4 ms·

> I don't think there's a way to have full price insensitivity and to keep prices in check Maybe I've misunderstood you but how can there be no way to achieve

> I don't think there's a way to have full price insensitivity and to keep prices in check Maybe I've misunderstood you but how can there be no way to achieve what almost every other country has achieved?

cheald 7y ago
Well, I don't think other countries have achieved actual price insensitivity, in the sense of "fully inelastic demand". Fundamentally, for any scarce resource, supply, demand, and price are necessarily linked. Medical care is scarce - consuming a unit of medication or a time slot with a doctor precludes someone else from consuming the same. The allocation mechanism can be monetary (price), temporal (wait times/backlogs), or regulatory (restriction from certain services or treatments), but there must be an allocation mechanism. As far as I know, there's no country in the world where you can get all the medical care you demand when you demand it without consideration of price; if you're not paying monetarily, you're subject to rationing or restrictions that otherwise limit the demand you can place on the system. In Singapore, for example, Medisave only covers drugs that the government has deemed cost-effective. Need a high-cost experimental medication? Not permitted. Denmark has notably bad cancer survival rates, much a consequence of long wait times for screenings and treatments. The US, by comparison, has some of the highest cancer survival rates in the developed world, arguably because Americans can (and do) spend on tests and screenings at far higher rates than other countries. IIRC, Americans get medical imaging scans at a rate roughly 100-1000% higher than patients in other first-world nations. Most of those scans don't find anything, and if you're a government bean counter deciding how to allocate this year's medical budget, they're going to be high on the list to cut or ration - but when they find something, those early warnings and immediate access to aggressive (and expensive) treatment make a significant difference.

cheald 7y ago

Well, I don't think other countries have achieved actual price insensitivity, in the sense of "fully inelastic demand". Fundamentally, for any scarce resource, supply, demand, and price are necessarily linked. Medical care is scarce - consuming a unit of medication or a time slot with a doctor precludes someone else from consuming the same. The allocation mechanism can be monetary (price), temporal (wait times/backlogs), or regulatory (restriction from certain services or treatments), but there must be an allocation mechanism. As far as I know, there's no country in the world where you can get all the medical care you demand when you demand it without consideration of price; if you're not paying monetarily, you're subject to rationing or restrictions that otherwise limit the demand you can place on the system. In Singapore, for example, Medisave only covers drugs that the government has deemed cost-effective. Need a high-cost experimental medication? Not permitted. Denmark has notably bad cancer survival rates, much a consequence of long wait times for screenings and treatments. The US, by comparison, has some of the highest cancer survival rates in the developed world, arguably because Americans can (and do) spend on tests and screenings at far higher rates than other countries. IIRC, Americans get medical imaging scans at a rate roughly 100-1000% higher than patients in other first-world nations. Most of those scans don't find anything, and if you're a government bean counter deciding how to allocate this year's medical budget, they're going to be high on the list to cut or ration - but when they find something, those early warnings and immediate access to aggressive (and expensive) treatment make a significant difference.