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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 m

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.

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.