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It's also just not a good idea. Social welfare programs act as single buyers/negotiators and can exploit economies of scale and collective bargaining to deliver

It's also just not a good idea. Social welfare programs act as single buyers/negotiators and can exploit economies of scale and collective bargaining to deliver reduced costs. Something that individuals can't do. Giving everyone their own money for, say healthcare costs, and having them navigate markets alone... achieves exactly the kind of divide-and-conquer that price-gouging pharmaceutical companies and hospitals have wet dreams about. The only good UBI supplements, but does not replace, most existing social welfare programs. Replacing existing programs just creates an open season for vultures.

ibeckermayer 6y ago
Why would people making individual purchasing decisions tend to coincide with prices going down for essential goods like food and clothing, but not for healthcare?
- danans 6y ago
  Because the largest chunk of healthcare delivery expenditures is for chronic and severe or emergency procedures for which people have no ability to shop around for due to the time sensitivity of the issue, or because the complexity and presentation of their health issue is not understood enough to put any price on. For example, you go into the hospital for abdominal pain, but it turns out that you need a massive orthopedic surgery to fix a congenital issue that only 2 surgeons in your area can perform (true story). Or you are a severe diabetes or lupus sufferer who has routine hospitalizations for a variety of infections you get at random due to their underlying condition. Need a tooth filling replaced? Of course, shop around. Need emergency dental surgery because you had traumatic facial impact playing soccer? Not so much. Emergency treatments to sick geriatric patients to extend their lives by weeks and months: also very expensive. Routine doctor's office visits to remove a wart from your foot, or diagnose a sore throat, which you can shop around for, are not where the high costs comes from.
  - ibeckermayer 6y ago
    > Routine doctor's office visits to remove a wart from your foot, or diagnose a sore throat, which you can shop around for, are not where the high costs comes from. Yet those do have insanely high costs as well, as compared to the rest of the economy. We live in an economy where medicine tends to get more expensive, rather than less, i.e: https://www.nbcnews.com/health/diabetes/u-s-insulin-costs-patient-nearly-doubled-2012-2016-study-n961296 https://www.nbcnews.com/health/diabetes/u-s-insulin-costs-pa.... Doesn't it make sense to figure out why the basics are getting more expensive, before suggesting we engage in a national price-fixing experiment?

ibeckermayer 6y ago

Why would people making individual purchasing decisions tend to coincide with prices going down for essential goods like food and clothing, but not for healthcare?

danans 6y ago
Because the largest chunk of healthcare delivery expenditures is for chronic and severe or emergency procedures for which people have no ability to shop around for due to the time sensitivity of the issue, or because the complexity and presentation of their health issue is not understood enough to put any price on. For example, you go into the hospital for abdominal pain, but it turns out that you need a massive orthopedic surgery to fix a congenital issue that only 2 surgeons in your area can perform (true story). Or you are a severe diabetes or lupus sufferer who has routine hospitalizations for a variety of infections you get at random due to their underlying condition. Need a tooth filling replaced? Of course, shop around. Need emergency dental surgery because you had traumatic facial impact playing soccer? Not so much. Emergency treatments to sick geriatric patients to extend their lives by weeks and months: also very expensive. Routine doctor's office visits to remove a wart from your foot, or diagnose a sore throat, which you can shop around for, are not where the high costs comes from.
- ibeckermayer 6y ago
  > Routine doctor's office visits to remove a wart from your foot, or diagnose a sore throat, which you can shop around for, are not where the high costs comes from. Yet those do have insanely high costs as well, as compared to the rest of the economy. We live in an economy where medicine tends to get more expensive, rather than less, i.e: https://www.nbcnews.com/health/diabetes/u-s-insulin-costs-patient-nearly-doubled-2012-2016-study-n961296 https://www.nbcnews.com/health/diabetes/u-s-insulin-costs-pa.... Doesn't it make sense to figure out why the basics are getting more expensive, before suggesting we engage in a national price-fixing experiment?