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If one argues in favor of "free market" solutions for healthcare, then one MUST argue in favor of pricing transparency. A functioning free market requires the o

by ptmcc 7y ago

If one argues in favor of "free market" solutions for healthcare, then one MUST argue in favor of pricing transparency. A functioning free market requires the open and honest sharing of price information for consumers to make informed choices. Now, whether or not health care should operate under free market principles is a different discussion entirely. But the established powers seem to consistently fall back on the free market argument, but continue to keep pricing as opaque and complicated as possible.

dmix 7y ago
The US has long ago abandoned free market healthcare. I don't know why people keep calling it that. It's some bastard child of socialized medicine where the poor and old are covered mixed with gov mandated private insurance coming from a few very large insurance companies capable of operating within the regulatory environment. Which is basically one step removed from full blown single-payer public health insurance (as we have here in Canada) and about a hundred steps removed from "free market" health care. I hope the US gov decides on single payer soon as I see no path towards going back to an actual market. Which would be better than the current system which features much of the worst of both worlds.
- tombert 7y ago
  I've been saying this for years. The only way that our healthcare is truly capitalistic is that someone makes a profit. When I got appendicitis a few months ago, it's not like I went on Yelp and searched for the best prices and and reviews; I went to the hospital that was closest, and prayed that it was covered by my insurance.
- TrevorJ 7y ago
  Yep. It's the worst of both worlds right now. Either take it over fully, or devolve it to a pure free market system, with medicaid backstops.
- phil248 7y ago
  "The US has long ago abandoned free market healthcare." Not true. Like literally every sector of a mixed economy, there is government interference. And sure, there is a lot more in the healthcare industry than most. But it does operate as a highly regulated market system wherein private enterprises compete and consumers make decisions. And certainly it is not strictly "free market", but then again nothing is.
- AzzieElbab 7y ago
  US health-care costs are out of this world. However, for the life of me I cannot begin to comprehend why every Canadian keeps using our healthcare system as example of success when incidents like these are becoming more and more common https://www.cbc.ca/news/canada/newfoundland-labrador/samanthan-rideout-amputee-broken-foot-1.5184582 https://www.cbc.ca/news/canada/newfoundland-labrador/samanth... https://www.cbc.ca/news/canada/nova-scotia/mother-iwk-halifx-hospital-mental-health-refusing-to-leave-1.5181626 https://www.cbc.ca/news/canada/nova-scotia/mother-iwk-halifx... and for a description of typical hospital visit https://www.cbc.ca/news/opinion/health-care-1.5170948 https://www.cbc.ca/news/opinion/health-care-1.5170948 note, CBC is basically a more liberal Canadian CNN
  - dmix 7y ago
    It’s always lesser of evils when you’re dealing with critical gov services. If you can’t provide a better alternative then it’s still an improvement. The much larger UK NHS system where even hospitals are publicly run would be even harder to pull off in America. So single payer insurance is basically the lowest hurdle. Plus the simpler the better. At some point the right in the US has to concede on healthcare because it’s already been gutted and killed by a thousand cuts. And I say that as a libertarian leaning person. You can’t honestly believe they can solve this problem by writing a thousand more small reform bills. Plus if you give the mob public healthcare they will be much more tolerant of pro-economy policies and take a strong argument away from the people who want to gut even more industries so they function just as poorly as the pseudo healthcare market in the name of “fairness” and “equity” (mediocrity for all!). Lesser of evils.
  - marrone12 7y ago
    Well the maritimes have much less funding overall than other provinces, and their health outcomes are noticeably worse.
SkyBelow 7y ago
Competitors are tightly controlled, thus someone hiding their prices isn't easily supplanted by someone who is revealing them. A free market solution would be to let anyone choose to hide their prices but to not protect their market share from more customer friendly competitors. The existing system is nothing like a free market and anyone trying to justify keeping things the way they are with that reasoning is either being intentionally dishonest or is completely naive about the situation.
pitaj 7y ago
I don't think mandates can solve price transparency. I think in order for price transparency to happen we need to eliminate employer-provided insurance, and have insurance companies competing directly for consumers. Eliminating minimum coverage mandates could also help by allowing companies to compete on different levels of coverage. Additionally, patents and the onerous burden of the FDA need to be reduced to encourage competition.
- Tostino 7y ago
  The minimums in place are already trash no one should have to deal with. Allowing even crappier plans is the last thing we need.
- tomp 7y ago
  Why do you doubt mandates could solve price transparency? If you make the mandate correctly (e.g. “default price is $0, any other price must be disclosed upfront”) it would IMO cause complete price transparency pretty quickly...
- observer12 7y ago
  How would eliminating employer insurance provide pricing transparency? Insurance companies don't typically disclose the prices they negotiate. They might disclose the prices a consumer pays but don't confuse this with the cost of healthcare. For an example say two options for a medical service have different cost. One charges $5000 and the other charges $8000. Say the insurance covers all but $500 no matter which choice is made. A consumer typically would only see the cost to them which is $500 and not the $3000 difference between the cost of the same service depending on provider.
dna_polymerase 7y ago
> If one argues in favor of "free market" solutions for healthcare, then one MUST argue in favor of pricing transparency. Absolutely not. > A functioning free market requires the open and honest sharing of price information for consumers to make informed choices. A free market does not require any of this. In a free market the producer can do whatever they want, in a free market the consumer is free to choose different options if given producer does not adhere to their personal standards thus driving other providers to either change their behavior or just losing business. A free market does not require a government ruling them to adhere to some business practices. That is regulation and not a free market.
- kyshoc 7y ago
  > A free market does not require any of this. In theory, no, but in practice market failure is usually due to information asymmetry and consolidation. The real world is, unfortunately, not full of that economists call "perfect competitors". > in a free market the consumer is free to choose different options if given producer does not adhere to their personal standards This requires information symmetry -- per Wikipedia, a free market is "a system in which the prices for goods and services are determined by the open market". How can the this work if pricing information isn't available to one side of the market? > A free market does not require a government ruling them to adhere to some business practices Free markets in practice require legal guardrails around things such as information symmetry and anticompetitive behavior, in order to protect against market failure. Again, per Wikipedia: "[free markets] require a framework that allows new market entrants". This regulation is not for its own sake, but _to keep a market free (i.e., open to competition) by protecting it from the grasp of one extremely powerful entity going forward_.
  - ameister14 7y ago
    Actually, in theory, yes. The theory of a free market definitely requires transparent pricing, amongst many other unlikely things.
- ameister14 7y ago
  You are incorrect. For a theoretical free market to exist, there must be perfect information. Otherwise, the optimal equilibrium points wouldn't be reached and so it would not be a free market, it would be a market failure.
ip26 7y ago
I've noticed the more stridently someone identifies as a "free market" proponent, the more they seem to push back against the basic principals of a well-functioning free market.
TomMckenny 7y ago
>If one argues in favor of "free market" solutions for healthcare, then one MUST argue in favor of pricing transparency. Indeed. And generally there is an enormous difference between "pro business" and "pro free market". In many cases they are the opposite. For example the information asymmetry you point out. Another is lack of enforcement of anti-trust. Heaven help consumers and employees who live in the wrong one.

by ptmcc 7y ago

dmix 7y ago

The US has long ago abandoned free market healthcare. I don't know why people keep calling it that. It's some bastard child of socialized medicine where the poor and old are covered mixed with gov mandated private insurance coming from a few very large insurance companies capable of operating within the regulatory environment. Which is basically one step removed from full blown single-payer public health insurance (as we have here in Canada) and about a hundred steps removed from "free market" health care. I hope the US gov decides on single payer soon as I see no path towards going back to an actual market. Which would be better than the current system which features much of the worst of both worlds.

tombert 7y ago
I've been saying this for years. The only way that our healthcare is truly capitalistic is that someone makes a profit. When I got appendicitis a few months ago, it's not like I went on Yelp and searched for the best prices and and reviews; I went to the hospital that was closest, and prayed that it was covered by my insurance.
TrevorJ 7y ago
Yep. It's the worst of both worlds right now. Either take it over fully, or devolve it to a pure free market system, with medicaid backstops.
phil248 7y ago
"The US has long ago abandoned free market healthcare." Not true. Like literally every sector of a mixed economy, there is government interference. And sure, there is a lot more in the healthcare industry than most. But it does operate as a highly regulated market system wherein private enterprises compete and consumers make decisions. And certainly it is not strictly "free market", but then again nothing is.
AzzieElbab 7y ago
US health-care costs are out of this world. However, for the life of me I cannot begin to comprehend why every Canadian keeps using our healthcare system as example of success when incidents like these are becoming more and more common https://www.cbc.ca/news/canada/newfoundland-labrador/samanthan-rideout-amputee-broken-foot-1.5184582 https://www.cbc.ca/news/canada/newfoundland-labrador/samanth... https://www.cbc.ca/news/canada/nova-scotia/mother-iwk-halifx-hospital-mental-health-refusing-to-leave-1.5181626 https://www.cbc.ca/news/canada/nova-scotia/mother-iwk-halifx... and for a description of typical hospital visit https://www.cbc.ca/news/opinion/health-care-1.5170948 https://www.cbc.ca/news/opinion/health-care-1.5170948 note, CBC is basically a more liberal Canadian CNN
- dmix 7y ago
  It’s always lesser of evils when you’re dealing with critical gov services. If you can’t provide a better alternative then it’s still an improvement. The much larger UK NHS system where even hospitals are publicly run would be even harder to pull off in America. So single payer insurance is basically the lowest hurdle. Plus the simpler the better. At some point the right in the US has to concede on healthcare because it’s already been gutted and killed by a thousand cuts. And I say that as a libertarian leaning person. You can’t honestly believe they can solve this problem by writing a thousand more small reform bills. Plus if you give the mob public healthcare they will be much more tolerant of pro-economy policies and take a strong argument away from the people who want to gut even more industries so they function just as poorly as the pseudo healthcare market in the name of “fairness” and “equity” (mediocrity for all!). Lesser of evils.
- marrone12 7y ago
  Well the maritimes have much less funding overall than other provinces, and their health outcomes are noticeably worse.

SkyBelow 7y ago

Competitors are tightly controlled, thus someone hiding their prices isn't easily supplanted by someone who is revealing them. A free market solution would be to let anyone choose to hide their prices but to not protect their market share from more customer friendly competitors. The existing system is nothing like a free market and anyone trying to justify keeping things the way they are with that reasoning is either being intentionally dishonest or is completely naive about the situation.

pitaj 7y ago

I don't think mandates can solve price transparency. I think in order for price transparency to happen we need to eliminate employer-provided insurance, and have insurance companies competing directly for consumers. Eliminating minimum coverage mandates could also help by allowing companies to compete on different levels of coverage. Additionally, patents and the onerous burden of the FDA need to be reduced to encourage competition.

Tostino 7y ago
The minimums in place are already trash no one should have to deal with. Allowing even crappier plans is the last thing we need.
tomp 7y ago
Why do you doubt mandates could solve price transparency? If you make the mandate correctly (e.g. “default price is $0, any other price must be disclosed upfront”) it would IMO cause complete price transparency pretty quickly...
observer12 7y ago
How would eliminating employer insurance provide pricing transparency? Insurance companies don't typically disclose the prices they negotiate. They might disclose the prices a consumer pays but don't confuse this with the cost of healthcare. For an example say two options for a medical service have different cost. One charges $5000 and the other charges $8000. Say the insurance covers all but $500 no matter which choice is made. A consumer typically would only see the cost to them which is $500 and not the $3000 difference between the cost of the same service depending on provider.

dna_polymerase 7y ago

> If one argues in favor of "free market" solutions for healthcare, then one MUST argue in favor of pricing transparency. Absolutely not. > A functioning free market requires the open and honest sharing of price information for consumers to make informed choices. A free market does not require any of this. In a free market the producer can do whatever they want, in a free market the consumer is free to choose different options if given producer does not adhere to their personal standards thus driving other providers to either change their behavior or just losing business. A free market does not require a government ruling them to adhere to some business practices. That is regulation and not a free market.

kyshoc 7y ago
> A free market does not require any of this. In theory, no, but in practice market failure is usually due to information asymmetry and consolidation. The real world is, unfortunately, not full of that economists call "perfect competitors". > in a free market the consumer is free to choose different options if given producer does not adhere to their personal standards This requires information symmetry -- per Wikipedia, a free market is "a system in which the prices for goods and services are determined by the open market". How can the this work if pricing information isn't available to one side of the market? > A free market does not require a government ruling them to adhere to some business practices Free markets in practice require legal guardrails around things such as information symmetry and anticompetitive behavior, in order to protect against market failure. Again, per Wikipedia: "[free markets] require a framework that allows new market entrants". This regulation is not for its own sake, but _to keep a market free (i.e., open to competition) by protecting it from the grasp of one extremely powerful entity going forward_.
- ameister14 7y ago
  Actually, in theory, yes. The theory of a free market definitely requires transparent pricing, amongst many other unlikely things.
ameister14 7y ago
You are incorrect. For a theoretical free market to exist, there must be perfect information. Otherwise, the optimal equilibrium points wouldn't be reached and so it would not be a free market, it would be a market failure.

ip26 7y ago

I've noticed the more stridently someone identifies as a "free market" proponent, the more they seem to push back against the basic principals of a well-functioning free market.

TomMckenny 7y ago

>If one argues in favor of "free market" solutions for healthcare, then one MUST argue in favor of pricing transparency. Indeed. And generally there is an enormous difference between "pro business" and "pro free market". In many cases they are the opposite. For example the information asymmetry you point out. Another is lack of enforcement of anti-trust. Heaven help consumers and employees who live in the wrong one.