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Am I right in reading that this guy's message is "this is a systemic problem", but primarily just complaining that spending is too high, and that somehow health

Am I right in reading that this guy's message is "this is a systemic problem", but primarily just complaining that spending is too high, and that somehow healthcare spending will collapse society? High healthcare spending that was effective would be great! A healthy population is a productive population, not to mention the moral benefits. The problem is not at all that we spend too much, it's that we toss the money at a loosely regulated market that captures the value rather than using it to deliver excellent results. This is the predictable outcome of any market that can push costs onto externalities or that defeats competition. Some markets are incompatible with competition, and the best you can do in those cases is nationalization with oversight. You can't meaningfully vote with your wallet when you're willing to pay anything for treatment, so at the cost of the optimizing force of markets we fall back to voting with our actual votes for the policy we want. This doesn't guarantee a perfect healthcare system, but it does give better outcomes than what we get by trying to force it into a marketplace.

spyckie2 2y ago
My wife and I recently applied to receive a breast pump covered by insurance because why not? She is pregnant and while it is not certain she will need it, it’s better to be safe than sorry right? We got the breast pump, some Chinese product that, on Amazon, retails for no more than 50$. Given the quality I was frankly surprised to see that the health insurance had been charged 300$. Not even the iPhone of breast pumps in the market would cost that much. It was vendored to us by some organization that is no doubt making a living from selling cheap Chinese produced breast pumps and charging a 600% markup. This is the exact same thing that is happening to Tylenol, a 50 cent drug that is marked up to 79$ when given at a hospital. To ambulance trips. To routine checkups. To medical exams. To X-rays and to cat scans. Literally everything that is covered by insurance is enjoying exorbitant mark ups. Buyers can’t vote with their wallets because there is no choice. The illusion of choice is barely even there, as difference health insurance coverage covers the same things only at different price points. As a buyer of health insurance you can’t not pay for the 300$ breast pump, or the 79$ Tylenol. There is no choice you can choose to avoid that. And since I bought the $300 dollar breast pump, I contributed to the bloated premiums by causing the expenses for breast pumps to be much higher than it needs to be. So I should apologize to you all. But of course I have no option except to make premiums higher for all of you because I want my wife to have a breast pump. There is no other way to fix any of this nonsense except to socialize healthcare completely.
- jtwaleson 2y ago
  The device itself probably cost $50 to manufacture, but it's a medical device which is strictly regulated. You're also paying for the additional quality control, the regulatory approval, the post-market surveillance studies etc. There is a lot of legally required overhead when you do business in regulated industries. Some of it necessary, other things maybe not so much. It will be interesting to see if DOGE/Musk/Trump will actually change any of this. Agreed about the absurdity of the Tylenol though.
  - spyckie2 2y ago
    https://a.co/d/63gQ3Kl https://a.co/d/63gQ3Kl I sympathize with strict regulation but the market sells the exact same “medical device” at much lower cost and my point stands - there is no option to pay market price for a breast pump instead of the insurance hiked price, regardless of whether it is a 3rd party pocketing the margin or if the margin is the cost of additional regulation.
    - jtwaleson 2y ago
      Agreed!
  - idle_zealot 2y ago
    Why on Earth would reducing regulatory overhead decrease medical device/drug costs? That would only be the case if competition had already driven costs down as much as possible and margins were thin. If companies are currently able to charge high margins and their costs are lowered why would they choose to pass on any savings to buyers? Surely they would just maintain their prices and capture more profit.
    - jtwaleson 2y ago
      To be honest I didn't think about the price changes. Having been in the medical devices industry I'm just curious if the regulations are actually going to change.
- 2y ago
lxgr 2y ago
> High healthcare spending that was effective would be great! There's still obvious limits. Imagine everybody spending 80% of their income on healthcare, of which 100% goes to doctors performing effective and required procedures: Society would still collapse, since people do have needs other than healthcare.

spyckie2 2y ago

My wife and I recently applied to receive a breast pump covered by insurance because why not? She is pregnant and while it is not certain she will need it, it’s better to be safe than sorry right? We got the breast pump, some Chinese product that, on Amazon, retails for no more than 50$. Given the quality I was frankly surprised to see that the health insurance had been charged 300$. Not even the iPhone of breast pumps in the market would cost that much. It was vendored to us by some organization that is no doubt making a living from selling cheap Chinese produced breast pumps and charging a 600% markup. This is the exact same thing that is happening to Tylenol, a 50 cent drug that is marked up to 79$ when given at a hospital. To ambulance trips. To routine checkups. To medical exams. To X-rays and to cat scans. Literally everything that is covered by insurance is enjoying exorbitant mark ups. Buyers can’t vote with their wallets because there is no choice. The illusion of choice is barely even there, as difference health insurance coverage covers the same things only at different price points. As a buyer of health insurance you can’t not pay for the 300$ breast pump, or the 79$ Tylenol. There is no choice you can choose to avoid that. And since I bought the $300 dollar breast pump, I contributed to the bloated premiums by causing the expenses for breast pumps to be much higher than it needs to be. So I should apologize to you all. But of course I have no option except to make premiums higher for all of you because I want my wife to have a breast pump. There is no other way to fix any of this nonsense except to socialize healthcare completely.

jtwaleson 2y ago
The device itself probably cost $50 to manufacture, but it's a medical device which is strictly regulated. You're also paying for the additional quality control, the regulatory approval, the post-market surveillance studies etc. There is a lot of legally required overhead when you do business in regulated industries. Some of it necessary, other things maybe not so much. It will be interesting to see if DOGE/Musk/Trump will actually change any of this. Agreed about the absurdity of the Tylenol though.
- spyckie2 2y ago
  https://a.co/d/63gQ3Kl https://a.co/d/63gQ3Kl I sympathize with strict regulation but the market sells the exact same “medical device” at much lower cost and my point stands - there is no option to pay market price for a breast pump instead of the insurance hiked price, regardless of whether it is a 3rd party pocketing the margin or if the margin is the cost of additional regulation.
  - jtwaleson 2y ago
    Agreed!
- idle_zealot 2y ago
  Why on Earth would reducing regulatory overhead decrease medical device/drug costs? That would only be the case if competition had already driven costs down as much as possible and margins were thin. If companies are currently able to charge high margins and their costs are lowered why would they choose to pass on any savings to buyers? Surely they would just maintain their prices and capture more profit.
  - jtwaleson 2y ago
    To be honest I didn't think about the price changes. Having been in the medical devices industry I'm just curious if the regulations are actually going to change.
2y ago

lxgr 2y ago

> High healthcare spending that was effective would be great! There's still obvious limits. Imagine everybody spending 80% of their income on healthcare, of which 100% goes to doctors performing effective and required procedures: Society would still collapse, since people do have needs other than healthcare.