4 ms·

Why not? You also can't live without food but there is a market for that. Even when you don't have time to cook and need food on short notice, there are plenty

Why not? You also can't live without food but there is a market for that. Even when you don't have time to cook and need food on short notice, there are plenty of fast food and delivery options available. There is nothing impossible about a situation where a hospital has a reputation for being cheap but having long wait times while another hospital is more expensive but has shorter wait times. Then in an urgency you wouldn't need to shop around, you would decide based on each hospital's reputation. Unfortunately hospitals don't publish their median wait times, patient outcomes or even their prices. If they were forced to publish those things, maybe a market would emerge.

Robotbeat 9y ago
You can live for weeks without food, it can be stored easily (unlike services which aren't stored at all), and the barrier to entry is low... Many people even have their own food gardens. It's also very amenable to nearly complete automation. Therefore food is super cheap.
- saint_fiasco 9y ago
  I understand that healthcare is more expensive than food for all those reasons. What I don't understand is why there can't be a market for it. Expensive services can have markets too.
- throwawayaway12 9y ago
  >I understand that healthcare is more expensive than food for all those reasons. What I don't understand is why there can't be a market for it. Expensive services can have markets too. At the moment the only thing I can think of that are expensive services are also luxury services. Most people consider health care to be a basic service that should be open to those who need it, regardless of wealth.
  - saint_fiasco 9y ago
    Back to the food analogy, people who can't afford the food they need to live are given food stamps. Even so, there is still a market for food. People know ahead of time what the exact price of the thing they are buying with their food stamps. Nutritional information is available on the packaging. Why exactly can't I know ahead of time how much will each hospital in my area charge if I have a heart attack and have to go to their ER? Why can't I know which hospital has better survival rates, or the shortest wait times? That information is all that is needed to have a healthcare market. It should not be impossible.
- bobwaycott 9y ago
  Those things you just described certainly sound an awful lot like food to me. How exactly is that living without food for weeks?
  - Robotbeat 9y ago
    I was talking about food. Sorry if I was unclear!
kaitai 9y ago
You can live on Doritos and donuts for weeks or years. You can be an ill-informed and lazy consumer and survive. I have learned when I can substitute oil for butter without problems and when it'll cause disaster. How many people on HN have done the reading to know when a fecal occult blood test can and can't be substituted for a colonoscopy? And those are generally tests that don't have urgency. When you're in the hospital because you've been vomiting for 6 hours and are passing out, are you going to say yes to the abdominal CT? This recently came up with a friend, who called me for advice. I was with a doctor in the moment, who said that he didn't see why it was indicated (for a host of reasons). The doc got on the phone with friend who handed the phone to the physician's assistant who was going to bring him to the CT, and argued the guy out of the CT. This took knowledge, effort, and persuasion. Who here is going to be able to self-diagnose and say, "Skip the CT -- I'll have it if X has not improved in 24 hours and Y continues to decline." For many reasons, in the US there is a lot of "defensive medicine" practiced. The doc would rather order the CT than defend against a lawsuit, and for him/her it takes less time to order the CT when the patient rolls in than wait 24 hours while observing the patient in the hospital. But it's not actually in the patient's best interest. Our incentives are not aligned, and patients do not have the time or baseline knowledge to evaluate individual treatments.

Robotbeat 9y ago

You can live for weeks without food, it can be stored easily (unlike services which aren't stored at all), and the barrier to entry is low... Many people even have their own food gardens. It's also very amenable to nearly complete automation. Therefore food is super cheap.

saint_fiasco 9y ago
I understand that healthcare is more expensive than food for all those reasons. What I don't understand is why there can't be a market for it. Expensive services can have markets too.
throwawayaway12 9y ago
>I understand that healthcare is more expensive than food for all those reasons. What I don't understand is why there can't be a market for it. Expensive services can have markets too. At the moment the only thing I can think of that are expensive services are also luxury services. Most people consider health care to be a basic service that should be open to those who need it, regardless of wealth.
- saint_fiasco 9y ago
  Back to the food analogy, people who can't afford the food they need to live are given food stamps. Even so, there is still a market for food. People know ahead of time what the exact price of the thing they are buying with their food stamps. Nutritional information is available on the packaging. Why exactly can't I know ahead of time how much will each hospital in my area charge if I have a heart attack and have to go to their ER? Why can't I know which hospital has better survival rates, or the shortest wait times? That information is all that is needed to have a healthcare market. It should not be impossible.
bobwaycott 9y ago
Those things you just described certainly sound an awful lot like food to me. How exactly is that living without food for weeks?
- Robotbeat 9y ago
  I was talking about food. Sorry if I was unclear!

kaitai 9y ago

You can live on Doritos and donuts for weeks or years. You can be an ill-informed and lazy consumer and survive. I have learned when I can substitute oil for butter without problems and when it'll cause disaster. How many people on HN have done the reading to know when a fecal occult blood test can and can't be substituted for a colonoscopy? And those are generally tests that don't have urgency. When you're in the hospital because you've been vomiting for 6 hours and are passing out, are you going to say yes to the abdominal CT? This recently came up with a friend, who called me for advice. I was with a doctor in the moment, who said that he didn't see why it was indicated (for a host of reasons). The doc got on the phone with friend who handed the phone to the physician's assistant who was going to bring him to the CT, and argued the guy out of the CT. This took knowledge, effort, and persuasion. Who here is going to be able to self-diagnose and say, "Skip the CT -- I'll have it if X has not improved in 24 hours and Y continues to decline." For many reasons, in the US there is a lot of "defensive medicine" practiced. The doc would rather order the CT than defend against a lawsuit, and for him/her it takes less time to order the CT when the patient rolls in than wait 24 hours while observing the patient in the hospital. But it's not actually in the patient's best interest. Our incentives are not aligned, and patients do not have the time or baseline knowledge to evaluate individual treatments.