensive for similar reasons (tuition prices are highly correlated with financial aid grants and federal student loan availability). So basically, the common worldview that we need more government intervention is garbage. We just need government intervention in the right places (and nowhere else), preventing fraud and holding criminals liable.

frgtpsswrdlame 9y ago
>Do we? I think the world needs at least one private healthcare market powerhouse to drive the advancement of medicine -- right now, it's mostly the US. 1/3 of the research in the US is already publically funded, there's no reason that amount couldn't be increased and there's no reason why other governments couldn't also drive up public investment. >I think a more free healthcare system would advance faster, save lives, and be cheaper. We have one of the most government distorted healthcare economies in a world, including compared to countries with universal health care systems. But your system isn't more free. Universal healthcare is obviously the most free system. >So basically, the common worldview that we need more government intervention is garbage. We just need government intervention in the right places (and nowhere else), preventing fraud and holding criminals liable. Why would we keep twisting and twisting this market? And where does the strange confidence come from that we just have to tweak it like this and then it'll all work? We have examples of well functioning healthcare systems. They're universal.