4 ms·

> Free marketeers will say a fair price is what someone is willing to pay. Which is exactly why the system is broken. How much are you willing to spend to not

> Free marketeers will say a fair price is what someone is willing to pay. Which is exactly why the system is broken. How much are you willing to spend to not die? Healthcare is one of those things that markets just aren't good at setting prices for. The demand curve is a wreck. I think the US has proved conclusively that a market based approach is a mistake.

SoftTalker 4y ago
> How much are you willing to spend to not die? Of course most health care is not an immediate life or death situation. Most of it is for chronic issues or routine "well care" where you would have ample time to compare prices at different providers, if there were a straightforward way to do that.
- ClumsyPilot 4y ago
  Time is an important component, but is not enough. Tere is no utility price - for example if all tv producers conspire and set TV prices at $10,000 for entry level tv i will go without one. So will all consumers. Thats your price limit. However that does not apply to medicine, see epipen scandal. prices can be inceeased infinitely. Also Many medicines enjoy patent protection and thus have no competition,
  - thephyber 4y ago
    While what you say is mostly true, it's not the whole story. Price transparency doesn't fix price fixing, broken intellectual property laws, etc. But it does increase competition in a space where opacity is currently a feature. Americans are paying so much that medical visits to other countries are affordable. Trips to Mexico or Canada to purchase medicines. Trips to Europe to get a hip replacement. The fact that "Medical tourism" even has a term means that Americans are searching for ways to reduce cost. Price transparency is a tool, even if it's debatable about how big the lever is.
- komali2 4y ago
  For non life or death things, it's still kind of, idk, what's a good economic word to describe "something you basically have to / will inevitably buy?" Your arm is broken and was put in a splint. To get the splint removed properly you gotta go back to the hospital for them to saw it off (and xray to determine it's a good time to saw the thing off). You're gonna... shop around and compare prices for this routine? I mean, you HAVE to get the splint off or your arm will rot off, plus, your quality of life is reduced with it on. "The Market" is armed with the knowledge that you've gotta get the thing off. Even with a couple hospital "options," the hospitals and insurance companies can collude (implicitly or otherwise) to charge basically whatever they want for the operation. The question isn't, what's a fair price, the question is, how much of this person's income can we extract before they'll risk cutting the thing off themselves. It seems irrational to try to justify this environment when considering the needs of the citizenry. All signs point to methods of organizing healthcare that take as much power as possible from "the market" (which just means whoever can form oligopoly), be that by having a single payer system or by simply nationalizing healthcare.
- Klinky 4y ago
  I don't really think the make or break is from a $100 spread on wellness visits. It's going to be the acute illnesses and injury that you do not have time to plan for that are the killer. Also chronic illness often can be difficult to manage, with acute flare-ups requiring unexpected hospitalizations. If you're on immuno/biologic therapy, more of the cost is in your drugs than in the doctor or facility. As GP pointed out there are a myriad of medical/diagnostic codes, and variety of scenarios that could turn something like a baby delivery from a $5,000 affair into a $500,000 affair. Do we really expect that patient to accurately compare all the medical/diagnostic codes between providers to determine if they're getting gouged or not? Would it even be ethical to take a baby out of a NICU to try to save $50,000? We need to stop acting like healthcare is like buying a car or buying Fruity Pebbles from the store. People aren't going bankrupt because they spent an extra $100 on a wellness visit. They're going bankrupt because of needed care that was very expensive, and even cutting the price in half or by 2/3rds would've still resulted in them going bankrupt. I guess with pricing transparency they can more confidently find out they can't afford it anywhere.
  - thephyber 4y ago
    Ugh. I feel like defeatism like this comment is what causes the paralysis against fixing all of our medical cost issues. > Do we really expect that patient to accurately compare all the medical/diagnostic codes between providers Forest for the trees. The end user doesn't need to micromanage medical codes when deciding which provider to use. They need a cost "grade" for each provider (maybe based on averages or select common procedures). Apps like Google Maps would be able to help us decide the cost versus distance equation. Price transparency bends the cost curve down. It doesn't matter whether it is wellness or Urgent Care. So long as you are conscious, you should have information+tools to help you decide where to go. Obviously if you are arguing single-payer, that would be a different situation but since most Americans don't have that, we need to address the issues that apply to us. Facilities mark up the drugs they provide. Pharmacies have mark-up. Price transparency helps those transactions as well. > acute illnesses and injury that you do not have time to plan for that are the killer Perhaps, but not for everyone. Kidney dialysis is an example of a predictable, frequent, necessary for 500,000 Americans) and expensive ($3k - $15k per month) and represents about 6% of all American healthcare spending.[1] Working price transparency for a few of the large cost drivers like dialysis would increase competition on price and reduce the total paid by patients and insurers (and thus, all insured). > even cutting the price in half or by 2/3rds would've still resulted in them going bankrupt. Price transparency won't fix all of the price distortions. Nobody is saying it will. But it's a necessary component of bringing prices down, along with like 80 other changes. [1] https://healthpolicy.usc.edu/brookings-schaeffer/congress-should-end-dialysis-companies-third-party-games-with-insurance-coverage/ https://healthpolicy.usc.edu/brookings-schaeffer/congress-sh...
ChadNauseam 4y ago
The price for non-lifesaving healthcare is ridiculously high as well, so there must be something more to the story than this

SoftTalker 4y ago

> How much are you willing to spend to not die? Of course most health care is not an immediate life or death situation. Most of it is for chronic issues or routine "well care" where you would have ample time to compare prices at different providers, if there were a straightforward way to do that.

ClumsyPilot 4y ago
Time is an important component, but is not enough. Tere is no utility price - for example if all tv producers conspire and set TV prices at $10,000 for entry level tv i will go without one. So will all consumers. Thats your price limit. However that does not apply to medicine, see epipen scandal. prices can be inceeased infinitely. Also Many medicines enjoy patent protection and thus have no competition,
- thephyber 4y ago
  While what you say is mostly true, it's not the whole story. Price transparency doesn't fix price fixing, broken intellectual property laws, etc. But it does increase competition in a space where opacity is currently a feature. Americans are paying so much that medical visits to other countries are affordable. Trips to Mexico or Canada to purchase medicines. Trips to Europe to get a hip replacement. The fact that "Medical tourism" even has a term means that Americans are searching for ways to reduce cost. Price transparency is a tool, even if it's debatable about how big the lever is.
komali2 4y ago
For non life or death things, it's still kind of, idk, what's a good economic word to describe "something you basically have to / will inevitably buy?" Your arm is broken and was put in a splint. To get the splint removed properly you gotta go back to the hospital for them to saw it off (and xray to determine it's a good time to saw the thing off). You're gonna... shop around and compare prices for this routine? I mean, you HAVE to get the splint off or your arm will rot off, plus, your quality of life is reduced with it on. "The Market" is armed with the knowledge that you've gotta get the thing off. Even with a couple hospital "options," the hospitals and insurance companies can collude (implicitly or otherwise) to charge basically whatever they want for the operation. The question isn't, what's a fair price, the question is, how much of this person's income can we extract before they'll risk cutting the thing off themselves. It seems irrational to try to justify this environment when considering the needs of the citizenry. All signs point to methods of organizing healthcare that take as much power as possible from "the market" (which just means whoever can form oligopoly), be that by having a single payer system or by simply nationalizing healthcare.
Klinky 4y ago
I don't really think the make or break is from a $100 spread on wellness visits. It's going to be the acute illnesses and injury that you do not have time to plan for that are the killer. Also chronic illness often can be difficult to manage, with acute flare-ups requiring unexpected hospitalizations. If you're on immuno/biologic therapy, more of the cost is in your drugs than in the doctor or facility. As GP pointed out there are a myriad of medical/diagnostic codes, and variety of scenarios that could turn something like a baby delivery from a $5,000 affair into a $500,000 affair. Do we really expect that patient to accurately compare all the medical/diagnostic codes between providers to determine if they're getting gouged or not? Would it even be ethical to take a baby out of a NICU to try to save $50,000? We need to stop acting like healthcare is like buying a car or buying Fruity Pebbles from the store. People aren't going bankrupt because they spent an extra $100 on a wellness visit. They're going bankrupt because of needed care that was very expensive, and even cutting the price in half or by 2/3rds would've still resulted in them going bankrupt. I guess with pricing transparency they can more confidently find out they can't afford it anywhere.
- thephyber 4y ago
  Ugh. I feel like defeatism like this comment is what causes the paralysis against fixing all of our medical cost issues. > Do we really expect that patient to accurately compare all the medical/diagnostic codes between providers Forest for the trees. The end user doesn't need to micromanage medical codes when deciding which provider to use. They need a cost "grade" for each provider (maybe based on averages or select common procedures). Apps like Google Maps would be able to help us decide the cost versus distance equation. Price transparency bends the cost curve down. It doesn't matter whether it is wellness or Urgent Care. So long as you are conscious, you should have information+tools to help you decide where to go. Obviously if you are arguing single-payer, that would be a different situation but since most Americans don't have that, we need to address the issues that apply to us. Facilities mark up the drugs they provide. Pharmacies have mark-up. Price transparency helps those transactions as well. > acute illnesses and injury that you do not have time to plan for that are the killer Perhaps, but not for everyone. Kidney dialysis is an example of a predictable, frequent, necessary for 500,000 Americans) and expensive ($3k - $15k per month) and represents about 6% of all American healthcare spending.[1] Working price transparency for a few of the large cost drivers like dialysis would increase competition on price and reduce the total paid by patients and insurers (and thus, all insured). > even cutting the price in half or by 2/3rds would've still resulted in them going bankrupt. Price transparency won't fix all of the price distortions. Nobody is saying it will. But it's a necessary component of bringing prices down, along with like 80 other changes. [1] https://healthpolicy.usc.edu/brookings-schaeffer/congress-should-end-dialysis-companies-third-party-games-with-insurance-coverage/ https://healthpolicy.usc.edu/brookings-schaeffer/congress-sh...

ChadNauseam 4y ago

The price for non-lifesaving healthcare is ridiculously high as well, so there must be something more to the story than this