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Healthcare will ALWAYS be a market. All something like single payer does is distort the market incentives. It generally trades innovation for quantity of cove

Healthcare will ALWAYS be a market. All something like single payer does is distort the market incentives. It generally trades innovation for quantity of covered people. There's an argument to be made there, for sure, but you can't pretend like you're going to make something impervious to the drives and interests of consumers and potential providers. With regard to elective vs non-elective, only about 2% of all healthcare costs are categorized as emergency care. So there's plenty of wiggle room for people to shop around for a good price or wait for better market conditions. What I would love to see is taking Medicare/Medicaid and instead of paying for healthcare services we just cut a check for cold hard cash to everyone who would've been receiving government funded care. Then they can spend that money on whatever they want. I guarantee you prices will drop through the floor. Some of those people will choose quality of life over longevity by going on vacation instead of paying for healthcare. I say good for them, do whatever you want it's none of my business.

tomkarlo 9y ago
Have you ever actually tried to "shop around" for a serious, non-elective procedure like chemo or surgery? It's very difficult to get quotes, you can't easily compare providers (there's no obviously corpus of "ratings" from other prior customers) and you're often limited to the 1-3 providers who are close enough to your home. That's not exactly a recipe for an effective market. Re your medicare proposal, are you suggesting that people who are diagnosed with cancer should get a cash check for the estimated value of the treatment? The incentive for fraud and graft in that kind of system would be incredible - lots of diagnoses are relatively subjective, and you'd be rewarding people for reporting every possible ailment they might be eligible for. If you're saying just give them their dollar average benefits, that pretty much defeats the whole purpose of having a risk pool.
- Consultant32452 9y ago
  >It's very difficult to get quotes It's very difficult to get quotes because no one is actually paying for it themselves. This would be solved immediately by empowering individual consumers. >you can't easily compare providers (there's no obviously corpus of "ratings" from other prior customers) This is because your insurance provider has chosen for you. Once again, this would be resolved by putting peoples' money back into their own hands. >If you're saying just give them their dollar average benefits, that pretty much defeats the whole purpose of having a risk pool. In my head I included still providing disaster coverage, but failed to type it. So that should alleviate your fears regarding things like getting cancer.
  - tomkarlo 9y ago
    Can you point to an example where any of these three things have happened in the real world? "Still providing disaster coverage"... is pretty much all of what health insurance does for people over 65. The annual spend on preventative care is dwarfed by a single common incident (fall, flu, cancer) at that age.
    - Consultant32452 9y ago
      There's an urgent care place near me that I sometimes go to. They cater to a lot of people without insurance. The prices for all of their services are posted on a big menu board like you'd see at a fast food restaurant. Here's a citation that shows emergency care is only 2% of all healthcare. Of course, that's the entire healthcare market, not just elderly care. I'd be interested in any citations you could provide that shows that system-wide preventative care is dwarfed by the system-wide costs of major incidents for the elderly. http://www.politifact.com/truth-o-meter/statements/2013/oct/28/nick-gillespie/does-emergency-care-account-just-2-percent-all-hea/ http://www.politifact.com/truth-o-meter/statements/2013/oct/...
      - tomkarlo 9y ago
        You're confusing emergency care with non-elective care. Just because something isn't an ER visit doesn't mean you don't need to get treated for it immediately. E.g. the flu. > I'd be interested in any citations you could provide that shows that system-wide preventative care is dwarfed by the system-wide costs of major incidents for the elderly. 95% of healthcare spend is reactive, 5% is preventative[0] Medical spending in the last three years before death accounts for 13.4 percent of aggregate US medical spending.[1] And this ignores major treatments for people over 65 that occur more than 3 years before they die (and on average, people live 20+ years after they turn 65.) [0] http://www.newsweek.com/health-prevention-worth-money-86075 http://www.newsweek.com/health-prevention-worth-money-86075 [1] https://meps.ahrq.gov/data_files/publications/st429/stat429.pdf https://meps.ahrq.gov/data_files/publications/st429/stat429....
        9y ago
- fuzzybeard 9y ago
  The industry isn't built to support market based solutions which is why providers couldn't give you a price even if you asked. That's what parent poster is trying to say. There just isn't pricing transparency so you can't get pricing. Where it's been shown to work is with smaller doctors offices for routine procedures like a flu shot. If you ask for a price and offer cash, they can work with customers on that.
mullen 9y ago
What a bunch libertarian non-sense. Health Care is not market since there is hardly any market opaqueness. You simply don't know how much anything costs in health care, its all a big mystery until you get your bill. Health providers are out to make sure you never know how much something costs until it is time to pay for it. It is very difficult to shop around for prices in the American health care system. Your average person can't do it and most really capable people could not do it either. Giving people cash as their Medicare/Medicaid would be a complete disaster. Bulk buying by the government goes right out the window, no cost controls at all and completely ignores what insurance is in the first place. People are generally dumb. If you gave them cash and said this is your medicare, they would take it and spend it on everything but medical care. In the end, they would get sick and die or be crippled or worse, they would still go to the hospital and then leave everyone else with the bill. We know prices would never drop to the floor because that is the system we have in place now and prices keep going up.
- Consultant32452 9y ago
  >Health Care is not market since there is hardly any market opaqueness. You simply don't know how much anything costs in health care, its all a big mystery until you get your bill. Health providers are out to make sure you never know how much something costs until it is time to pay for it. Define "how much something costs?" I can pull up the spec sheet from my insurance company and tell you the in network price and out of network price for just about anything. The crappy system we have now sets the price between you and the insurance company. It's not that the providers don't want you to know how much something costs, they don't know how much it costs. Conversely, I can go into the local urgent care here, a place that caters to many uninsured. The prices for their services are literally posted on the wall, not unlike the menu at a fast food restaurant. You know exactly how much an x-ray costs, or a cold/flu visit, or a cast, etc. When people are paying for these services with their own money and the prices aren't the result of some individualized, convoluted pay schedule with your insurance provider, then the prices suddenly become extremely transparent. >and completely ignores what insurance is in the first place. Insurance is there to help you out in the event of a disaster, not to pay your ongoing day to day costs. So let's make sure we're really talking about insurance. >If you gave them cash and said this is your medicare, they would take it and spend it on everything but medical care. In the end, they would get sick and die or be crippled or worse, That is historically incorrect. Yes, people may choose to spend less on healthcare than you would like them to, but why do you feel the need to be so authoritarian about your opinion on what's best for them? >then leave everyone else with the bill. Only if people like you force it on us. >We know prices would never drop to the floor because that is the system we have in place now and prices keep going up. As was pointed out by another poster the prices for elective surgeries like LASIK which are not covered by health insurance are going down over time. It's funny to me that you have no problem accepting that some people would take their Medicare money and blow it on something else, but you think that healthcare providers would not do anything to try to convince those people to spend their dollars with them.

tomkarlo 9y ago

Have you ever actually tried to "shop around" for a serious, non-elective procedure like chemo or surgery? It's very difficult to get quotes, you can't easily compare providers (there's no obviously corpus of "ratings" from other prior customers) and you're often limited to the 1-3 providers who are close enough to your home. That's not exactly a recipe for an effective market. Re your medicare proposal, are you suggesting that people who are diagnosed with cancer should get a cash check for the estimated value of the treatment? The incentive for fraud and graft in that kind of system would be incredible - lots of diagnoses are relatively subjective, and you'd be rewarding people for reporting every possible ailment they might be eligible for. If you're saying just give them their dollar average benefits, that pretty much defeats the whole purpose of having a risk pool.

Consultant32452 9y ago
>It's very difficult to get quotes It's very difficult to get quotes because no one is actually paying for it themselves. This would be solved immediately by empowering individual consumers. >you can't easily compare providers (there's no obviously corpus of "ratings" from other prior customers) This is because your insurance provider has chosen for you. Once again, this would be resolved by putting peoples' money back into their own hands. >If you're saying just give them their dollar average benefits, that pretty much defeats the whole purpose of having a risk pool. In my head I included still providing disaster coverage, but failed to type it. So that should alleviate your fears regarding things like getting cancer.
- tomkarlo 9y ago
  Can you point to an example where any of these three things have happened in the real world? "Still providing disaster coverage"... is pretty much all of what health insurance does for people over 65. The annual spend on preventative care is dwarfed by a single common incident (fall, flu, cancer) at that age.
  - Consultant32452 9y ago
    There's an urgent care place near me that I sometimes go to. They cater to a lot of people without insurance. The prices for all of their services are posted on a big menu board like you'd see at a fast food restaurant. Here's a citation that shows emergency care is only 2% of all healthcare. Of course, that's the entire healthcare market, not just elderly care. I'd be interested in any citations you could provide that shows that system-wide preventative care is dwarfed by the system-wide costs of major incidents for the elderly. http://www.politifact.com/truth-o-meter/statements/2013/oct/28/nick-gillespie/does-emergency-care-account-just-2-percent-all-hea/ http://www.politifact.com/truth-o-meter/statements/2013/oct/...
    - tomkarlo 9y ago
      You're confusing emergency care with non-elective care. Just because something isn't an ER visit doesn't mean you don't need to get treated for it immediately. E.g. the flu. > I'd be interested in any citations you could provide that shows that system-wide preventative care is dwarfed by the system-wide costs of major incidents for the elderly. 95% of healthcare spend is reactive, 5% is preventative[0] Medical spending in the last three years before death accounts for 13.4 percent of aggregate US medical spending.[1] And this ignores major treatments for people over 65 that occur more than 3 years before they die (and on average, people live 20+ years after they turn 65.) [0] http://www.newsweek.com/health-prevention-worth-money-86075 http://www.newsweek.com/health-prevention-worth-money-86075 [1] https://meps.ahrq.gov/data_files/publications/st429/stat429.pdf https://meps.ahrq.gov/data_files/publications/st429/stat429....
      - 9y ago
fuzzybeard 9y ago
The industry isn't built to support market based solutions which is why providers couldn't give you a price even if you asked. That's what parent poster is trying to say. There just isn't pricing transparency so you can't get pricing. Where it's been shown to work is with smaller doctors offices for routine procedures like a flu shot. If you ask for a price and offer cash, they can work with customers on that.

mullen 9y ago

What a bunch libertarian non-sense. Health Care is not market since there is hardly any market opaqueness. You simply don't know how much anything costs in health care, its all a big mystery until you get your bill. Health providers are out to make sure you never know how much something costs until it is time to pay for it. It is very difficult to shop around for prices in the American health care system. Your average person can't do it and most really capable people could not do it either. Giving people cash as their Medicare/Medicaid would be a complete disaster. Bulk buying by the government goes right out the window, no cost controls at all and completely ignores what insurance is in the first place. People are generally dumb. If you gave them cash and said this is your medicare, they would take it and spend it on everything but medical care. In the end, they would get sick and die or be crippled or worse, they would still go to the hospital and then leave everyone else with the bill. We know prices would never drop to the floor because that is the system we have in place now and prices keep going up.

Consultant32452 9y ago
>Health Care is not market since there is hardly any market opaqueness. You simply don't know how much anything costs in health care, its all a big mystery until you get your bill. Health providers are out to make sure you never know how much something costs until it is time to pay for it. Define "how much something costs?" I can pull up the spec sheet from my insurance company and tell you the in network price and out of network price for just about anything. The crappy system we have now sets the price between you and the insurance company. It's not that the providers don't want you to know how much something costs, they don't know how much it costs. Conversely, I can go into the local urgent care here, a place that caters to many uninsured. The prices for their services are literally posted on the wall, not unlike the menu at a fast food restaurant. You know exactly how much an x-ray costs, or a cold/flu visit, or a cast, etc. When people are paying for these services with their own money and the prices aren't the result of some individualized, convoluted pay schedule with your insurance provider, then the prices suddenly become extremely transparent. >and completely ignores what insurance is in the first place. Insurance is there to help you out in the event of a disaster, not to pay your ongoing day to day costs. So let's make sure we're really talking about insurance. >If you gave them cash and said this is your medicare, they would take it and spend it on everything but medical care. In the end, they would get sick and die or be crippled or worse, That is historically incorrect. Yes, people may choose to spend less on healthcare than you would like them to, but why do you feel the need to be so authoritarian about your opinion on what's best for them? >then leave everyone else with the bill. Only if people like you force it on us. >We know prices would never drop to the floor because that is the system we have in place now and prices keep going up. As was pointed out by another poster the prices for elective surgeries like LASIK which are not covered by health insurance are going down over time. It's funny to me that you have no problem accepting that some people would take their Medicare money and blow it on something else, but you think that healthcare providers would not do anything to try to convince those people to spend their dollars with them.