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Yes, it should be "free markets...until the wolves take over the whole system". It's impressive how quickly those profit maximization ideas have caught on, driv

Yes, it should be "free markets...until the wolves take over the whole system". It's impressive how quickly those profit maximization ideas have caught on, driven by technology (I blame Excel more than anything), and throughout the entire system. The healthcare cash-cow benefits a LOT of people, workers, suppliers, and (especially) administrators at both hospitals and doctors offices. A poor healthcare system is a great way to create BS jobs, and have a de facto welfare system while not actually legislating for it. It is remarkable how quickly and completely the noble ideals of the professions (medicine and law) have totally fallen to the profit motive. Now, you are a fool if you show self-restraint, because no one will notice, and your unscrupulous competitors will eat your lunch. It's the kind of pervasive corruption that can only happen when literally everyone in the system, including the victims, have given up.

npmaile 6y ago
I think the argument you are responding to is not the one the previous user presented. This issue isn't that people are trying to maximize profit leading to issues. The problem is that there is undue government interference in the market leading to all of the negatives that come from people selfishly trying to maximize profit in a cynical way with none of the benefits of people trying to maximize profits by providing a product that people will prefer over the competition.
- arcticbull 6y ago
  Free markets generally work better the less leverage one party has over another. When the negotiation is "pay up or die" then it's de facto not a free market [1] and the government has a responsibility to step in and address it. The minimum viable remediation is a two-tier system in which the government takes the "or die" out of the conversation. The best approach IMO is single-payer where the government takes the "pay up" part out too, as it allows the system to be globally optimized. At the end of the day health insurance isn't insurance, it's at best a structured payments plan. You buy insurance against things that may or may not happen. You will get sick and you will die. That's not insurance. [1] https://corporatefinanceinstitute.com/resources/knowledge/economics/free-market/ https://corporatefinanceinstitute.com/resources/knowledge/ec...
  - unishark 6y ago
    Personally I've never been told to pay up before receiving treatment at a hospital. Especially when I arrive there unconscious. And Herb Cohen would say once you've received the service, you're actually in a great negotiating position. People actually negotiate hospital bills all the time. Especially in those crazy stories you hear about. And you need a citation for your claim about when free markets do and don't work.
    - arcticbull 6y ago
      > Personally I've never been told to pay up before receiving treatment at a hospital. Of course you have. The first thing you did when you walked in was hand them your ID and coverage info. You think hospitals operate on the honor system? As a Canadian I've never been asked to pay up before or after receiving treatment [edit: at the point of care]. And before you jump into taxation, Canadians pay less per capita in taxes than Americans ($13K vs $14K), and that's before you factor in the $600 per month in private tax you directly (or indirectly via employer) have to pay your insurers. > Especially when I arrive there unconscious. You either have insurance or you're driven into Chapter 11. Further I suspect this is not due to good will but rather government intervention. > And Herb Cohen would say once you've received the service, you're actually in a great negotiating position. The debt was incurred once the service was rendered, and you are now liable. 66.5% of all bankruptcies in the US are medical -- are they just bad negotiators? I'm not sure what point you're trying to make but it's not in good faith. > People actually negotiate hospital bills all the time. Especially in those crazy stories you hear about. That sounds the worst. > And you need a citation for your claim about when free markets do and don't work. Voluntary contractual exchange is one of the undisputed key pillars to a free market economy. If you're being told you will die without the service it is a coercive exchange and therefore violates one of the key tenets. [1] If I hold a gun to your head and tell you to buy my oranges for $1000 or I kill you, is the free market price of oranges $1000? If I tell you that you have cancer and you'll die unless you get $48,000 worth of chemotherapy, is that a free market? [2] A free market requires both the voluntary production and voluntary consumption of services. [1] https://en.wikipedia.org/wiki/Free_market https://en.wikipedia.org/wiki/Free_market [2] https://www.asbestos.com/featured-stories/high-cost-of-cancer-treatment https://www.asbestos.com/featured-stories/high-cost-of-cance...
- whiddershins 6y ago
  The thing is, government intervention is probably the biggest way the wolves take over. They distort the market to their benefit using governmental force (aka. regulation)
  - Brian_K_White 6y ago
    I can't imagine why I am so unmoved by this tale of woe of the horrible government intervention.
  - arcticbull 6y ago
    This article may change your mind [1]. It's an NPR interview with Cigna's former head of corporate comms, an executive in charge of pushing lies about socialized medicine. He has since come to terms with what he'd done and is working to undo the harm he has caused to the American people. "Canada has done a better job [re: COVID], I think, because of having the kind of health care system you have in making sure that everyone who needs to be treated is treated. And so that was what prompted that. And I felt that to provide some context, I needed to describe what I used to do for a living to try to scare people away from the Canadian health care system because insurance companies fear that. They know that if the U.S. moves to a system like that, it would certainly put a real crimp in their profits." "Our industry PR and lobbying group, AHIP, supplied my colleagues and me with cherry-picked data and anecdotes to make people think Canadians wait endlessly for their care. It's a lie. And I'll always regret the disservice I did to folks on both sides of the border." [1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-former-cigna-executive-praises-canadas-health-care-system https://www.npr.org/2020/06/27/884307565/after-pushing-lies-...
  - deleted 6y ago
    [deleted]
  - ineedasername 6y ago
    Who are wolves, the government? If so, I'd be open to suggestions on how the problems can be solved some other way. There's not much regulation related to healthcare pricing at the moment, and between bankruptcies related to medical debt & lack of coverage leading to preventable illness or death, it seems like the wolves are already in control of the system.
- tomc1985 6y ago
  > This issue isn't that people are trying to maximize profit leading to issues. This is exactly the issue. You cannot seriously think that the trainwreck that is US healthcare is what it is solely because of government intereference? Would Cigna fund and run the tiny little community clinics that serve with sliding-scale pricing? Would Kaiser willingly insure students with preexisting conditions at a fair price? (I know that in my case, they wouldn't) What "free market" incentive is there for these insurance companies to cover people that would clearly cost them more money than they receive? Those people need help and sickness/viruses do not have any concept of money, and they effect people indiscriminately. You are promoting a healthcare system for the wealthy and privileged, which is exactly what we have right now and what needs to be torn down.
deleted 6y ago
[deleted]

npmaile 6y ago

I think the argument you are responding to is not the one the previous user presented. This issue isn't that people are trying to maximize profit leading to issues. The problem is that there is undue government interference in the market leading to all of the negatives that come from people selfishly trying to maximize profit in a cynical way with none of the benefits of people trying to maximize profits by providing a product that people will prefer over the competition.

arcticbull 6y ago
Free markets generally work better the less leverage one party has over another. When the negotiation is "pay up or die" then it's de facto not a free market [1] and the government has a responsibility to step in and address it. The minimum viable remediation is a two-tier system in which the government takes the "or die" out of the conversation. The best approach IMO is single-payer where the government takes the "pay up" part out too, as it allows the system to be globally optimized. At the end of the day health insurance isn't insurance, it's at best a structured payments plan. You buy insurance against things that may or may not happen. You will get sick and you will die. That's not insurance. [1] https://corporatefinanceinstitute.com/resources/knowledge/economics/free-market/ https://corporatefinanceinstitute.com/resources/knowledge/ec...
- unishark 6y ago
  Personally I've never been told to pay up before receiving treatment at a hospital. Especially when I arrive there unconscious. And Herb Cohen would say once you've received the service, you're actually in a great negotiating position. People actually negotiate hospital bills all the time. Especially in those crazy stories you hear about. And you need a citation for your claim about when free markets do and don't work.
  - arcticbull 6y ago
    > Personally I've never been told to pay up before receiving treatment at a hospital. Of course you have. The first thing you did when you walked in was hand them your ID and coverage info. You think hospitals operate on the honor system? As a Canadian I've never been asked to pay up before or after receiving treatment [edit: at the point of care]. And before you jump into taxation, Canadians pay less per capita in taxes than Americans ($13K vs $14K), and that's before you factor in the $600 per month in private tax you directly (or indirectly via employer) have to pay your insurers. > Especially when I arrive there unconscious. You either have insurance or you're driven into Chapter 11. Further I suspect this is not due to good will but rather government intervention. > And Herb Cohen would say once you've received the service, you're actually in a great negotiating position. The debt was incurred once the service was rendered, and you are now liable. 66.5% of all bankruptcies in the US are medical -- are they just bad negotiators? I'm not sure what point you're trying to make but it's not in good faith. > People actually negotiate hospital bills all the time. Especially in those crazy stories you hear about. That sounds the worst. > And you need a citation for your claim about when free markets do and don't work. Voluntary contractual exchange is one of the undisputed key pillars to a free market economy. If you're being told you will die without the service it is a coercive exchange and therefore violates one of the key tenets. [1] If I hold a gun to your head and tell you to buy my oranges for $1000 or I kill you, is the free market price of oranges $1000? If I tell you that you have cancer and you'll die unless you get $48,000 worth of chemotherapy, is that a free market? [2] A free market requires both the voluntary production and voluntary consumption of services. [1] https://en.wikipedia.org/wiki/Free_market https://en.wikipedia.org/wiki/Free_market [2] https://www.asbestos.com/featured-stories/high-cost-of-cancer-treatment https://www.asbestos.com/featured-stories/high-cost-of-cance...
whiddershins 6y ago
The thing is, government intervention is probably the biggest way the wolves take over. They distort the market to their benefit using governmental force (aka. regulation)
- Brian_K_White 6y ago
  I can't imagine why I am so unmoved by this tale of woe of the horrible government intervention.
- arcticbull 6y ago
  This article may change your mind [1]. It's an NPR interview with Cigna's former head of corporate comms, an executive in charge of pushing lies about socialized medicine. He has since come to terms with what he'd done and is working to undo the harm he has caused to the American people. "Canada has done a better job [re: COVID], I think, because of having the kind of health care system you have in making sure that everyone who needs to be treated is treated. And so that was what prompted that. And I felt that to provide some context, I needed to describe what I used to do for a living to try to scare people away from the Canadian health care system because insurance companies fear that. They know that if the U.S. moves to a system like that, it would certainly put a real crimp in their profits." "Our industry PR and lobbying group, AHIP, supplied my colleagues and me with cherry-picked data and anecdotes to make people think Canadians wait endlessly for their care. It's a lie. And I'll always regret the disservice I did to folks on both sides of the border." [1] https://www.npr.org/2020/06/27/884307565/after-pushing-lies-former-cigna-executive-praises-canadas-health-care-system https://www.npr.org/2020/06/27/884307565/after-pushing-lies-...
- deleted 6y ago
  [deleted]
- ineedasername 6y ago
  Who are wolves, the government? If so, I'd be open to suggestions on how the problems can be solved some other way. There's not much regulation related to healthcare pricing at the moment, and between bankruptcies related to medical debt & lack of coverage leading to preventable illness or death, it seems like the wolves are already in control of the system.
tomc1985 6y ago
> This issue isn't that people are trying to maximize profit leading to issues. This is exactly the issue. You cannot seriously think that the trainwreck that is US healthcare is what it is solely because of government intereference? Would Cigna fund and run the tiny little community clinics that serve with sliding-scale pricing? Would Kaiser willingly insure students with preexisting conditions at a fair price? (I know that in my case, they wouldn't) What "free market" incentive is there for these insurance companies to cover people that would clearly cost them more money than they receive? Those people need help and sickness/viruses do not have any concept of money, and they effect people indiscriminately. You are promoting a healthcare system for the wealthy and privileged, which is exactly what we have right now and what needs to be torn down.

deleted 6y ago

[deleted]