4 ms·

>The US is an extreme example of a system that optimizes totally for choice...and it achieves that aim. I'm not sure this is true, or at least, I don't underst

>The US is an extreme example of a system that optimizes totally for choice...and it achieves that aim. I'm not sure this is true, or at least, I don't understand what pre-requisites for this to be true the U.S. posseses. Insurance is not allowed to trade across state lines, the private marketplace has a small selection of plans, most people get their insurance from their jobs meaning they only know the details of their medical plans AFTER a non-trivial time down payment (in other words, the transaction costs are high) I think the criticism that the U.S. system doesn't really have that many positives is a fair enough assessment.

hogFeast 7y ago
> I'm not sure this is true Have you been to a place that doesn't optimise for this? The US is one of the only places in the world where if you are sick, the medicine (if it exists) is 100% available. I have a relative who lives in a place that doesn't have this aim...she is sick, medicine exists but "policy" is not to cure people who have that illness because the return on investment isn't high enough...in fact, she can't receive treatment at all for it outside of primary care. This happens quite frequently with cancer/epilepsy outside the US too...the medicine exists, you just can't get it... ...and you are complaining about only having a "small selection of plans"...must be nice. Try selecting from one plan that might not cover you when you get sick (and if you get very sick, there might be nothing beyond primary care i.e. your local doctor who isn't a specialist).
- AmpsterMan 7y ago
  Wait. You've moved the goal post. Your original statement was about optimizing for choice. I'm not sure the United States optimizes for choice and so provided some counter-examples. The topic of availability of drugs or treatments didn't come into play at all. Furthermore, there is no "complaining" as you put it. Moreover, I also contend that the U.S. has 100% availability. There are many rural areas which lack access to more specialist care. Many states are limiting Planned Parenthood services beyond abortions which is itself a form of care. Some medicine is too expensive to be affordable, and so on.

hogFeast 7y ago

> I'm not sure this is true Have you been to a place that doesn't optimise for this? The US is one of the only places in the world where if you are sick, the medicine (if it exists) is 100% available. I have a relative who lives in a place that doesn't have this aim...she is sick, medicine exists but "policy" is not to cure people who have that illness because the return on investment isn't high enough...in fact, she can't receive treatment at all for it outside of primary care. This happens quite frequently with cancer/epilepsy outside the US too...the medicine exists, you just can't get it... ...and you are complaining about only having a "small selection of plans"...must be nice. Try selecting from one plan that might not cover you when you get sick (and if you get very sick, there might be nothing beyond primary care i.e. your local doctor who isn't a specialist).

AmpsterMan 7y ago
Wait. You've moved the goal post. Your original statement was about optimizing for choice. I'm not sure the United States optimizes for choice and so provided some counter-examples. The topic of availability of drugs or treatments didn't come into play at all. Furthermore, there is no "complaining" as you put it. Moreover, I also contend that the U.S. has 100% availability. There are many rural areas which lack access to more specialist care. Many states are limiting Planned Parenthood services beyond abortions which is itself a form of care. Some medicine is too expensive to be affordable, and so on.