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Even then it would not be truly free because you would need to make decisions in a medical emergency with limited options. It would be like shopping for a denti

Even then it would not be truly free because you would need to make decisions in a medical emergency with limited options. It would be like shopping for a dentist with an abscess that could kill you tomorrow.

AnthonyMouse 6y ago
That would only apply to the 10% of medical costs spent on emergency care. It makes little sense to operate the other 90% based on requirements that don't exist in those cases. Emergency care is also inherently local. You could operate emergency rooms under the same framework as you do fire departments. Which doesn't require a national fire department to manufacture the fire extinguishers you buy for your house or repair the damage to your car a week after a car accident.
- mattnewton 6y ago
  But also doesn't require fire insurance for someone to try pulling you out of a burning building. I think diseases that take longer but are still affecting your quality of life are just as important to consider, but also think they distort decision making and fail to work like a free market as a result. The "free market" has failed to provide affordable dental care outside large insurance policies, which are inaccessible to almost a quarter of americans, for example. https://www.coloniallife.com/employer-resource-center/2018/april/the-surprising-truth-about-dental-insurance https://www.coloniallife.com/employer-resource-center/2018/a...
  - AnthonyMouse 6y ago
    > But also doesn't require fire insurance for someone to try pulling you out of a burning building. Right, so your city should operate an emergency room funded mostly by taxpayers, and then just charge a fixed deductible (e.g. $1000) for emergency care, which isn't enough to induce bankruptcy in general but is enough to deter people from using it in place of primary care. > The "free market" has failed to provide affordable dental care outside large insurance policies, which are inaccessible to almost a quarter of americans, for example. Your link is to the promotional material of a dental insurance company. Dental isn't generally a market that requires insurance. You need health insurance because heart surgery or chemotherapy is a six figure expense that would bankrupt nearly everyone. Paying $1500 for dental work doesn't require insurance, it requires a payment plan. It isn't an expense large enough to require insuring against.
    - mattnewton 6y ago
      > Right, so your city should operate an emergency room funded mostly by taxpayers, and then just charge a fixed deductible (e.g. $1000) for emergency care, which isn't enough to induce bankruptcy in general but is enough to deter people from using it in place of primary care This is just a public option that covers little and without the bargaining power on price a state has versus a city, right? Why wouldn't the same logic go for a larger entity taking up the mantle? And if we treat only emergencies with the plan, we incentize poor people to ignore cheaper preventative care in the market based system, and to wait until it becomes an emergency that costs many multiples to fix. > Dental isn't generally a market that requires insurance. Also from that link, in practice most uninsured americans just don't seek dental care. This matches my personal experience of being uninsured.
      - sershe 6y ago
        The latter is probably not causal - poor Americans have no money for either insurance or dental care, whereas non-poor would pay for retail dental anyway, but they also mostly have insurance.
        mattnewton 6y ago
        The end result is still broken for nearly a quarter of americans and could be fixed with state sponsored care. That dental care is tolerated to be this way is not a good argument for free markets in healthcare working, to me at least.

AnthonyMouse 6y ago

That would only apply to the 10% of medical costs spent on emergency care. It makes little sense to operate the other 90% based on requirements that don't exist in those cases. Emergency care is also inherently local. You could operate emergency rooms under the same framework as you do fire departments. Which doesn't require a national fire department to manufacture the fire extinguishers you buy for your house or repair the damage to your car a week after a car accident.

mattnewton 6y ago
But also doesn't require fire insurance for someone to try pulling you out of a burning building. I think diseases that take longer but are still affecting your quality of life are just as important to consider, but also think they distort decision making and fail to work like a free market as a result. The "free market" has failed to provide affordable dental care outside large insurance policies, which are inaccessible to almost a quarter of americans, for example. https://www.coloniallife.com/employer-resource-center/2018/april/the-surprising-truth-about-dental-insurance https://www.coloniallife.com/employer-resource-center/2018/a...
- AnthonyMouse 6y ago
  > But also doesn't require fire insurance for someone to try pulling you out of a burning building. Right, so your city should operate an emergency room funded mostly by taxpayers, and then just charge a fixed deductible (e.g. $1000) for emergency care, which isn't enough to induce bankruptcy in general but is enough to deter people from using it in place of primary care. > The "free market" has failed to provide affordable dental care outside large insurance policies, which are inaccessible to almost a quarter of americans, for example. Your link is to the promotional material of a dental insurance company. Dental isn't generally a market that requires insurance. You need health insurance because heart surgery or chemotherapy is a six figure expense that would bankrupt nearly everyone. Paying $1500 for dental work doesn't require insurance, it requires a payment plan. It isn't an expense large enough to require insuring against.
  - mattnewton 6y ago
    > Right, so your city should operate an emergency room funded mostly by taxpayers, and then just charge a fixed deductible (e.g. $1000) for emergency care, which isn't enough to induce bankruptcy in general but is enough to deter people from using it in place of primary care This is just a public option that covers little and without the bargaining power on price a state has versus a city, right? Why wouldn't the same logic go for a larger entity taking up the mantle? And if we treat only emergencies with the plan, we incentize poor people to ignore cheaper preventative care in the market based system, and to wait until it becomes an emergency that costs many multiples to fix. > Dental isn't generally a market that requires insurance. Also from that link, in practice most uninsured americans just don't seek dental care. This matches my personal experience of being uninsured.
    - sershe 6y ago
      The latter is probably not causal - poor Americans have no money for either insurance or dental care, whereas non-poor would pay for retail dental anyway, but they also mostly have insurance.
      - mattnewton 6y ago
        The end result is still broken for nearly a quarter of americans and could be fixed with state sponsored care. That dental care is tolerated to be this way is not a good argument for free markets in healthcare working, to me at least.