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Free markets are a problem when there is a resource that can be monopolized (doctors / medical supplies) or when corporate goals are at direct odds to community

Free markets are a problem when there is a resource that can be monopolized (doctors / medical supplies) or when corporate goals are at direct odds to community interest (a deregulated BP despoiling the Gulf of Mexico because safety measures are expensive and fuck you.) Home Depot would happily gouge you if they could form a cartel and gain enough control of the supply chain.

mpyne 13y ago
And not only would they happily gouge you, but they would then claim they have a duty to their shareholders to do so, as the law permits them to do it. This is, after all, the reason we tend to avoid government monopolies if we can avoid it. It's not just that government is inefficient, it's that monopolies are inefficient, whether "private sector" or otherwise.
aamar 13y ago
I'm in much agreement with your initial point (that free markets allow for price-fixing), but you're getting a lot of comments here because you overstate your case! There's nothing peculiar about medical supplies that make them easy monopolized. Pharmaceuticals and medical devices (neither of which are the topic of the original post) enjoy patent protection, but there are often many out-of-patent substitutes available. Doctors are limited, but that is primarily because the state makes it illegal to practice "medicine" without either being a doctor or being supervised by one. Much other scarcity stems from this one, e.g. limited insurance options because it's difficult to create a physician network. There are absolutely free-market-advocates out there who would remedy price-fixing problem by allowing self-taught people practice medicine. That should increase enough market-entrants to break any cartels we see. I'm not one of those advocates, because I see some sort of quality guarantees as helpful in this arena. But there are lots of aspects of the healthcare market that could benefit from more market-like behavior, whereas there are other aspects which could use less (i.e. more regulation). We need nuance in order to make progress.
- krichman 13y ago
  But we want the state to regulate medical practitioners! Even if we support natural selection acting on humans, we don't want an ambulance to take us to a homeopathic healer or Christian scientist, we want them to take us to a licensed professional.
  - aamar 13y ago
    I agree! Apologies if I was confusing on that point. Though I do suspect the states should license more MDs and provide more ability for PAs & NPs to practice without direct supervision. I do very much believe more consumer choice for non-urgent care would be helpful, i.e. lab choice, hospital choice, a menu of drug options (ratings, side effects, out of pocket cost). This is controversial for a number of reasons, but after considerable, I believe this would have significant positive impact on the overall efficiency of healthcare.

mpyne 13y ago

And not only would they happily gouge you, but they would then claim they have a duty to their shareholders to do so, as the law permits them to do it. This is, after all, the reason we tend to avoid government monopolies if we can avoid it. It's not just that government is inefficient, it's that monopolies are inefficient, whether "private sector" or otherwise.

aamar 13y ago

I'm in much agreement with your initial point (that free markets allow for price-fixing), but you're getting a lot of comments here because you overstate your case! There's nothing peculiar about medical supplies that make them easy monopolized. Pharmaceuticals and medical devices (neither of which are the topic of the original post) enjoy patent protection, but there are often many out-of-patent substitutes available. Doctors are limited, but that is primarily because the state makes it illegal to practice "medicine" without either being a doctor or being supervised by one. Much other scarcity stems from this one, e.g. limited insurance options because it's difficult to create a physician network. There are absolutely free-market-advocates out there who would remedy price-fixing problem by allowing self-taught people practice medicine. That should increase enough market-entrants to break any cartels we see. I'm not one of those advocates, because I see some sort of quality guarantees as helpful in this arena. But there are lots of aspects of the healthcare market that could benefit from more market-like behavior, whereas there are other aspects which could use less (i.e. more regulation). We need nuance in order to make progress.

krichman 13y ago
But we want the state to regulate medical practitioners! Even if we support natural selection acting on humans, we don't want an ambulance to take us to a homeopathic healer or Christian scientist, we want them to take us to a licensed professional.
- aamar 13y ago
  I agree! Apologies if I was confusing on that point. Though I do suspect the states should license more MDs and provide more ability for PAs & NPs to practice without direct supervision. I do very much believe more consumer choice for non-urgent care would be helpful, i.e. lab choice, hospital choice, a menu of drug options (ratings, side effects, out of pocket cost). This is controversial for a number of reasons, but after considerable, I believe this would have significant positive impact on the overall efficiency of healthcare.