3 ms·

The vast majority of healthcare expenditure is preventive or planned care, which is largely fungible. MRIs are fungible. Primary care is fungible. Antibiotics a

by bhupy 6y ago

The vast majority of healthcare expenditure is preventive or planned care, which is largely fungible. MRIs are fungible. Primary care is fungible. Antibiotics are fungible. To the extent that healthcare isn't fungible, it's in very specific cases like end-of-life care, cancer, catastrophic surgery, and rare patented drugs. They also account for a tiny minority of overall health expenditure. We can use different tools across both of those problems.

dwohnitmok 6y ago
> The vast majority of healthcare expenditure is preventive or planned care I don't think that's true for the U.S. Preventive care and planned care (if understood to be stuff like physicals, blood checks, screening, etc. including your examples of MRIs and primary care) as far as I remember is actually a small minority of healthcare expenditures (< 20% is a number I recall). I can try to root around for sources if you're curious, but I'm also curious where you're getting the impression of "vast majority." > Antibiotics are fungible. Not really. Definitely not in the same way that food is fungible. I assume you're talking about generics here? But generics again actually make up a startlingly small minority of healthcare expenditure costs despite making up the majority of prescriptions IIRC (again I'm going off memory but I think it was something like 75% of medication expenditures are due to medicines with no allowed generic alternatives). Basically the places that you're suggesting the free market should best apply to are already the smallest slices of the healthcare expenditure pie (and also already quite effective in that limited domain).
- kgwgk 6y ago
  I think he includes things like hip replacements which are "elective" and not of the "pay now or be dead" kind.
  - dwohnitmok 6y ago
    Ah, I don't ever remember reading numbers for those so I can't comment on that (I'd be curious if anyone has a breakdown of surgery costs by elective, semi-elective, and emergency). But even stuff like hip replacement kind of is on a sliding scale. How much choice do you have if the alternative is death? What about cognitive impairment? What about blindness? What about impaired range of motion? What about mild discomfort? What about pure annoyance?

by bhupy 6y ago

dwohnitmok 6y ago

> The vast majority of healthcare expenditure is preventive or planned care I don't think that's true for the U.S. Preventive care and planned care (if understood to be stuff like physicals, blood checks, screening, etc. including your examples of MRIs and primary care) as far as I remember is actually a small minority of healthcare expenditures (< 20% is a number I recall). I can try to root around for sources if you're curious, but I'm also curious where you're getting the impression of "vast majority." > Antibiotics are fungible. Not really. Definitely not in the same way that food is fungible. I assume you're talking about generics here? But generics again actually make up a startlingly small minority of healthcare expenditure costs despite making up the majority of prescriptions IIRC (again I'm going off memory but I think it was something like 75% of medication expenditures are due to medicines with no allowed generic alternatives). Basically the places that you're suggesting the free market should best apply to are already the smallest slices of the healthcare expenditure pie (and also already quite effective in that limited domain).

kgwgk 6y ago
I think he includes things like hip replacements which are "elective" and not of the "pay now or be dead" kind.
- dwohnitmok 6y ago
  Ah, I don't ever remember reading numbers for those so I can't comment on that (I'd be curious if anyone has a breakdown of surgery costs by elective, semi-elective, and emergency). But even stuff like hip replacement kind of is on a sliding scale. How much choice do you have if the alternative is death? What about cognitive impairment? What about blindness? What about impaired range of motion? What about mild discomfort? What about pure annoyance?