4 ms·

Spot on. I would also add that it's extremely inelastic. If you want to stay alive, you don't have a choice as to whether you need healthcare. Capitalism is am

Spot on. I would also add that it's extremely inelastic. If you want to stay alive, you don't have a choice as to whether you need healthcare. Capitalism is amazing except for where market failures occur, which is many cases. The industries that suck the most also have the most market failures: healthcare, housing, and education

coredog64 2y ago
Not every healthcare intervention is a matter of life and death. If you get your glasses today or next week, you’re still generally better off. Once we stop motte-and-baileying this, then we can have productive discussions that identify cases where market capitalism actually does work and then fortify the cases where it doesn’t.
- quantified 2y ago
  We can define healthcare more or less expansively. Seeing clearly, like many things, is sorr of optional of course. But the example of glasses is interesting in its own way with the predatory pricing of the Essilor-Luxottica monopoly on opticians' offices.
- dgb23 2y ago
  I generally agree with this take. But it's not easy to draw that line. There are obvious cases and many non-obvious ones. To make an exaggerated point: Medical research is not too far off from throwing things at the wall and seeing what sticks. A lot of working therapies and drugs aren't as well understood as one would hope. Also it's incredibly complicated. I'm thinking of preventative measures, psychosomatic symptoms, rare conditions, varying sensitivity, long term risks and so on. There's just no easy answer to any of those things. In a perfect world, you'd have the social control by families and communities combined with the expertise of health care professionals that determine where the line is on a case by case basis.
- mindslight 2y ago
  > Once we stop motte-and-baileying this, then we can have productive discussions that identify cases where market capitalism actually does work and then fortify the cases where it doesn’t. Well said, 100% this. It's also worth noting that so many things that one might abstractly think of as matters of life and death are currently being provided on a "sometime in the next several months if you're lucky" basis. There are surely some aspects of healthcare that can never really have a functioning market dynamic, like emergency care. But the vast majority of medical care is provided not at the speed of cardiac monitor beeping, but rather at the speed of scheduled appointments and billable events. What we really have is one big market failure due to criminal behavior of "insurance" companies (price fixing and restraint of trade) as well as providers (collusion and extortion). I'd say that no matter who may be ultimately paying, two critical first steps to restoring some patient agency are outlawing "insurance" "networks" and outlawing post-facto billing shakedowns.
- maxerickson 2y ago
  Stuff like glasses and dental work mostly works ok in the US, because employers provide limited coverage. You can buy really expensive glasses, but they aren't the only option.
baggy_trough 2y ago
> The industries that suck the most also have the most market failures: healthcare, housing, and education The healthcare, housing, and education industries are some of the most highly regulated. Which came first, the market failure or the regulation?
- spencerchubb 2y ago
  Market failure came before regulation. Standard Oil had a monopoly in the oil industry, so antitrust became a thing. There was information asymmetry around food and drugs, because there's no way for a consumer to really know what's in a food or a drug. So the FDA mandates that they put out accurate info with penalties for incorrect info. Information asymmetry and moral hazard led to 2008 financial crisis, which then led to Dodd-Frank reform
  - baggy_trough 2y ago
    At this point I think it's quite obvious that the cure is worse than the disease.
    - spencerchubb 2y ago
      Not obvious to me! How is the cure obviously worse?
VancouverMan 2y ago
> Capitalism is amazing except for where market failures occur, which is many cases. The industries that suck the most also have the most market failures: healthcare, housing, and education Those sectors you listed are actually among the least-capitalist and least-free-market in many locations. They typically involve widespread and extremely invasive government interference that leads to significant inefficiency, service quality problems, and pricing distortions. The healthcare industry, for example, is highly regulated in most jurisdictions. This eliminates most (or potentially even all, in particularly socialist systems) competition, which in turn eliminates consumer choice and also eliminates the incentives needed to ensure everybody involved behaves efficiently. The housing industry is also highly regulated in most jurisdictions, and especially in urban areas where demand for housing can be highest. Restrictive zoning regulations, overzealous development review processes, unrealistic building codes, and financial system regulation result in a variety of market distortions that in turn can negatively affect the supply of available housing, the type and quality of housing that is built, rental rates, and purchase prices. The education sector has perhaps the most government involvement of the examples you gave. In many places, it's provided directly by the government itself. Even if private options do happen to exist, they're often subjected to government-imposed accreditation and curriculum restrictions that neuter their independence. The situation can get particularly bad once government funding gets involved, especially in higher education, which can introduce severe tuition pricing distortions, inefficient use of resources, and so forth. When a so-called "market failure" occurs, it's usually because there isn't actually a free market involved at all, but rather significant government interference and other socialist policies.
- soco 2y ago
  Please explain like I'm 5 how the US private healthcare insurance system is a socialist policy. Also with comparison with actual democratic socialist countries which somehow manage to provide healthcare without those major hiccups as seen in the land of the free (screech)
- spencerchubb 2y ago
  Have you ever wondered why those sectors have the most government intervention? It's precisely because those sectors are prone to market failure. Of course government intervention has flaws too. I hope that we can make our government smarter and more effective over time.

coredog64 2y ago

Not every healthcare intervention is a matter of life and death. If you get your glasses today or next week, you’re still generally better off. Once we stop motte-and-baileying this, then we can have productive discussions that identify cases where market capitalism actually does work and then fortify the cases where it doesn’t.

quantified 2y ago
We can define healthcare more or less expansively. Seeing clearly, like many things, is sorr of optional of course. But the example of glasses is interesting in its own way with the predatory pricing of the Essilor-Luxottica monopoly on opticians' offices.
dgb23 2y ago
I generally agree with this take. But it's not easy to draw that line. There are obvious cases and many non-obvious ones. To make an exaggerated point: Medical research is not too far off from throwing things at the wall and seeing what sticks. A lot of working therapies and drugs aren't as well understood as one would hope. Also it's incredibly complicated. I'm thinking of preventative measures, psychosomatic symptoms, rare conditions, varying sensitivity, long term risks and so on. There's just no easy answer to any of those things. In a perfect world, you'd have the social control by families and communities combined with the expertise of health care professionals that determine where the line is on a case by case basis.
mindslight 2y ago
> Once we stop motte-and-baileying this, then we can have productive discussions that identify cases where market capitalism actually does work and then fortify the cases where it doesn’t. Well said, 100% this. It's also worth noting that so many things that one might abstractly think of as matters of life and death are currently being provided on a "sometime in the next several months if you're lucky" basis. There are surely some aspects of healthcare that can never really have a functioning market dynamic, like emergency care. But the vast majority of medical care is provided not at the speed of cardiac monitor beeping, but rather at the speed of scheduled appointments and billable events. What we really have is one big market failure due to criminal behavior of "insurance" companies (price fixing and restraint of trade) as well as providers (collusion and extortion). I'd say that no matter who may be ultimately paying, two critical first steps to restoring some patient agency are outlawing "insurance" "networks" and outlawing post-facto billing shakedowns.
maxerickson 2y ago
Stuff like glasses and dental work mostly works ok in the US, because employers provide limited coverage. You can buy really expensive glasses, but they aren't the only option.

baggy_trough 2y ago

> The industries that suck the most also have the most market failures: healthcare, housing, and education The healthcare, housing, and education industries are some of the most highly regulated. Which came first, the market failure or the regulation?

spencerchubb 2y ago
Market failure came before regulation. Standard Oil had a monopoly in the oil industry, so antitrust became a thing. There was information asymmetry around food and drugs, because there's no way for a consumer to really know what's in a food or a drug. So the FDA mandates that they put out accurate info with penalties for incorrect info. Information asymmetry and moral hazard led to 2008 financial crisis, which then led to Dodd-Frank reform
- baggy_trough 2y ago
  At this point I think it's quite obvious that the cure is worse than the disease.
  - spencerchubb 2y ago
    Not obvious to me! How is the cure obviously worse?

VancouverMan 2y ago

> Capitalism is amazing except for where market failures occur, which is many cases. The industries that suck the most also have the most market failures: healthcare, housing, and education Those sectors you listed are actually among the least-capitalist and least-free-market in many locations. They typically involve widespread and extremely invasive government interference that leads to significant inefficiency, service quality problems, and pricing distortions. The healthcare industry, for example, is highly regulated in most jurisdictions. This eliminates most (or potentially even all, in particularly socialist systems) competition, which in turn eliminates consumer choice and also eliminates the incentives needed to ensure everybody involved behaves efficiently. The housing industry is also highly regulated in most jurisdictions, and especially in urban areas where demand for housing can be highest. Restrictive zoning regulations, overzealous development review processes, unrealistic building codes, and financial system regulation result in a variety of market distortions that in turn can negatively affect the supply of available housing, the type and quality of housing that is built, rental rates, and purchase prices. The education sector has perhaps the most government involvement of the examples you gave. In many places, it's provided directly by the government itself. Even if private options do happen to exist, they're often subjected to government-imposed accreditation and curriculum restrictions that neuter their independence. The situation can get particularly bad once government funding gets involved, especially in higher education, which can introduce severe tuition pricing distortions, inefficient use of resources, and so forth. When a so-called "market failure" occurs, it's usually because there isn't actually a free market involved at all, but rather significant government interference and other socialist policies.

soco 2y ago
Please explain like I'm 5 how the US private healthcare insurance system is a socialist policy. Also with comparison with actual democratic socialist countries which somehow manage to provide healthcare without those major hiccups as seen in the land of the free (screech)
spencerchubb 2y ago
Have you ever wondered why those sectors have the most government intervention? It's precisely because those sectors are prone to market failure. Of course government intervention has flaws too. I hope that we can make our government smarter and more effective over time.