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Look at how well competition works in our broken healthcare system. Our costs are the highest in the world yet our life expectancy and infant mortality isn’t al

Look at how well competition works in our broken healthcare system. Our costs are the highest in the world yet our life expectancy and infant mortality isn’t all that great. Or look at education at all levels, where costs have also skyrocketed and public options keep getting cut because bureaucrats from “competing” private industries try to push their agenda (you could argue this is even worse in healthcare and pharma). Competition and profit motive hasn’t been proven to work so well for public goods, in my opinion, but would love to hear of examples where it worked. This is why for some things we still agree we should pay for at a government level (local or national), such as firefighters, defense, mail, etc, etc. Not even going to get into how inflationary ubi would be, instantly driving up costs due to “rational” economic behavior.

0x262d 7y ago
competition and capitalism work well to drive technological improvement in conditions of extreme scarcity such as existed 100+ years ago. of course, it does this pretty violently. there's no reason to believe it is better than democratic, central planning (note: not stalinism) in either this or the last century. public planning would, of course, go out of its way to incentivize automation and further technological improvement... something that has historically been publicly funded anyway. edit: typos and stuff
- icelancer 7y ago
  > there's no reason to believe it is better than democratic, central planning Can you name an example of this succeeding at the same rate American capitalism has if Stalinism is not one?
  - 0x262d 7y ago
    I can't, because American capitalism bombs every attempt to provide an example of an alternative out of existence, precisely to cause people to think there is no alternative in conversations like this. I will say that despite massive sanctions and material scarcity, and an incomplete level of democracy, Cuba gets a lot of things more right than the US (for instance, healthcare for non-rich people). They are also fucking up their environment way less. But it's still scarcity socialism and could be way better. the US also has a very incomplete level of democracy edit: escaping asterisks
Stronico 7y ago
It would not be inflationary - inflation is a monetary phenomenon - not a fiscal one. Wages might go up, which results in higher prices, but that is not the same thing as inflation (which is a GENERAL increase in prices and fall in the purchasing power of money).
Brendinooo 7y ago
There isn't true competition in the US's healthcare system. Could very well argue that it's not possible because you can't shop treatment for a heart attack to get the best price, but I can say with confidence that trying to keep costs down for prenatal/labor/delivery was unlike any other buying experience I've had. Lasik is a good example of how a less-regulated medical procedure got more cost-competitive over time, but again, it's elective. https://surgerycenterok.com/ https://surgerycenterok.com/ is an example of a place that's at least doing flat, visible pricing, which shouldn't be a revelation in a market-based system, but is.
bhupy 7y ago
Healthcare is NOT a free market, there is no pricing mechanism like there is in literally every other industry. It is the only good/service in America in which the prices are known/paid only AFTER the services are rendered. https://fee.org/articles/imagine-if-we-paid-for-food-like-we-do-healthcare/ https://fee.org/articles/imagine-if-we-paid-for-food-like-we...
- leetcrew 7y ago
  > It is the only good/service in America in which the prices are known/paid only AFTER the services are rendered. this is not really true. if you are having nontrivial repairs done on your house or car, they will give you an estimate upfront, but there can easily be unforseen problems that cause the work to cost a lot more. you might decide to have your car fixed later, but it's hard to pull the plug on a kitchen remodel halfway through. there's all kind of work that gets done without knowing how much it will cost beforehand.
  - bhupy 7y ago
    You're right, I was being hyperbolic. I'd qualify my statement with preventive* healthcare, the near entirety of which can function on upfront prices.
    - leetcrew 7y ago
      to your credit, I can't think of another field where there is so much uncertainty over how much something will cost when they already know exactly what they are going to do, what materials they will need to do it, and how long it will take.
dsfyu404ed 7y ago
>Look at how well competition works in our broken healthcare system. There no effective competition which is why the "race to the bottom" is not taking place. >Competition and profit motive hasn’t been proven to work so well for public goods, in my opinion, but would love to hear of examples where it worked. Shipping everything larger than a letter comes to mind. >This is why for some things we still agree we should pay for things at a government level (local or national), such as firefighters, defense, mail, etc, etc. Just because the government regulates and pays (fully or partially) doesn't mean the government should deliver the service. Private utilities seem to be slightly less dysfunctional than government owned ones. Private EMTs work fine. Private security isn't known for brutalizing people without a good reason. The roads are plowed at pretty competitive rates by private contractors. Don't get me wrong, some "essential for society to function" services should be provided by or managed by government to varying degrees but the degree depends on the service. In housing a service does not inherently make it better.
weberc2 7y ago
I'm of the impression that public investment in education increased manifold since the ~60s without much improvement in outcomes. Presumably education is an example of goverment management gone awry (which is not to say that private management would fare better).
icelancer 7y ago
> Look at how well competition works in our broken healthcare system. Our costs are the highest in the world yet our life expectancy and infant mortality isn’t all that great. Yes, we have the worst of both worlds: We socialize losses and capitalize gains. Banking/healthcare are two examples of non-free markets, because there is no ability to let them fail. When you cap the downside, you get exactly what we have. This is a good example of poor market interventionism, not free marketeering, which is not to say that a free market is the right approach for healthcare (I think it should be fully socialized).

0x262d 7y ago

competition and capitalism work well to drive technological improvement in conditions of extreme scarcity such as existed 100+ years ago. of course, it does this pretty violently. there's no reason to believe it is better than democratic, central planning (note: not stalinism) in either this or the last century. public planning would, of course, go out of its way to incentivize automation and further technological improvement... something that has historically been publicly funded anyway. edit: typos and stuff

icelancer 7y ago
> there's no reason to believe it is better than democratic, central planning Can you name an example of this succeeding at the same rate American capitalism has if Stalinism is not one?
- 0x262d 7y ago
  I can't, because American capitalism bombs every attempt to provide an example of an alternative out of existence, precisely to cause people to think there is no alternative in conversations like this. I will say that despite massive sanctions and material scarcity, and an incomplete level of democracy, Cuba gets a lot of things more right than the US (for instance, healthcare for non-rich people). They are also fucking up their environment way less. But it's still scarcity socialism and could be way better. the US also has a very incomplete level of democracy edit: escaping asterisks

Stronico 7y ago

It would not be inflationary - inflation is a monetary phenomenon - not a fiscal one. Wages might go up, which results in higher prices, but that is not the same thing as inflation (which is a GENERAL increase in prices and fall in the purchasing power of money).

Brendinooo 7y ago

There isn't true competition in the US's healthcare system. Could very well argue that it's not possible because you can't shop treatment for a heart attack to get the best price, but I can say with confidence that trying to keep costs down for prenatal/labor/delivery was unlike any other buying experience I've had. Lasik is a good example of how a less-regulated medical procedure got more cost-competitive over time, but again, it's elective. https://surgerycenterok.com/ https://surgerycenterok.com/ is an example of a place that's at least doing flat, visible pricing, which shouldn't be a revelation in a market-based system, but is.

bhupy 7y ago

Healthcare is NOT a free market, there is no pricing mechanism like there is in literally every other industry. It is the only good/service in America in which the prices are known/paid only AFTER the services are rendered. https://fee.org/articles/imagine-if-we-paid-for-food-like-we-do-healthcare/ https://fee.org/articles/imagine-if-we-paid-for-food-like-we...

leetcrew 7y ago
> It is the only good/service in America in which the prices are known/paid only AFTER the services are rendered. this is not really true. if you are having nontrivial repairs done on your house or car, they will give you an estimate upfront, but there can easily be unforseen problems that cause the work to cost a lot more. you might decide to have your car fixed later, but it's hard to pull the plug on a kitchen remodel halfway through. there's all kind of work that gets done without knowing how much it will cost beforehand.
- bhupy 7y ago
  You're right, I was being hyperbolic. I'd qualify my statement with preventive* healthcare, the near entirety of which can function on upfront prices.
  - leetcrew 7y ago
    to your credit, I can't think of another field where there is so much uncertainty over how much something will cost when they already know exactly what they are going to do, what materials they will need to do it, and how long it will take.

dsfyu404ed 7y ago

>Look at how well competition works in our broken healthcare system. There no effective competition which is why the "race to the bottom" is not taking place. >Competition and profit motive hasn’t been proven to work so well for public goods, in my opinion, but would love to hear of examples where it worked. Shipping everything larger than a letter comes to mind. >This is why for some things we still agree we should pay for things at a government level (local or national), such as firefighters, defense, mail, etc, etc. Just because the government regulates and pays (fully or partially) doesn't mean the government should deliver the service. Private utilities seem to be slightly less dysfunctional than government owned ones. Private EMTs work fine. Private security isn't known for brutalizing people without a good reason. The roads are plowed at pretty competitive rates by private contractors. Don't get me wrong, some "essential for society to function" services should be provided by or managed by government to varying degrees but the degree depends on the service. In housing a service does not inherently make it better.

weberc2 7y ago

I'm of the impression that public investment in education increased manifold since the ~60s without much improvement in outcomes. Presumably education is an example of goverment management gone awry (which is not to say that private management would fare better).

icelancer 7y ago

> Look at how well competition works in our broken healthcare system. Our costs are the highest in the world yet our life expectancy and infant mortality isn’t all that great. Yes, we have the worst of both worlds: We socialize losses and capitalize gains. Banking/healthcare are two examples of non-free markets, because there is no ability to let them fail. When you cap the downside, you get exactly what we have. This is a good example of poor market interventionism, not free marketeering, which is not to say that a free market is the right approach for healthcare (I think it should be fully socialized).