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In all sane markets, the buyer is both the person who selects the goods to purchase, and the one who pays the price agreed upon. These things seem linked, but i

In all sane markets, the buyer is both the person who selects the goods to purchase, and the one who pays the price agreed upon. These things seem linked, but it turns out it's really easy for them to be separated. When medical care is funded by health insurance, you are the person who selects the goods, but you're not the one that pays the price. In some cases, you will never even be informed of the price, you don't want to be. And you rarely find out unless there are "problems". The insurer doesn't worry if the bills are high, they'll just raise your premiums... but your monkey brain never makes the connection that your poor goods selection resulted in the higher price. It might even be unfair to blame you, even if you are careful which products you purchase, someone else was curious and you're punished with them. This incentivizes you to be less careful, not more. But if bills are really getting out of hand, the insurance company can just deny the claim. This incentivizes the medical care provider to raise the number on the bills. If half of claims are denied, just double the bills and the math works out. The medical care provider is incentivized to get tricky with the billing codes, to obfuscate, to over-complicate. Over decades, a culture of being borderline fraudulent develops, a mythology that it's impossible to even know the costs upfront. If I wanted to invent a machine that would cause prices to spiral out of control at the fastest possible rate, I don't think I could beat this. > public education By all means, I wish medical care could be as wonderful as public education. We could have the excellence of inner city Baltimore schools, coupled with the overabundance of service we see in California schools and the high levels of compensation of the average nationwide teacher salaries. Never mind the great outcomes that institution provides.

dgb23 2y ago
I'm not American so I don't know whether the last paragraph is sarcastic or not. But from the tone I guess it is. Public education where I live is not perfect, but it works well and teachers are compensated fairly. I consider it one of the bedrocks of a democratic society. In know of people who went to public schools in America and have said good things about it. From my very limited knowledge it seems like the quality of public schools varies a lot from area to area though.
- rickydroll 2y ago
  I am American and since it's been mumble mumble years since the public school system, I'm sure the situation is changed. I grew up in a factory town and they did a pretty good job teaching the basics of English, mathematics, and science. Going to college was a bit of a shock but that's a well-known problem. Nowadays, it is incredibly variable because school systems are funded at the local level, most the curricula is decided at the local level so you can go from a very well-funded high-quality teacher school like the Newton, Wellesley, and Weston high schools to the low income areas out West where the public school system has been outsourced to Christian schools. I also think the public school system is a bedrock of a democratic society if the curriculum is uniform and covers critical thinking, history, literature, and sciences without flinching. I feel like we need to draw a line in the sand and say what someone needs to know to be a citizen of this country. The problem is, there are lots of different opinions where that line should go ranging from the religious and racist to the equally dogmatic far left.
- stvltvs 2y ago
  It's sarcasm. I think it's misguided to point at the failures of one chronically underfunded public function to say that another would also perform poorly, unless the point is to say we would probably underfund public health care as well.

dgb23 2y ago

I'm not American so I don't know whether the last paragraph is sarcastic or not. But from the tone I guess it is. Public education where I live is not perfect, but it works well and teachers are compensated fairly. I consider it one of the bedrocks of a democratic society. In know of people who went to public schools in America and have said good things about it. From my very limited knowledge it seems like the quality of public schools varies a lot from area to area though.

rickydroll 2y ago
I am American and since it's been mumble mumble years since the public school system, I'm sure the situation is changed. I grew up in a factory town and they did a pretty good job teaching the basics of English, mathematics, and science. Going to college was a bit of a shock but that's a well-known problem. Nowadays, it is incredibly variable because school systems are funded at the local level, most the curricula is decided at the local level so you can go from a very well-funded high-quality teacher school like the Newton, Wellesley, and Weston high schools to the low income areas out West where the public school system has been outsourced to Christian schools. I also think the public school system is a bedrock of a democratic society if the curriculum is uniform and covers critical thinking, history, literature, and sciences without flinching. I feel like we need to draw a line in the sand and say what someone needs to know to be a citizen of this country. The problem is, there are lots of different opinions where that line should go ranging from the religious and racist to the equally dogmatic far left.
stvltvs 2y ago
It's sarcasm. I think it's misguided to point at the failures of one chronically underfunded public function to say that another would also perform poorly, unless the point is to say we would probably underfund public health care as well.