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Really? Is that how things like healthcare costs in the USA work out? Competition solves all? Because we have unlimited hospitals and doctors and yet a Tylenol

by ck2 13y ago

Really? Is that how things like healthcare costs in the USA work out? Competition solves all? Because we have unlimited hospitals and doctors and yet a Tylenol in the hospital is hundreds of dollars (Obamacare won't fix that either because now more people can pay hundreds). Internet, Cable, Cellphone service, all seem to rise to the most people can afford. Rent on apartment complexes near each other owned by different management companies magically stay within a several percent of each other. If you gave everyone $1000 a month, rent will magically rise to at least half that for even the smallest efficiency.

deleted 13y ago
[deleted]
brianlweiner 13y ago
We actually don't have unlimited hospitals or doctors. New hospital constructions will often require a 'Certificate of Need' - existing hospitals can essentially veto any expansions. We haven't expanded our medical school supplies in 30 years either. We essentially graduate the same # of doctors as we did in 1980, although demand for medical services has increased significantly over that period. https://www.aamc.org/download/153708/data/charts1982to2012.pdf https://www.aamc.org/download/153708/data/charts1982to2012.p...
- ck2 13y ago
  There are nearly 6000 hospitals in the USA with nearly a million beds. That's a MASSIVE amount of overlapping resources. Yet every cost in a hospital, even to get to one via ambulance, is breath-taking. There are countries with far fewer resources (ie. Canada) with far lower costs.
danieldk 13y ago
If you gave everyone $1000 a month, rent will magically rise to at least half that for even the smallest efficiency. You do realize that there is a minimum wage in The Netherlands (Euro 1469 per month gross) and welfare (e.g. for a married couple Euro 1323, single up to Euro 926 per month)? So, that should've happened already. Besides that, we have a system for social housing, which everyone with a low income can use, which is regulated. E.g. when I was still a PhD candidate, I made a bit over 2000 Euro (gross) per month, but could rent a house with three bedrooms for 390 Euro. The price is determined based on size, facilities, etc. I like the idea of a basic income, since it would kill a lot of bureaucracy that checks that people who are able to work actively solicit positions, etc. It'd be nice if the CPB (the organization that is responsible for making guestimations of economic effects) could work it through.
- ck2 13y ago
  Sounds like you already have cost control in place. In which case basic income guarantees could work. In the USA it would become a predatory market to squeeze money from.
bhauer 13y ago
We don't have a whole lot of competition in healthcare. Few of us pay for healthcare out of pocket, and many who do so use the finicky and artificial construction on top of the current employer-subsidy system called health savings accounts. Don't get me wrong, given our current system of employer-provided health insurance, the HSA is my preference by a wide margin. But I'd prefer if it were economically viable to purchase my health coverage directly rather than through my employer. I don't want my employer providing this kind of thing for me. It's a market perversion. Just give me a salary, please. To my mind, competition (in the meager form we have today) is the only force our healthcare system has keeping prices low. And the prices are not low, at least in most medical fields, which goes to show how little competition we have. Third-party payers drive prices upward because the first-party consumer has no incentive to seek a fair trade. Many of us with health insurance use the insurance to pay for everything including routine visits and check-ups. It's as if oil changes were covered by car insurance—you wouldn't care how much an oil change cost—or replacement batteries were included in cell phone loss insurance—you wouldn't care how much a battery cost. Oh, my battery is being finicky, better get a new one since they're free. I prefer a basic income versus the current central-planning approach to safety netting. The central planners cause the price problems by inhibiting the market's ability to transmit unmolested price signals. Internet, cable, cellphone service—all services with significant terrestrial regulation. Periodically an innovator attempts to get around the regulation by delivering via a new means (e.g., Internet by line of sight), but it can hardly be said that, for example, cable is not a public/private hybrid. Regulatory capture means we don't have market competition. > Rent on apartment complexes near each other owned by different management companies magically stay within a several percent of each other. Yeah. Wait, are you saying this is inherently bad?

by ck2 13y ago

deleted 13y ago

[deleted]

brianlweiner 13y ago

We actually don't have unlimited hospitals or doctors. New hospital constructions will often require a 'Certificate of Need' - existing hospitals can essentially veto any expansions. We haven't expanded our medical school supplies in 30 years either. We essentially graduate the same # of doctors as we did in 1980, although demand for medical services has increased significantly over that period. https://www.aamc.org/download/153708/data/charts1982to2012.pdf https://www.aamc.org/download/153708/data/charts1982to2012.p...

ck2 13y ago
There are nearly 6000 hospitals in the USA with nearly a million beds. That's a MASSIVE amount of overlapping resources. Yet every cost in a hospital, even to get to one via ambulance, is breath-taking. There are countries with far fewer resources (ie. Canada) with far lower costs.

danieldk 13y ago

If you gave everyone $1000 a month, rent will magically rise to at least half that for even the smallest efficiency. You do realize that there is a minimum wage in The Netherlands (Euro 1469 per month gross) and welfare (e.g. for a married couple Euro 1323, single up to Euro 926 per month)? So, that should've happened already. Besides that, we have a system for social housing, which everyone with a low income can use, which is regulated. E.g. when I was still a PhD candidate, I made a bit over 2000 Euro (gross) per month, but could rent a house with three bedrooms for 390 Euro. The price is determined based on size, facilities, etc. I like the idea of a basic income, since it would kill a lot of bureaucracy that checks that people who are able to work actively solicit positions, etc. It'd be nice if the CPB (the organization that is responsible for making guestimations of economic effects) could work it through.

ck2 13y ago
Sounds like you already have cost control in place. In which case basic income guarantees could work. In the USA it would become a predatory market to squeeze money from.

bhauer 13y ago

We don't have a whole lot of competition in healthcare. Few of us pay for healthcare out of pocket, and many who do so use the finicky and artificial construction on top of the current employer-subsidy system called health savings accounts. Don't get me wrong, given our current system of employer-provided health insurance, the HSA is my preference by a wide margin. But I'd prefer if it were economically viable to purchase my health coverage directly rather than through my employer. I don't want my employer providing this kind of thing for me. It's a market perversion. Just give me a salary, please. To my mind, competition (in the meager form we have today) is the only force our healthcare system has keeping prices low. And the prices are not low, at least in most medical fields, which goes to show how little competition we have. Third-party payers drive prices upward because the first-party consumer has no incentive to seek a fair trade. Many of us with health insurance use the insurance to pay for everything including routine visits and check-ups. It's as if oil changes were covered by car insurance—you wouldn't care how much an oil change cost—or replacement batteries were included in cell phone loss insurance—you wouldn't care how much a battery cost. Oh, my battery is being finicky, better get a new one since they're free. I prefer a basic income versus the current central-planning approach to safety netting. The central planners cause the price problems by inhibiting the market's ability to transmit unmolested price signals. Internet, cable, cellphone service—all services with significant terrestrial regulation. Periodically an innovator attempts to get around the regulation by delivering via a new means (e.g., Internet by line of sight), but it can hardly be said that, for example, cable is not a public/private hybrid. Regulatory capture means we don't have market competition. > Rent on apartment complexes near each other owned by different management companies magically stay within a several percent of each other. Yeah. Wait, are you saying this is inherently bad?