5 ms·

> But why doesn't this happen to restaurants, or super markets or car mechanics? Because you do not have to go to those places. Years ago, when I was a kid, I

by jmclnx 2y ago

> But why doesn't this happen to restaurants, or super markets or car mechanics? Because you do not have to go to those places. Years ago, when I was a kid, I heard my parents, uncles and aunts have a big discussion while I was in bed. They were talking about the trend of For Profit Health Care, the outcome they came up with was prices will eventually raise up to extortion levels, why, because that is what everyone needs. So here we are, being extorted by insurance and equity firms. And many Doctors are in the same boat with us, they are being squeezed with insurance costs and bureaucracy. My Dr has to have 3 people working in the office just to deal with health Insurance. As a kid, it use to be 1 nurse and the nurse would deal wit paper work and help the Dr when needed. Plus their insurance costs were low compared to now.

dartos 2y ago
My parents are dentists and most of the memories from when I was a kid (pre 2013) of my dad working was him dialing up and arguing with insurance providers. They’d send checks 6months late and often miss them. They also forced certain prices for him to stay “in-network” Insurances don’t seem to help anyone.
- bluGill 2y ago
  Insurance helps those who pay them. Just note that for most Americans they are not the one paying.
  - dartos 2y ago
    For dental insurance, those insurance companies force healthcare providers to keep artificially high prices, even for out of network patients. For example, with my parent’s independent office, people would come in without insurance and unable to pay the high fees for say a filling or a crown. My parents were technically able to charge much lower prices (more than half off in the case of normal cleanings,) but were unable to because of the contract they had with their insurance network. Moreover, the listed price mandated by the insurance was not the same as the payout my parents received after filling the claim. (The payout was always less. Sometimes much less than the mandated price) I don’t see who benefits in this situation besides the insurance company. Even if my employer pays for my insurance, I still need to meet some premium most of the time. And what I pay is inflated because of the in-network contracts Consider also that, in the states at least, dental insurance is separate from medical.
srackey 2y ago
This is why other goods you absolutely need, like clothes, shoes, and food, are ALSO some of the most expensive out there.
- sofixa 2y ago
  But those are vastly more flexible. You can pick which clothes to buy from which store/vendor, you can buy second hand, you can get clothes donated. You can buy cheap filling food, in bulk, get by on rice and potatoes, etc. You can't get get a second hand operation or medicine.
  - SkyBelow 2y ago
    They are more flexible because they are less regulated. Restaurants don't have a certificate of need to stop competitors from showing up. You can buy food internationally and have it shipped in if you can't find it locally for a reasonable price, but try to do the same with medication and you'll have a bad time. You can even look at less regulated medication, like pet meds, and see how much cheaper some are. We don't need to go that far, just like how people food is more regulated than pet food, but without being as regulated as our current market for healthcare.
    - harimau777 2y ago
      They don't need to be as highly regulated as medicine needs to be. Even children can learn most of the important elements of food safety (cook to a certain temperature, don't cross contaminate utensils, wash your hands, etc.). Much of medicine is vastly more complex than something like food safety or clothing safety.
    - XorNot 2y ago
      The funny thing is in Australia, pet medication always generates sticker shock because it's a lot more expensive for the consumer then PBS subsidized pharmaceuticals.
    - sofixa 2y ago
      > They are more flexible because they are less regulated No, because when your tooth hurts now, or you're bleeding now, or you need to get vaccinated to avoid you getting hepatitis, there's very little choice in the matter. Healthcare is a fundamentally inelastic good. A dangerous one too, because bad quality healthcare can literally kill people. Inaccessibility of healthcare kills people too. Look, there is no need to reinvent the wheel here. The US can look into any other developed country on the planet for inspiration. Every single one of them has a better, more accessible, cheaper for everyone involved, usually more or at least differently regulated, with better outcomes, model. > No Way to Prevent This,' Says Only Nation Where This Regularly Happens
SkyBelow 2y ago
>Because you do not have to go to those places. Food is an extreme need, and while there are many types of businesses that provide food, we can wrap those up into one larger class of food provider businesses and ask why they aren't being captured and squeezed. Sure, some are to hunt or garden, but that number is far too small when you think of places with the highest concentrations of people. Food even has regulations, but it manages to not lead to monopolies that can charge whatever they want because if the price goes too high, other players can jump through the hoops to enter the market. The regulation on healthcare has reached the point of a stranglehold.
- Eddy_Viscosity2 2y ago
  > why they aren't being captured and squeezed. They are. Maybe not by PE, but capitalism finds a way. This isn't the first time either the two big grocery chains in Canada have a long history of exploiting market dominance to screw over people who want to eat. https://www.ctvnews.ca/business/competition-bureau-probes-alleged-anticompetitive-conduct-by-loblaws-sobeys-owners-1.6899175 https://www.ctvnews.ca/business/competition-bureau-probes-al...
- harimau777 2y ago
  It's much easier to switch to different options with food than it is with healthcare. For example, if cartel forms around tropical fruits, people can switch to apples. This makes it much more difficult for someone to exert market power over the food market than over the medical market. Medical care also often involves crisis situations where you absolutely need care right now so you don't have much leverage. On the other hand, most of the time people have some flexibility in how much they eat, when they eat, and what they eat.
  - SkyBelow 2y ago
    Healthcare prices aren't only high for emergency care, so it shows that the emergency nature of the work isn't the issue. I'm sure doing a statistical regression would show roughly what percentage of the issue is due to it, but I would expect it to be very low given the prices of things like medication needed on an ongoing basis where one could shop around, if it was legal to do so. One can also look at elective or non-emergency surgeries, especially those where people use medical tourism to find cheaper options. That is an extreme form of shopping around, which they have to do because more local forms of shopping around are legally banned.
bko 2y ago
Lots of people don't go to the doctor when they probably should. Most spending isn't emergency room visits. I imagine prob half is connected to obesity and smoking. Just lose weight and you don't have to go. The health insurance profit margin is around 3.3%. Maybe they're just bad at extortion There are certain topics people feel very strongly about with no insight or experience, they say things that are demonstrably false and refuse to look at it objectively. Unfortunately US healthcare is one of those https://content.naic.org/sites/default/files/inline-files/health-2022-mid-year-industry-report.pdf https://content.naic.org/sites/default/files/inline-files/he...
- faster 2y ago
  A long time ago I worked for a company that had a "cost plus" contract to build and operate a thing. I took a management class while I was there and one of the people in the class was a consultant who had been hired to map the division's revenue flow. Almost everyone there was a manager and all of them were on the edge of their seats while he explained. Basically, you mark up the little stuff that everything is built on ($1/page for copies, for example) so the margins look smaller when you get to anything substantial. So 3.3% is a meaningless number until it has been audited all the way down to the smallest purchases.
  - bko 2y ago
    Well if the market price for something is X and your margins are small but X is big you do well. But someone can innovate and do it for half X and now his margins are 50% so he makes more money. The question is why can't I provide insurance at the market price and just bring in efficiencies to get my cost down and margin up? The reason is that it's not a real market through onerous regulations. People are forced to buy it, new entrants aren't allowed and there is an implicit threat that if margins get big politicians will come after you. So were stuck in this crappy system
Arnt 2y ago
Are you saying the medicine is necessary, unlike food?
- cogman10 2y ago
  No, they are saying medicine is necessary unlike restaurants. But further, medicine has extremely low competition at all levels. There are few companies producing penicillin, you likely don't have a lot of options for hospital care (especially if you need a specialist), and your insurance was likely not something you picked. Compare that to food, where you can get it from multiple grocery stores, gas stations, or even order it online. If you are in a place with 1 restaurant it's highly likely there are 10 competing restaurants. Heck, if you have some land you can even grow your own food in a garden. Medicine is a necessity with few providers which makes it a particularly bad fit for capitalism. It can't be made cheaper or more available by cutting regulations. They are necessary to keep the industry from killing people.
  - pdonis 2y ago
    > they are saying medicine is necessary unlike restaurants. But not unlike supermarkets, which were also mentioned. > Medicine is a necessity with few providers which makes it a particularly bad fit for capitalism Medicine does not have few providers because of "capitalism". It has few providers because of regulation that artificially limits the supply of providers. In a free market, the market would provide whatever supply of providers is needed to meet people's health care needs in the most efficient way. But regulation prevents that from happening. > They are necessary to keep the industry from killing people. Yet somehow we manage to have regulations to prevent food from killing people, without restricting the supply of supermarkets, and without impairing competition among them. We could do the same for health care.
    - Arnt 2y ago
      Supermarkets is exactly what I had in mind, but perhaps it was stupid. The cost of health care is kind of… a×b+c×d, except more complicated, where a is the hourly cost of a physician, b is the number of times you get an hour's care, c is the cost of a pill and d is the number of pills you get. Want the total sum to decrease? Then pick which one of a, b, c and d you want to decrease, and look at whether competition can help. A lot of this thread sounds like just "private equity is evil and therefore guilty", nothing to do with goal-directed efficacy.
refurb 2y ago
> Because you do not have to go to those places. What do you mean? I do absolutely need to go to grocery stores. I would starve otherwise?
- KittenInABox 2y ago
  You do not need to go to a specific grocery store that is the only one available within X miles from you. For me, I have 2 walkable stores, 4-5 bikeable stores, and 10+ via Instacart.
  - pdonis 2y ago
    Exactly. Now imagine that the same were true for health care.
  - refurb 2y ago
    How is healthcare different? Do you not have multiple doctors you can go to? Weren’t not talking about insurance networks. We’re talking about how healthcare can’t be free market. Insurance networks aren’t a requirement of a free market. There are private healthcare systems that don’t have networks.
    - KittenInABox 2y ago
      Generally, no I don't. I have basically two hospital systems to choose from. All specialists I require seeing are only available in these two hospital systems if I want to be covered by my insurance. I can see a variety of primary care physicians, but I cannot see e.g. a rheumatologist outside specific hospital conglomerates.
      - refurb 2y ago
        > if I want to be covered by my insurance But insurance networks aren't a requirement of free markets. So your argument that in today's system (only one form of a free market for healthcare) proves free markets don't work is ignoring alternatives. It sounds like you actually would have plenty of physicians to choose from, just like when you buy food.
jibe 2y ago
Because you do not have to go to those places. Everyone has to eat, so everyone except a small number of farmers does have to go to either restaurants or markets.
- s1artibartfast 2y ago
  The price of filet mignon has not gone up because everyone has to eat it. Unless someone is on a subsistence diet, there are tradeoffs taking place.
brigadier132 2y ago
> Because you do not have to go to those places. You don't need to go to college either but prices for that have gone up more than 10x. If anything, I can skip going to the doctor for a very long time because of cost (and people do unfortunately). > They were talking about the trend of For Profit Health Care, the outcome they came up with was prices will eventually raise up to extortion levels, why, because that is what everyone needs. Healthcare has always been for profit.
- thereddaikon 2y ago
  The reason college costs have gone up is because the government decided to make it so anyone could get college loans and they couldn't discharge them through bankruptcy. Then the public education system told everyone that if you don't go to college you'll be a poor loser. So while you don't have to go to college in the strictest sense, you have the same effect. Everyone does because they are told they must. And the schools know they are guaranteed those sweet federal loans which have strings on the naïve 17 year olds but none on the colleges. Why not raise prices? Why not build unnecessary ego projects? The incentive is to lower standards, enroll as many students as possible and raise tuition. Even state universities do this.
  - yterdy 2y ago
    It should be noted that "told they must" is not simply bad Boomer advice, but a reflection of the reality that the vast majority of white-collar work (even work that must mostly be trained on-the-job, due to the particular policies and protocols of any given business) requires a Bachelor's degree be on your resume if you don't want your application binned immediately.
    - thereddaikon 2y ago
      Excellent point. I work in IT and for years there weren't IT specific degrees from state universities. My degree is completely unrelated and it never was really a factor in hiring because a BS in IT wasn't a thing. Until the last few years it is now. And every young aspiring IT professional with one of those degrees I've spoken to or worked with had a similar experience. Its a useless degree that doesn't prepare you for the industry. I was expecting they would walk out with a good, broad foundation and some good industry certs to match but that's not the case. Its all theory, little to no application and huge knowledge gaps. They were scammed. I feel like my history degree is more applicable. At least it taught me how to write decently. Why do these IT BS's exist? It must be just to sell kids another piece of paper. Tech got big enough that the education cartel decided they needed to gatekeep it.
the_real_cher 2y ago
It's a case of prices following the law of supply and demand for ones life/health is infinite. Healthcare doesn't really work in a capitalistic marketplace.
- nojvek 2y ago
  Demand isn’t quite infinite. It’s ~350 million people but supply is quite limited. Same with housing. Demand is increasing faster than supply hence price increases. Price increases make housing a great financial instrument due to ease of getting mortgage loans. Also why we need to have a sane immigration strategy. Can’t bring in too many people too fast (like Canada) Private equity is playing cards on the arbitrage that any asset that increases in demand much faster than supply, and can be loan leveraged is a great investment.
  - the_real_cher 2y ago
    I mean the demand for anything is 350 million people. But most things people have a price ceiling they're willing to pay. Health care there is no price people won't pay for their lives, so the demand ceiling is essentially the entire net worth of the entire population
- pdonis 2y ago
  > demand for ones life/health is infinite No, it isn't. People make all kinds of tradeoffs that place a finite value on their lives. What skews the health care market is that people do not see the actual cost of what they are getting; they only see a small fraction of that cost. So their demand is way out of proportion to the actual supply of health care. Further, because they can't see the actual costs, patients have no idea whether the health care they are getting is actually worth what they cost. (The lack of transparency about the actual effectiveness of health care doesn't help either.) > Healthcare doesn't really work in a capitalistic marketplace No, health care doesn't really work in a regulated marketplace where people are not given the information they need to make accurate judgments about what health care is worth its cost.
  - 2y ago
pdonis 2y ago
> Because you do not have to go to those places. Restaurants, yes. But supermarkets and car mechanics? Everyone has to eat, and everyone who has a car has to get it fixed sometimes. In fact, people need to eat much more often than they need health care--yet supermarkets are somehow able to provide a wide selection of food at reasonable prices. The same could be done for health care if it were a competitive free market instead of being regulated so heavily.
- II2II 2y ago
  > Everyone has to eat, and everyone who has a car has to get it fixed sometimes. I realize this isn't what you meant, but some people have gardens to supplement their food supply and some people repair their own car. I'm not a car owner, but I do repair my own bike and the reason for it is that the required parts and tools are usually much less expensive than a one-time repair (with the biggest expense, tools, being spread across multiple repairs). As for the regulation of health care, it exists for a reason. Some of those reasons are for the public good. You only need to look at alternative medicine to understand that there are a lot of snake oils salesmen out there. Letting people portray themselves as legitimate doctors would only muddy the water. Then there are factors such as competence. It is difficult enough to deal with in a regulated system, never mind an unregulated one.
  - pdonis 2y ago
    > As for the regulation of health care, it exists for a reason. One can argue that there are valid reasons to regulate health care. But, as I pointed out elsewhere in this discussion, similar reasons exist to regulate food, and we do regulate food for those reasons, but that doesn't prevent us from having free market competition in food suppliers.
  - Turing_Machine 2y ago
    > some people have gardens to supplement their food supply and some people repair their own car. Basically no one in the First World grows enough calories in their garden to make a significant difference, and repairing your own car nowadays generally requires buying lots of expen$ive test equipment. The days of the shade tree mechanic are sadly long over.
vt85 2y ago
[dead]
eviks 2y ago
>> super markets or car mechanics? > Because you do not have to go to those places. You do if you want to get food and don't grow everything yourself?

by jmclnx 2y ago

dartos 2y ago

My parents are dentists and most of the memories from when I was a kid (pre 2013) of my dad working was him dialing up and arguing with insurance providers. They’d send checks 6months late and often miss them. They also forced certain prices for him to stay “in-network” Insurances don’t seem to help anyone.

bluGill 2y ago
Insurance helps those who pay them. Just note that for most Americans they are not the one paying.
- dartos 2y ago
  For dental insurance, those insurance companies force healthcare providers to keep artificially high prices, even for out of network patients. For example, with my parent’s independent office, people would come in without insurance and unable to pay the high fees for say a filling or a crown. My parents were technically able to charge much lower prices (more than half off in the case of normal cleanings,) but were unable to because of the contract they had with their insurance network. Moreover, the listed price mandated by the insurance was not the same as the payout my parents received after filling the claim. (The payout was always less. Sometimes much less than the mandated price) I don’t see who benefits in this situation besides the insurance company. Even if my employer pays for my insurance, I still need to meet some premium most of the time. And what I pay is inflated because of the in-network contracts Consider also that, in the states at least, dental insurance is separate from medical.

srackey 2y ago

This is why other goods you absolutely need, like clothes, shoes, and food, are ALSO some of the most expensive out there.

sofixa 2y ago
But those are vastly more flexible. You can pick which clothes to buy from which store/vendor, you can buy second hand, you can get clothes donated. You can buy cheap filling food, in bulk, get by on rice and potatoes, etc. You can't get get a second hand operation or medicine.
- SkyBelow 2y ago
  They are more flexible because they are less regulated. Restaurants don't have a certificate of need to stop competitors from showing up. You can buy food internationally and have it shipped in if you can't find it locally for a reasonable price, but try to do the same with medication and you'll have a bad time. You can even look at less regulated medication, like pet meds, and see how much cheaper some are. We don't need to go that far, just like how people food is more regulated than pet food, but without being as regulated as our current market for healthcare.
  - harimau777 2y ago
    They don't need to be as highly regulated as medicine needs to be. Even children can learn most of the important elements of food safety (cook to a certain temperature, don't cross contaminate utensils, wash your hands, etc.). Much of medicine is vastly more complex than something like food safety or clothing safety.
  - XorNot 2y ago
    The funny thing is in Australia, pet medication always generates sticker shock because it's a lot more expensive for the consumer then PBS subsidized pharmaceuticals.
  - sofixa 2y ago
    > They are more flexible because they are less regulated No, because when your tooth hurts now, or you're bleeding now, or you need to get vaccinated to avoid you getting hepatitis, there's very little choice in the matter. Healthcare is a fundamentally inelastic good. A dangerous one too, because bad quality healthcare can literally kill people. Inaccessibility of healthcare kills people too. Look, there is no need to reinvent the wheel here. The US can look into any other developed country on the planet for inspiration. Every single one of them has a better, more accessible, cheaper for everyone involved, usually more or at least differently regulated, with better outcomes, model. > No Way to Prevent This,' Says Only Nation Where This Regularly Happens

SkyBelow 2y ago

>Because you do not have to go to those places. Food is an extreme need, and while there are many types of businesses that provide food, we can wrap those up into one larger class of food provider businesses and ask why they aren't being captured and squeezed. Sure, some are to hunt or garden, but that number is far too small when you think of places with the highest concentrations of people. Food even has regulations, but it manages to not lead to monopolies that can charge whatever they want because if the price goes too high, other players can jump through the hoops to enter the market. The regulation on healthcare has reached the point of a stranglehold.

Eddy_Viscosity2 2y ago
> why they aren't being captured and squeezed. They are. Maybe not by PE, but capitalism finds a way. This isn't the first time either the two big grocery chains in Canada have a long history of exploiting market dominance to screw over people who want to eat. https://www.ctvnews.ca/business/competition-bureau-probes-alleged-anticompetitive-conduct-by-loblaws-sobeys-owners-1.6899175 https://www.ctvnews.ca/business/competition-bureau-probes-al...
harimau777 2y ago
It's much easier to switch to different options with food than it is with healthcare. For example, if cartel forms around tropical fruits, people can switch to apples. This makes it much more difficult for someone to exert market power over the food market than over the medical market. Medical care also often involves crisis situations where you absolutely need care right now so you don't have much leverage. On the other hand, most of the time people have some flexibility in how much they eat, when they eat, and what they eat.
- SkyBelow 2y ago
  Healthcare prices aren't only high for emergency care, so it shows that the emergency nature of the work isn't the issue. I'm sure doing a statistical regression would show roughly what percentage of the issue is due to it, but I would expect it to be very low given the prices of things like medication needed on an ongoing basis where one could shop around, if it was legal to do so. One can also look at elective or non-emergency surgeries, especially those where people use medical tourism to find cheaper options. That is an extreme form of shopping around, which they have to do because more local forms of shopping around are legally banned.

bko 2y ago

Lots of people don't go to the doctor when they probably should. Most spending isn't emergency room visits. I imagine prob half is connected to obesity and smoking. Just lose weight and you don't have to go. The health insurance profit margin is around 3.3%. Maybe they're just bad at extortion There are certain topics people feel very strongly about with no insight or experience, they say things that are demonstrably false and refuse to look at it objectively. Unfortunately US healthcare is one of those https://content.naic.org/sites/default/files/inline-files/health-2022-mid-year-industry-report.pdf https://content.naic.org/sites/default/files/inline-files/he...

faster 2y ago
A long time ago I worked for a company that had a "cost plus" contract to build and operate a thing. I took a management class while I was there and one of the people in the class was a consultant who had been hired to map the division's revenue flow. Almost everyone there was a manager and all of them were on the edge of their seats while he explained. Basically, you mark up the little stuff that everything is built on ($1/page for copies, for example) so the margins look smaller when you get to anything substantial. So 3.3% is a meaningless number until it has been audited all the way down to the smallest purchases.
- bko 2y ago
  Well if the market price for something is X and your margins are small but X is big you do well. But someone can innovate and do it for half X and now his margins are 50% so he makes more money. The question is why can't I provide insurance at the market price and just bring in efficiencies to get my cost down and margin up? The reason is that it's not a real market through onerous regulations. People are forced to buy it, new entrants aren't allowed and there is an implicit threat that if margins get big politicians will come after you. So were stuck in this crappy system

Arnt 2y ago

Are you saying the medicine is necessary, unlike food?

cogman10 2y ago
No, they are saying medicine is necessary unlike restaurants. But further, medicine has extremely low competition at all levels. There are few companies producing penicillin, you likely don't have a lot of options for hospital care (especially if you need a specialist), and your insurance was likely not something you picked. Compare that to food, where you can get it from multiple grocery stores, gas stations, or even order it online. If you are in a place with 1 restaurant it's highly likely there are 10 competing restaurants. Heck, if you have some land you can even grow your own food in a garden. Medicine is a necessity with few providers which makes it a particularly bad fit for capitalism. It can't be made cheaper or more available by cutting regulations. They are necessary to keep the industry from killing people.
- pdonis 2y ago
  > they are saying medicine is necessary unlike restaurants. But not unlike supermarkets, which were also mentioned. > Medicine is a necessity with few providers which makes it a particularly bad fit for capitalism Medicine does not have few providers because of "capitalism". It has few providers because of regulation that artificially limits the supply of providers. In a free market, the market would provide whatever supply of providers is needed to meet people's health care needs in the most efficient way. But regulation prevents that from happening. > They are necessary to keep the industry from killing people. Yet somehow we manage to have regulations to prevent food from killing people, without restricting the supply of supermarkets, and without impairing competition among them. We could do the same for health care.
  - Arnt 2y ago
    Supermarkets is exactly what I had in mind, but perhaps it was stupid. The cost of health care is kind of… a×b+c×d, except more complicated, where a is the hourly cost of a physician, b is the number of times you get an hour's care, c is the cost of a pill and d is the number of pills you get. Want the total sum to decrease? Then pick which one of a, b, c and d you want to decrease, and look at whether competition can help. A lot of this thread sounds like just "private equity is evil and therefore guilty", nothing to do with goal-directed efficacy.

refurb 2y ago

> Because you do not have to go to those places. What do you mean? I do absolutely need to go to grocery stores. I would starve otherwise?

KittenInABox 2y ago
You do not need to go to a specific grocery store that is the only one available within X miles from you. For me, I have 2 walkable stores, 4-5 bikeable stores, and 10+ via Instacart.
- pdonis 2y ago
  Exactly. Now imagine that the same were true for health care.
- refurb 2y ago
  How is healthcare different? Do you not have multiple doctors you can go to? Weren’t not talking about insurance networks. We’re talking about how healthcare can’t be free market. Insurance networks aren’t a requirement of a free market. There are private healthcare systems that don’t have networks.
  - KittenInABox 2y ago
    Generally, no I don't. I have basically two hospital systems to choose from. All specialists I require seeing are only available in these two hospital systems if I want to be covered by my insurance. I can see a variety of primary care physicians, but I cannot see e.g. a rheumatologist outside specific hospital conglomerates.
    - refurb 2y ago
      > if I want to be covered by my insurance But insurance networks aren't a requirement of free markets. So your argument that in today's system (only one form of a free market for healthcare) proves free markets don't work is ignoring alternatives. It sounds like you actually would have plenty of physicians to choose from, just like when you buy food.

jibe 2y ago

Because you do not have to go to those places. Everyone has to eat, so everyone except a small number of farmers does have to go to either restaurants or markets.

s1artibartfast 2y ago
The price of filet mignon has not gone up because everyone has to eat it. Unless someone is on a subsistence diet, there are tradeoffs taking place.

brigadier132 2y ago

> Because you do not have to go to those places. You don't need to go to college either but prices for that have gone up more than 10x. If anything, I can skip going to the doctor for a very long time because of cost (and people do unfortunately). > They were talking about the trend of For Profit Health Care, the outcome they came up with was prices will eventually raise up to extortion levels, why, because that is what everyone needs. Healthcare has always been for profit.

thereddaikon 2y ago
The reason college costs have gone up is because the government decided to make it so anyone could get college loans and they couldn't discharge them through bankruptcy. Then the public education system told everyone that if you don't go to college you'll be a poor loser. So while you don't have to go to college in the strictest sense, you have the same effect. Everyone does because they are told they must. And the schools know they are guaranteed those sweet federal loans which have strings on the naïve 17 year olds but none on the colleges. Why not raise prices? Why not build unnecessary ego projects? The incentive is to lower standards, enroll as many students as possible and raise tuition. Even state universities do this.
- yterdy 2y ago
  It should be noted that "told they must" is not simply bad Boomer advice, but a reflection of the reality that the vast majority of white-collar work (even work that must mostly be trained on-the-job, due to the particular policies and protocols of any given business) requires a Bachelor's degree be on your resume if you don't want your application binned immediately.
  - thereddaikon 2y ago
    Excellent point. I work in IT and for years there weren't IT specific degrees from state universities. My degree is completely unrelated and it never was really a factor in hiring because a BS in IT wasn't a thing. Until the last few years it is now. And every young aspiring IT professional with one of those degrees I've spoken to or worked with had a similar experience. Its a useless degree that doesn't prepare you for the industry. I was expecting they would walk out with a good, broad foundation and some good industry certs to match but that's not the case. Its all theory, little to no application and huge knowledge gaps. They were scammed. I feel like my history degree is more applicable. At least it taught me how to write decently. Why do these IT BS's exist? It must be just to sell kids another piece of paper. Tech got big enough that the education cartel decided they needed to gatekeep it.

the_real_cher 2y ago

It's a case of prices following the law of supply and demand for ones life/health is infinite. Healthcare doesn't really work in a capitalistic marketplace.

nojvek 2y ago
Demand isn’t quite infinite. It’s ~350 million people but supply is quite limited. Same with housing. Demand is increasing faster than supply hence price increases. Price increases make housing a great financial instrument due to ease of getting mortgage loans. Also why we need to have a sane immigration strategy. Can’t bring in too many people too fast (like Canada) Private equity is playing cards on the arbitrage that any asset that increases in demand much faster than supply, and can be loan leveraged is a great investment.
- the_real_cher 2y ago
  I mean the demand for anything is 350 million people. But most things people have a price ceiling they're willing to pay. Health care there is no price people won't pay for their lives, so the demand ceiling is essentially the entire net worth of the entire population
pdonis 2y ago
> demand for ones life/health is infinite No, it isn't. People make all kinds of tradeoffs that place a finite value on their lives. What skews the health care market is that people do not see the actual cost of what they are getting; they only see a small fraction of that cost. So their demand is way out of proportion to the actual supply of health care. Further, because they can't see the actual costs, patients have no idea whether the health care they are getting is actually worth what they cost. (The lack of transparency about the actual effectiveness of health care doesn't help either.) > Healthcare doesn't really work in a capitalistic marketplace No, health care doesn't really work in a regulated marketplace where people are not given the information they need to make accurate judgments about what health care is worth its cost.
- 2y ago

pdonis 2y ago

> Because you do not have to go to those places. Restaurants, yes. But supermarkets and car mechanics? Everyone has to eat, and everyone who has a car has to get it fixed sometimes. In fact, people need to eat much more often than they need health care--yet supermarkets are somehow able to provide a wide selection of food at reasonable prices. The same could be done for health care if it were a competitive free market instead of being regulated so heavily.

II2II 2y ago
> Everyone has to eat, and everyone who has a car has to get it fixed sometimes. I realize this isn't what you meant, but some people have gardens to supplement their food supply and some people repair their own car. I'm not a car owner, but I do repair my own bike and the reason for it is that the required parts and tools are usually much less expensive than a one-time repair (with the biggest expense, tools, being spread across multiple repairs). As for the regulation of health care, it exists for a reason. Some of those reasons are for the public good. You only need to look at alternative medicine to understand that there are a lot of snake oils salesmen out there. Letting people portray themselves as legitimate doctors would only muddy the water. Then there are factors such as competence. It is difficult enough to deal with in a regulated system, never mind an unregulated one.
- pdonis 2y ago
  > As for the regulation of health care, it exists for a reason. One can argue that there are valid reasons to regulate health care. But, as I pointed out elsewhere in this discussion, similar reasons exist to regulate food, and we do regulate food for those reasons, but that doesn't prevent us from having free market competition in food suppliers.
- Turing_Machine 2y ago
  > some people have gardens to supplement their food supply and some people repair their own car. Basically no one in the First World grows enough calories in their garden to make a significant difference, and repairing your own car nowadays generally requires buying lots of expen$ive test equipment. The days of the shade tree mechanic are sadly long over.

vt85 2y ago

[dead]

eviks 2y ago

>> super markets or car mechanics? > Because you do not have to go to those places. You do if you want to get food and don't grow everything yourself?