4 ms·

This is exactly what is wrong with health care in a free market. if you had an operation with a 10% chance of failure for $5000, would you take it? What if yo

This is exactly what is wrong with health care in a free market. if you had an operation with a 10% chance of failure for $5000, would you take it? What if you could spend twice the money and cut your risk down to 5% if you quadrupled the expense? $20000, even I'd take that option for you, as an objective observer. what if you could cut it down to 4% for $50000? Ok now it's getting a little silly, but it's still your life. what if you could cut it down to 4.75% for $100000? Don't you deserve the best? I mean this is your LIFE. In anything else this would be a silly investment, but your life? You can't take chances. It's a bizzare choice, but really the only rational one in your situation, you have to survive. So the thinking goes, we are incapable of negotiating for our own lives. To the point where it blinds us, by choosing that expense you doom the ones who can not afford it.

ctdonath 13y ago
This is exactly how economic reality works. Yes, your very life is subject to the costs of diminishing returns. We can't guarantee everyone the very best because it costs too much, and we can't force people to spend less on their life than they can afford and choose to spend because it's not yours to distribute. Tough choices aren't easy.
gvb 13y ago
The problem is that people want 0% risk and have someone else pay the infinite price tag.
ctdonath 13y ago
choosing that expense you doom the ones who can not afford it. Do I? Elsewhere in this thread is a post about a surgeon greatly improving the lives of those who cannot afford it by buying a used laparoscopic tool and creatively applying it. I've had laparoscopic surgery; thanks to the high price I & others pay, the laparoscopic instruments used may have replaced the very same one that Indian doctor is using. Far from "dooming the ones who cannot afford it", the system which regularly replaces top-end tools makes entirely acceptable equipment very affordable to regions which can't pay top-end prices. Disallow me from paying an extra $50,000 to get that extra 0.75% survival odds, and the surgeon very well may not buy that next-generation laparoscopic tool and, as a consequence, sell the still-perfectly-good used one at low cost ... making it possible for another doctor to increase the survival rate for his patients by 5%.
- GhotiFish 13y ago
  Are you sure that the constant push to the top-end lowers average prices? If we spend all our time making lamborghinis, that means that the old lamborghinis will be cheaper thus cars more affordable? I doubt this strategy. Make more laproscopic tools. Rather than tell your economic inferiors to live off your scraps. The healthcare market cannot chose to capture deadweight losses. People would view health care professionals treating rich and poor with different medical standards as an abomination. There is no Healthcare basic edition, Home basic, Home premium, Professional, Ultimate. If you raise the general cost of a heart surgery from $50K to $55K, and lower the mortatilty rate from 5% to 4.5%. Does the amount of people you save with that 0.5% worth the amount of people who can't make it to 55K, but could make it to 50K? Are you sure these numbers are in your favor? Well, I mean, yes of course they're in your favor, I mean everyone, as a whole.
maxharris 13y ago
This is exactly what is wrong with health care in a free market. What free market are you talking about? Medicare effectively controls the prices of medical procedures (since insurance companies reimburse non-Medicare recipients on the basis of tables the government puts out). It also controls the number of doctors (it does this by limiting the number of residency slots - see the Balanced Budget Act of 1997). The FDA regulates everything from the development and testing to packaging and marketing of drugs, medical devices and related products. Due to federal regulations, physicians are not permitted to discuss prices with one another. There are countless regulations that manipulate health insurance. And don't forget the 1943 IRS ruling that permanently established the link between health insurance and your employer. And this is all stuff that's mostly decades before Obamacare. That just scratches the surface. For example, I didn't even mention HMOs, which were created under Nixon via another set of regulations intended to control costs for things Johnson had done. A free market in health care? If there's one thing American health care has not had in the last 50 years, it's a free market. Sure, it has been slightly freer than in other countries, but that's not saying much.

ctdonath 13y ago

This is exactly how economic reality works. Yes, your very life is subject to the costs of diminishing returns. We can't guarantee everyone the very best because it costs too much, and we can't force people to spend less on their life than they can afford and choose to spend because it's not yours to distribute. Tough choices aren't easy.

gvb 13y ago

The problem is that people want 0% risk and have someone else pay the infinite price tag.

ctdonath 13y ago

choosing that expense you doom the ones who can not afford it. Do I? Elsewhere in this thread is a post about a surgeon greatly improving the lives of those who cannot afford it by buying a used laparoscopic tool and creatively applying it. I've had laparoscopic surgery; thanks to the high price I & others pay, the laparoscopic instruments used may have replaced the very same one that Indian doctor is using. Far from "dooming the ones who cannot afford it", the system which regularly replaces top-end tools makes entirely acceptable equipment very affordable to regions which can't pay top-end prices. Disallow me from paying an extra $50,000 to get that extra 0.75% survival odds, and the surgeon very well may not buy that next-generation laparoscopic tool and, as a consequence, sell the still-perfectly-good used one at low cost ... making it possible for another doctor to increase the survival rate for his patients by 5%.

GhotiFish 13y ago
Are you sure that the constant push to the top-end lowers average prices? If we spend all our time making lamborghinis, that means that the old lamborghinis will be cheaper thus cars more affordable? I doubt this strategy. Make more laproscopic tools. Rather than tell your economic inferiors to live off your scraps. The healthcare market cannot chose to capture deadweight losses. People would view health care professionals treating rich and poor with different medical standards as an abomination. There is no Healthcare basic edition, Home basic, Home premium, Professional, Ultimate. If you raise the general cost of a heart surgery from $50K to $55K, and lower the mortatilty rate from 5% to 4.5%. Does the amount of people you save with that 0.5% worth the amount of people who can't make it to 55K, but could make it to 50K? Are you sure these numbers are in your favor? Well, I mean, yes of course they're in your favor, I mean everyone, as a whole.

maxharris 13y ago

This is exactly what is wrong with health care in a free market. What free market are you talking about? Medicare effectively controls the prices of medical procedures (since insurance companies reimburse non-Medicare recipients on the basis of tables the government puts out). It also controls the number of doctors (it does this by limiting the number of residency slots - see the Balanced Budget Act of 1997). The FDA regulates everything from the development and testing to packaging and marketing of drugs, medical devices and related products. Due to federal regulations, physicians are not permitted to discuss prices with one another. There are countless regulations that manipulate health insurance. And don't forget the 1943 IRS ruling that permanently established the link between health insurance and your employer. And this is all stuff that's mostly decades before Obamacare. That just scratches the surface. For example, I didn't even mention HMOs, which were created under Nixon via another set of regulations intended to control costs for things Johnson had done. A free market in health care? If there's one thing American health care has not had in the last 50 years, it's a free market. Sure, it has been slightly freer than in other countries, but that's not saying much.