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You've also got the Certificate of Need system, introduced in the Nixon years on the theory that if allowed hospitals to compete with each other it would lead t
by Symmetry 5y ago
You've also got the Certificate of Need system, introduced in the Nixon years on the theory that if allowed hospitals to compete with each other it would lead to redundant capacity and thus higher costs.
And then there's the Medicaid reimbursement rates, decided by a committee using the labor theory of value rather than something sensible like cost benefit analysis and negotiation. And since it's illegal to charge someone else less than you charge Medicaid these tend to have a cascade effect.
Our healthcare system is a huge sequence of "make it so complicated that there are no obvious deficiencies" legal systems with layers of ad hoc patches its amazing it works as well as it does.
Normally I'm in favor of free markets but if nationalization is what it takes to clean up the current mess of a system we have then so be it.
- vidarh 5y agoThe way Medicare is artificially restricted from driving down cost is atrocious. Medicare + Medicaid combined costs about as much per capita - NOT per patient - as the UK NHS. Except the UK NHS provides universal cover. Now the NHS is an aberration and under severe pressure, but it is a good indication of just how inefficient Medicare and Medicaid are - and it's not that they can't do better, it's that they're legally prevented from using their market power.