4 ms·

If for-profit companies keep doing all these awful things, why people keep paying them money?

scythe 4y ago
> If for-profit companies keep doing all these awful things, why people keep paying them money? Healthcare privacy laws make it extremely difficult to evaluate the value proposition of care providers. You can't just, like, look up a list of their previous patients' medical histories.
nrmitchi 4y ago
Because at the moment the only real alternative is “dying”?
- xyzzyz 4y ago
  This is only true for a fraction of all healthcare that’s actually consumed. For my family, over past 4 years, maybe 10% of our healthcare consumption carried a significant risk of death if we elected to not consume it. As an explicit example, my wife took our infant daughter to a doctor the other day, because she was coughing and sneezing for a week already, and she wanted him to confirm that it’s most likely nothing to worry about. The doctor agreed. Insurance was billed $200, with $10 paid by us out of pocket. If we had to pay $200 out of pocket, we’d probably wait another week (and ended up not paying anything at all, because the coughing indeed disappeared before the end of the second week).
bgia 4y ago
Because their lives depend on it? Why do people keep paying ransoms? Does it mean that ransoming them is a good thing?
- maerF0x0 4y ago
  But the point was that they're doing things that either are unneeded or not effective. If either of those are true, their lives do not depend on those procedures.
  - Adrox 4y ago
    Exact same thing as Marketing spend. You cannot split the good from the bad. I really cannot understand how you can even think about doing healthcare system for profit. Posting this from a Single-pay country, Germany.
    - maerF0x0 4y ago
      Is Germany single provider too? In my armchair politics I do wonder if single payer, market provider might work. You get the competition of the market, but the tax payer purse. I think technically this is how medicare works but there are a bunch of nuances that make medicare not work (such as negotiation of prices).
      - Adrox 4y ago
        I'm not sure if it's matches "single payer". It has mandatory insurance. And you cannot choose most of the things that what you can get covered or not. I got a "government insurance", which is the most expensive, but also the one with the best cover. There is "private insurances" with cheaper premiums and less cover that are attractive to young people, but it's kind of hard to later in life switch back to the government one. Most countries in EU have kind of this mixed healthcare, with private, and public ones with the only goal to make sure the private offer competitive enough services... Same thing with hospitals, there is public hospitals, so private ones don't jack up the prices to crazy values...
        maerF0x0 4y ago
        I see, the American strategy seems to be increase competition to ensure prices are fair. A big problem being the corruption in the government through lobbying having a positive EROI such that companies are blocking good anti-trust policies (such as requiring transparency on prices) . A lot of people are negative about how America does things, but as far as I can tell most of the issues stem from corruption via money in politics. Capitalism and Market Economies seem to work well, but Crony Capitalism and Citizens United seem to just be friendly names for corruption.
Arubis 4y ago
In the case of healthcare, it’s because crippling, inescapable debt that spans multiple generations is still usually preferable to actual death.
- abfan1127 4y ago
  where in the US is there inescapable debt that spans multiple generations? What debt (other than IRS and student loans) are not dischargeable via bankruptcy?
fckgw 4y ago
To not die?
deleted 4y ago
[deleted]
user_7832 4y ago
Because, in an economic sense, of asymmetry between the parties. You only have a handful of car companies to buy a $30k green 5-door sedan from. But Ford can easily afford to lose you as a customer - Ford is more important to you than you are to them. An extreme case of this (in some places) is the internet provider. If they know they're the only ones they can basically charge much more than if you were living in an area with healthy competition. What're you gonna do, not use the net?
- xyzzyz 4y ago
  Ford can easily afford to lose me, individually, but typically things that will cause them to lose me, will also cause them to lose many other customers. In practice, there is no actual asymmetry: if I don’t like Ford, I can just go to dealership next door, and so can millions of other customers, which means Ford needs to be careful.
  - user_7832 4y ago
    Ford needs to be careful, yes. But Comcast in this example doesn't need to be. And for you to compete with Comcast by spinning your own ISP and having your own cables is not likely.
    - xyzzyz 4y ago
      Yes, I agree. My point is just that the asymmetry in market strength is not based purely on the size of the company relative to the consumer. In many competitive fields, it is the providers that are in a precarious situations instead of the customers, even if the providers are large corporations. Consider, for example, McDonalds: it’s a huge company, but it would be ridiculous to suggest that it enjoys significant market power over customers. Many such examples.
ikurei 4y ago
I have no clue if the bushings in my car really did need replacing. Not even sure what they are. My mechanic sure has an incentive to say they do, as he'll make money that way, but if what he says sounds kinda reasonable and I don't get weird vibes from him, I am not taking a gamble with my 1600kg, 120km/h destroyer-of-pedestrians-and-passengers. Most people aren't medical doctors, and most aren't gonna gamble with their health. It's a transaction where one side has way more information, less to loose, and therefore more power. Hopefully they use that power for good.

> If for-profit companies keep doing all these awful things, why people keep paying them money? Healthcare privacy laws make it extremely difficult to evaluate the value proposition of care providers. You can't just, like, look up a list of their previous patients' medical histories.

nrmitchi 4y ago

Because at the moment the only real alternative is “dying”?

xyzzyz 4y ago
This is only true for a fraction of all healthcare that’s actually consumed. For my family, over past 4 years, maybe 10% of our healthcare consumption carried a significant risk of death if we elected to not consume it. As an explicit example, my wife took our infant daughter to a doctor the other day, because she was coughing and sneezing for a week already, and she wanted him to confirm that it’s most likely nothing to worry about. The doctor agreed. Insurance was billed $200, with $10 paid by us out of pocket. If we had to pay $200 out of pocket, we’d probably wait another week (and ended up not paying anything at all, because the coughing indeed disappeared before the end of the second week).

bgia 4y ago

Because their lives depend on it? Why do people keep paying ransoms? Does it mean that ransoming them is a good thing?

maerF0x0 4y ago
But the point was that they're doing things that either are unneeded or not effective. If either of those are true, their lives do not depend on those procedures.
- Adrox 4y ago
  Exact same thing as Marketing spend. You cannot split the good from the bad. I really cannot understand how you can even think about doing healthcare system for profit. Posting this from a Single-pay country, Germany.
  - maerF0x0 4y ago
    Is Germany single provider too? In my armchair politics I do wonder if single payer, market provider might work. You get the competition of the market, but the tax payer purse. I think technically this is how medicare works but there are a bunch of nuances that make medicare not work (such as negotiation of prices).
    - Adrox 4y ago
      I'm not sure if it's matches "single payer". It has mandatory insurance. And you cannot choose most of the things that what you can get covered or not. I got a "government insurance", which is the most expensive, but also the one with the best cover. There is "private insurances" with cheaper premiums and less cover that are attractive to young people, but it's kind of hard to later in life switch back to the government one. Most countries in EU have kind of this mixed healthcare, with private, and public ones with the only goal to make sure the private offer competitive enough services... Same thing with hospitals, there is public hospitals, so private ones don't jack up the prices to crazy values...
      - maerF0x0 4y ago
        I see, the American strategy seems to be increase competition to ensure prices are fair. A big problem being the corruption in the government through lobbying having a positive EROI such that companies are blocking good anti-trust policies (such as requiring transparency on prices) . A lot of people are negative about how America does things, but as far as I can tell most of the issues stem from corruption via money in politics. Capitalism and Market Economies seem to work well, but Crony Capitalism and Citizens United seem to just be friendly names for corruption.

Arubis 4y ago

In the case of healthcare, it’s because crippling, inescapable debt that spans multiple generations is still usually preferable to actual death.

abfan1127 4y ago
where in the US is there inescapable debt that spans multiple generations? What debt (other than IRS and student loans) are not dischargeable via bankruptcy?

fckgw 4y ago

To not die?

deleted 4y ago

[deleted]

user_7832 4y ago

Because, in an economic sense, of asymmetry between the parties. You only have a handful of car companies to buy a $30k green 5-door sedan from. But Ford can easily afford to lose you as a customer - Ford is more important to you than you are to them. An extreme case of this (in some places) is the internet provider. If they know they're the only ones they can basically charge much more than if you were living in an area with healthy competition. What're you gonna do, not use the net?

xyzzyz 4y ago
Ford can easily afford to lose me, individually, but typically things that will cause them to lose me, will also cause them to lose many other customers. In practice, there is no actual asymmetry: if I don’t like Ford, I can just go to dealership next door, and so can millions of other customers, which means Ford needs to be careful.
- user_7832 4y ago
  Ford needs to be careful, yes. But Comcast in this example doesn't need to be. And for you to compete with Comcast by spinning your own ISP and having your own cables is not likely.
  - xyzzyz 4y ago
    Yes, I agree. My point is just that the asymmetry in market strength is not based purely on the size of the company relative to the consumer. In many competitive fields, it is the providers that are in a precarious situations instead of the customers, even if the providers are large corporations. Consider, for example, McDonalds: it’s a huge company, but it would be ridiculous to suggest that it enjoys significant market power over customers. Many such examples.

ikurei 4y ago

I have no clue if the bushings in my car really did need replacing. Not even sure what they are. My mechanic sure has an incentive to say they do, as he'll make money that way, but if what he says sounds kinda reasonable and I don't get weird vibes from him, I am not taking a gamble with my 1600kg, 120km/h destroyer-of-pedestrians-and-passengers. Most people aren't medical doctors, and most aren't gonna gamble with their health. It's a transaction where one side has way more information, less to loose, and therefore more power. Hopefully they use that power for good.