3 ms·

How does that make the article terrible? He's not saying that this is a good thing he's using this as an example of how broken the medical system is. Did you

How does that make the article terrible? He's not saying that this is a good thing he's using this as an example of how broken the medical system is. Did you read to the end? Or did you just get annoyed after the first few paragraphs and write this screed?

alex-g 13y ago
No, the author's argument is that this kind of negotiation is what ought to happen all the time; his example of brokenness is that insurance rules distort the marketplace and drive up prices. Far from objecting to haggling, he thinks it should happen more often. This is a fairly typical free-market argument. The parent post by munificent advances the counter-argument that patients are not always in a position to haggle over prices.
- Ensorceled 13y ago
  Ah, I thought of the surgeon wanting a free market similar to car pricing. There's the MRSP that is high but not crazy; you can haggle but, overall, prices would go down so you wouldn't have to haggle in order not to die or go bankrupt ...
munificent 13y ago
The author is arguing that we should use a free market for healthcare. He cites exactly one anecdote where a free market exchange happened to have worked out in the patient's benefit and then generalizes that to the entire healthcare industry. But he completely fails to take into account the fact that healthcare is about as far from an efficient market as you can get: 1. Patients often need healthcare right now or they will die which does not give them the time, opportunity or mindset to weigh alternatives and make an informed choice. 2. Patients are often unconscious when healthcare decisions must be made. 3. Patients are constrained in their choices by time and place. When you need healthcare, you often need it immediately and are unable to travel, which means you can only choose from the venues nearby. 4. Quality of product is nigh impossible for a patient to ascertain. You might be able to find the outcome history for a few care providers you're considering, but that presumes you can reliably tell which doctor will actually be the one to give you care. If you take a turn for the worse when they're off duty, now it's out of your hands. 5. Patients can't pick and choose pieces of care. Assuming somehow you do have the data to make decisions about which nurses, facilities, equipment, doctors, and anesthesiologists you want, you can't pick and choose them and assemble your own A-Team. No one argues that the medical system isn't broken, but arguing that we should replace it with individual customer chosen free markets is making the claim that somehow a bunch of stressed out amateurs with little time or medical knowledge who are currently suffering a medical malady will somehow be able to bargain more effectively than what we see now.
- Ensorceled 13y ago
  I'm Canadian so I think the US healthcare system is simply barbarous ... the US is a third world county in many respects. But, this is not how the free market works. When I bought my entertainment centre it cost around $3000 after haggling ... the MRSP for all the pieces was around $3500. This example was the MRSP was $23000 AFTER the insurance covered a bunch of it. The negotiated cost was $3000. In a free market system the MRSP would come down and none of these points would really matter (the constrained people would pay $3500 instead of the haggled price of $3000)

alex-g 13y ago

No, the author's argument is that this kind of negotiation is what ought to happen all the time; his example of brokenness is that insurance rules distort the marketplace and drive up prices. Far from objecting to haggling, he thinks it should happen more often. This is a fairly typical free-market argument. The parent post by munificent advances the counter-argument that patients are not always in a position to haggle over prices.

Ensorceled 13y ago
Ah, I thought of the surgeon wanting a free market similar to car pricing. There's the MRSP that is high but not crazy; you can haggle but, overall, prices would go down so you wouldn't have to haggle in order not to die or go bankrupt ...

munificent 13y ago

The author is arguing that we should use a free market for healthcare. He cites exactly one anecdote where a free market exchange happened to have worked out in the patient's benefit and then generalizes that to the entire healthcare industry. But he completely fails to take into account the fact that healthcare is about as far from an efficient market as you can get: 1. Patients often need healthcare right now or they will die which does not give them the time, opportunity or mindset to weigh alternatives and make an informed choice. 2. Patients are often unconscious when healthcare decisions must be made. 3. Patients are constrained in their choices by time and place. When you need healthcare, you often need it immediately and are unable to travel, which means you can only choose from the venues nearby. 4. Quality of product is nigh impossible for a patient to ascertain. You might be able to find the outcome history for a few care providers you're considering, but that presumes you can reliably tell which doctor will actually be the one to give you care. If you take a turn for the worse when they're off duty, now it's out of your hands. 5. Patients can't pick and choose pieces of care. Assuming somehow you do have the data to make decisions about which nurses, facilities, equipment, doctors, and anesthesiologists you want, you can't pick and choose them and assemble your own A-Team. No one argues that the medical system isn't broken, but arguing that we should replace it with individual customer chosen free markets is making the claim that somehow a bunch of stressed out amateurs with little time or medical knowledge who are currently suffering a medical malady will somehow be able to bargain more effectively than what we see now.

Ensorceled 13y ago
I'm Canadian so I think the US healthcare system is simply barbarous ... the US is a third world county in many respects. But, this is not how the free market works. When I bought my entertainment centre it cost around $3000 after haggling ... the MRSP for all the pieces was around $3500. This example was the MRSP was $23000 AFTER the insurance covered a bunch of it. The negotiated cost was $3000. In a free market system the MRSP would come down and none of these points would really matter (the constrained people would pay $3500 instead of the haggled price of $3000)