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> You already are? That's how health insurance works. I am not a defender of the insurance system. It blows. But single-payer is not the only other choice. I

> You already are? That's how health insurance works. I am not a defender of the insurance system. It blows. But single-payer is not the only other choice. I want a freer healthcare market where prices are known before consuming services. Real market competition could actually occur to bring down prices. For drugs, research and development for less profitable cases could be a very worthy target of government funding. I don't have all the answers but neither does single-payer.

burkaman 7y ago
Healthcare is not and cannot ever be a free market. You cannot have price transparency when a buyer may be unconscious at the time of "purchase". You cannot have price competition when buyers are frequently forced to immediately purchase a good or service if they don't want to die. Hospitals are chosen by proximity, not price. These are the consequences of being mortal human beings. If we were all immortal, and "healthcare" was nothing more than voluntary cosmetic surgery, a free market might make sense.
- macinjosh 7y ago
  > You cannot have price competition when buyers are frequently forced to immediately purchase a good or service if they don't want to die. The number of instances where this dire case occurs is minimal compared to every other instance. Sure, when its life and death its not practical. Perhaps those sorts of situations is where single payer or insurance makes sense. For humdrum things like physicals, wellness visits, cold and flu checks, vaccinations, routine labs and imaging, etc. a free market could work very well.
  - burkaman 7y ago
    Hospital care is the largest spending category by far: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... While the other things you list are technically not immediate life-or-death decisions, they still are not voluntary purchases. The presence of any kind of coercion distorts a free market. Also, I don't want to live in a society where individuals must decide between vaccinating their newborn children or paying their electricity bill that month. Or between getting a flu shot and buying groceries for the week. The externalities of these "individual" decisions are obvious, and a free market has no answer. Finally, let's imagine a system where emergency care is covered by a national single payer, but "humdrum things" are available in a free market. Now the poor can't afford basic physicals and flu shots, so we all end up paying more into the single payer system to cover such people being hospitalized for conditions that could have been prevented by regular medical checkups.

burkaman 7y ago

Healthcare is not and cannot ever be a free market. You cannot have price transparency when a buyer may be unconscious at the time of "purchase". You cannot have price competition when buyers are frequently forced to immediately purchase a good or service if they don't want to die. Hospitals are chosen by proximity, not price. These are the consequences of being mortal human beings. If we were all immortal, and "healthcare" was nothing more than voluntary cosmetic surgery, a free market might make sense.

macinjosh 7y ago
> You cannot have price competition when buyers are frequently forced to immediately purchase a good or service if they don't want to die. The number of instances where this dire case occurs is minimal compared to every other instance. Sure, when its life and death its not practical. Perhaps those sorts of situations is where single payer or insurance makes sense. For humdrum things like physicals, wellness visits, cold and flu checks, vaccinations, routine labs and imaging, etc. a free market could work very well.
- burkaman 7y ago
  Hospital care is the largest spending category by far: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... While the other things you list are technically not immediate life-or-death decisions, they still are not voluntary purchases. The presence of any kind of coercion distorts a free market. Also, I don't want to live in a society where individuals must decide between vaccinating their newborn children or paying their electricity bill that month. Or between getting a flu shot and buying groceries for the week. The externalities of these "individual" decisions are obvious, and a free market has no answer. Finally, let's imagine a system where emergency care is covered by a national single payer, but "humdrum things" are available in a free market. Now the poor can't afford basic physicals and flu shots, so we all end up paying more into the single payer system to cover such people being hospitalized for conditions that could have been prevented by regular medical checkups.