5 ms·

The root cause, in that, medicine is a for-profit endeavor and people are not only profiting, but seeking to maximize their profits on other people's basic need

The root cause, in that, medicine is a for-profit endeavor and people are not only profiting, but seeking to maximize their profits on other people's basic needs?

fastball 6y ago
Pretty much. Other things that don't help (somewhat US specific): 1. Layer of indirection created by the entire insurance system, which at this point is clearly not a good model for healthcare. Everyone needs/should have some amount of healthcare, so a system built entirely around the idea that only a minority of people should need to take advantage of the system is silly. 2. The half-assed government intervention of Medicare/Medicaid/ACA/etc – worst of both worlds in that when a government just injects shittons of money into the private sector (without very strong controls on price and behavior), what you end up with is ballooning costs... and that's about it. See also the govt. guaranteeing student loans for another example of the same. Or the Military Industrial Complex. And so on.
chongli 6y ago
It's a bit more complicated than that. Health care costs have skyrocketed in the US. One of the big contributors to that has been the explosion in testing, both routine and diagnostic. These large costs aren't always shared to the same degree with other countries that have socialized medicine. One example is with MRI scans. MRI machines, and the technicians and doctors who work with them, are insanely expensive. The US is, of course, not the only country with MRI machines. However, in countries with socialized medicine there may be a much longer wait for people to get an MRI scan for a non-critical issue. What about in the US? If you've got the money, you can get one right away. As a Canadian, I've seen tons of advertisements over the years targeting Canadians for MRIs as a cross-border service. So the question is: is getting an MRI now instead of waiting 6 months a basic need? Private MRI clinics are definitely profiting from it. It definitely seems frustrating for people on the waiting list who can't afford to cross the border and pay out of pocket. However, it doesn't seem nearly as bad as a company price-gouging people on life-saving insulin, for example.
- Animats 6y ago
  Too much of that is markup. The cost of MRI machines is down, and the cost of CT scanners is way down. But charges for those services have not dropped to match.
sbarzowski 6y ago
You could say the same about bakeries ("seeking to maximize their profits on other people's basic needs"). IMO the problem is more about (very) imperfect competition. Also medicine is very special in many ways (desperate buyers, doctors making decisions for them, moral and emotional weight, etc.), so it's hard to have incentives aligned.
- freeone3000 6y ago
  The entire food pipeline is heavily subsidized by the government, from advantageous loans to crop price insurance to direct cash subsidies to a sales tax exemption, to SNAP to people who can't afford food. I agree wholeheartedly with the bakery comment, that they try to maximize profits, but, bread is less than a dollar a loaf and significant expense and effort is taken to ensure everyone is fed. There seems to be no will to do the same for healthcare.

The root cause, in that, medicine is a for-profit endeavor and people are not only profiting, but seeking to maximize their profits on other people's basic needs?

fastball 6y ago

Pretty much. Other things that don't help (somewhat US specific): 1. Layer of indirection created by the entire insurance system, which at this point is clearly not a good model for healthcare. Everyone needs/should have some amount of healthcare, so a system built entirely around the idea that only a minority of people should need to take advantage of the system is silly. 2. The half-assed government intervention of Medicare/Medicaid/ACA/etc – worst of both worlds in that when a government just injects shittons of money into the private sector (without very strong controls on price and behavior), what you end up with is ballooning costs... and that's about it. See also the govt. guaranteeing student loans for another example of the same. Or the Military Industrial Complex. And so on.

chongli 6y ago

It's a bit more complicated than that. Health care costs have skyrocketed in the US. One of the big contributors to that has been the explosion in testing, both routine and diagnostic. These large costs aren't always shared to the same degree with other countries that have socialized medicine. One example is with MRI scans. MRI machines, and the technicians and doctors who work with them, are insanely expensive. The US is, of course, not the only country with MRI machines. However, in countries with socialized medicine there may be a much longer wait for people to get an MRI scan for a non-critical issue. What about in the US? If you've got the money, you can get one right away. As a Canadian, I've seen tons of advertisements over the years targeting Canadians for MRIs as a cross-border service. So the question is: is getting an MRI now instead of waiting 6 months a basic need? Private MRI clinics are definitely profiting from it. It definitely seems frustrating for people on the waiting list who can't afford to cross the border and pay out of pocket. However, it doesn't seem nearly as bad as a company price-gouging people on life-saving insulin, for example.

Animats 6y ago
Too much of that is markup. The cost of MRI machines is down, and the cost of CT scanners is way down. But charges for those services have not dropped to match.

sbarzowski 6y ago

You could say the same about bakeries ("seeking to maximize their profits on other people's basic needs"). IMO the problem is more about (very) imperfect competition. Also medicine is very special in many ways (desperate buyers, doctors making decisions for them, moral and emotional weight, etc.), so it's hard to have incentives aligned.

freeone3000 6y ago
The entire food pipeline is heavily subsidized by the government, from advantageous loans to crop price insurance to direct cash subsidies to a sales tax exemption, to SNAP to people who can't afford food. I agree wholeheartedly with the bakery comment, that they try to maximize profits, but, bread is less than a dollar a loaf and significant expense and effort is taken to ensure everyone is fed. There seems to be no will to do the same for healthcare.