4 ms·

It seems that that is what capitalism has become, the creation of many niche complex systems of which one can never be an expert.

by pan69 7y ago

javagram 7y ago
This is mainly an issue with healthcare in the US, not “capitalism”. The fact that providers can perform services on you without telling you up-front what the price will be is the problem. That isn’t how a lot of the rest of our capitalist society works - Amazon can’t raise the price of something I order from them after it’s shipped to me, my rent can’t change once I sign the lease contract which clearly states the charges up front, and so on...
- pan69 7y ago
  > The fact that providers can perform services on you without telling you up-front what the price will be is the problem. Of course. In an unregulated for-profit health care system that is definitely the problem and the way we got there was because of; if there are multiple vendors then prices will automatically go down. I'm not anti-capitalism. It just doesn't work for certain parts of society but it seems that in the US everything needs to be capitalised and the government clearly doesn't want to regulate this industry.
  - javagram 7y ago
    This article itself is about someone who is on Medicare (government-run health insurance) getting a surprise bill because the hospital has mis-assigned his procedure to the wrong category to allow them to run up the bill. FTA: “In a feeble attempt to ameliorate the problem, Congress passed the Notice Act in 2015, which requires hospitals to inform patients of the implications of their observation status within 36 hours after observation services have been initiated. In other words, hospitals must advise patients of their observation status only after they have already incurred the expense of surgery and hospitalization.” This type of thing seems like the most immediate problem. It makes no sense that the price can be raised 36 hours after a procedure has already begun. How is anyone supposed to negotiate that properly? Just saying, I don’t think “capitalism” is necessarily the boogeyman here. The government itself is failing to negotiate properly with the providers when running its socialist healthcare system in this instance. (And non-government payers will run into the same problems, getting unfair bills that couldn’t be anticipated or negotiated before agreeing to the service)
- AmericanChopper 7y ago
  One of the primary reasons healthcare is so expensive in the US is that so many of the factors that influence price are not constrained by competition. Fixing those problems is largely a political matter, not an economic one. The economics of capitalist systems do not make any claims about the functionality of markets that are allowed to exist without competition. Which is why all serious free market economists exclusively promote competitive free markets. A free market economist who doesn’t believe government has a role in ensuring markets are competitive is really just an extreme libertarian. Any market where the buyer is not the person who’s paying, or where the buyer has to make a purchasing decision before they know the price (or even what goods/services they’re agreeing to buy), cannot possibly be influenced by the laws of supply and demand. It’s the same reason that you can look at essentially any government spending project, and amaze yourself by how little the government manages to achieve with so much money. The payer doesn’t have any choice about how much taxes they pay, and the decision maker has a very poorly constrained supply of other people’s money to spend.
tryptophan 7y ago
Healthcare is literally the least "capitalistic" industry in the US. Posting prices is literally like a foundational concept. In many states, you still need to ask your local competitors for permission for if you can open up your own hospital. Perhaps the real issue is the lack of capitalist principles? Perhaps the issue is CMS trying to micromanage everything via billing in a very centrally planned manner? I think its interesting that the areas of the economy with the most government intervention are doing the worst... Healthcare, education, housing...etc. You could even throw in ISPs with their government guaranteed monopolies. Meanwhile tech had basically no regulation. What do we see? Many things are free (yes even to the poor! Without a government guarantee or people going around proclaiming that it is a human right! Insane!). The industry also has some of the highest paid (no tech minimum wage to bring it about, insane!) and best treated workers...
- __s 7y ago
  Some survivorship bias: industries that are doing well without regulation are the least likely to be regulated
- mnm1 7y ago
  Tech is enabling dictators, genocides, election tampering, massive theft, massive surveillance, addiction, etc. It's hardly doing well. Unless your definition of doing well is a few people profiting from the suffering of the masses. In that case, you're right tech is doing wonderful and we don't need government intervention. We could regulate tech to get this under control. Or we can deregulate medicine and forget about sanitizing surgical tools or sterilizing this and that. I'm sure the healthcare providers will do it themselves without being forced to. What could possibly go wrong with expecting healthcare providers to pay for necessary things they do not deem necessary for budget purposes? The plan is genius.
underwater 7y ago
It's not capitalist though, is it? The reason that hospitals can bill arbitrary amounts retroactively is because the government allows them to. The reason that there isn't strong competition between vendors is again because of government intervention.
- JadeNB 7y ago
  > It's not capitalist though, is it? The reason that hospitals can bill arbitrary amounts retroactively is because the government allows them to. The reason that there isn't strong competition between vendors is again because of government intervention. I think it's the opposite–yes, the government does allow this sort of behaviour, but that's because the health-care-adjacent parasites lobby so furiously against any efforts to stop it. It's scarcely the government stepping in to ensure this sort of banditry (why would they, when government officials don't benefit from it?).
refurb 7y ago
Yes, the subject of the article, Medicare, a government created and run health system is a great example of capitalism run wild. What?

It seems that that is what capitalism has become, the creation of many niche complex systems of which one can never be an expert.

by pan69 7y ago

It seems that that is what capitalism has become, the creation of many niche complex systems of which one can never be an expert.

javagram 7y ago

This is mainly an issue with healthcare in the US, not “capitalism”. The fact that providers can perform services on you without telling you up-front what the price will be is the problem. That isn’t how a lot of the rest of our capitalist society works - Amazon can’t raise the price of something I order from them after it’s shipped to me, my rent can’t change once I sign the lease contract which clearly states the charges up front, and so on...

pan69 7y ago
> The fact that providers can perform services on you without telling you up-front what the price will be is the problem. Of course. In an unregulated for-profit health care system that is definitely the problem and the way we got there was because of; if there are multiple vendors then prices will automatically go down. I'm not anti-capitalism. It just doesn't work for certain parts of society but it seems that in the US everything needs to be capitalised and the government clearly doesn't want to regulate this industry.
- javagram 7y ago
  This article itself is about someone who is on Medicare (government-run health insurance) getting a surprise bill because the hospital has mis-assigned his procedure to the wrong category to allow them to run up the bill. FTA: “In a feeble attempt to ameliorate the problem, Congress passed the Notice Act in 2015, which requires hospitals to inform patients of the implications of their observation status within 36 hours after observation services have been initiated. In other words, hospitals must advise patients of their observation status only after they have already incurred the expense of surgery and hospitalization.” This type of thing seems like the most immediate problem. It makes no sense that the price can be raised 36 hours after a procedure has already begun. How is anyone supposed to negotiate that properly? Just saying, I don’t think “capitalism” is necessarily the boogeyman here. The government itself is failing to negotiate properly with the providers when running its socialist healthcare system in this instance. (And non-government payers will run into the same problems, getting unfair bills that couldn’t be anticipated or negotiated before agreeing to the service)
AmericanChopper 7y ago
One of the primary reasons healthcare is so expensive in the US is that so many of the factors that influence price are not constrained by competition. Fixing those problems is largely a political matter, not an economic one. The economics of capitalist systems do not make any claims about the functionality of markets that are allowed to exist without competition. Which is why all serious free market economists exclusively promote competitive free markets. A free market economist who doesn’t believe government has a role in ensuring markets are competitive is really just an extreme libertarian. Any market where the buyer is not the person who’s paying, or where the buyer has to make a purchasing decision before they know the price (or even what goods/services they’re agreeing to buy), cannot possibly be influenced by the laws of supply and demand. It’s the same reason that you can look at essentially any government spending project, and amaze yourself by how little the government manages to achieve with so much money. The payer doesn’t have any choice about how much taxes they pay, and the decision maker has a very poorly constrained supply of other people’s money to spend.

tryptophan 7y ago

Healthcare is literally the least "capitalistic" industry in the US. Posting prices is literally like a foundational concept. In many states, you still need to ask your local competitors for permission for if you can open up your own hospital. Perhaps the real issue is the lack of capitalist principles? Perhaps the issue is CMS trying to micromanage everything via billing in a very centrally planned manner? I think its interesting that the areas of the economy with the most government intervention are doing the worst... Healthcare, education, housing...etc. You could even throw in ISPs with their government guaranteed monopolies. Meanwhile tech had basically no regulation. What do we see? Many things are free (yes even to the poor! Without a government guarantee or people going around proclaiming that it is a human right! Insane!). The industry also has some of the highest paid (no tech minimum wage to bring it about, insane!) and best treated workers...

__s 7y ago
Some survivorship bias: industries that are doing well without regulation are the least likely to be regulated
mnm1 7y ago
Tech is enabling dictators, genocides, election tampering, massive theft, massive surveillance, addiction, etc. It's hardly doing well. Unless your definition of doing well is a few people profiting from the suffering of the masses. In that case, you're right tech is doing wonderful and we don't need government intervention. We could regulate tech to get this under control. Or we can deregulate medicine and forget about sanitizing surgical tools or sterilizing this and that. I'm sure the healthcare providers will do it themselves without being forced to. What could possibly go wrong with expecting healthcare providers to pay for necessary things they do not deem necessary for budget purposes? The plan is genius.

underwater 7y ago

It's not capitalist though, is it? The reason that hospitals can bill arbitrary amounts retroactively is because the government allows them to. The reason that there isn't strong competition between vendors is again because of government intervention.

JadeNB 7y ago
> It's not capitalist though, is it? The reason that hospitals can bill arbitrary amounts retroactively is because the government allows them to. The reason that there isn't strong competition between vendors is again because of government intervention. I think it's the opposite–yes, the government does allow this sort of behaviour, but that's because the health-care-adjacent parasites lobby so furiously against any efforts to stop it. It's scarcely the government stepping in to ensure this sort of banditry (why would they, when government officials don't benefit from it?).

refurb 7y ago

Yes, the subject of the article, Medicare, a government created and run health system is a great example of capitalism run wild. What?