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Way to miss my point. Well done guy. Fight that good fight for unfettered capitalism. Americans don't need no stinking commie health system, amirite? Once agai

Way to miss my point. Well done guy. Fight that good fight for unfettered capitalism. Americans don't need no stinking commie health system, amirite? Once again: universal health doesn't mean price regulation. Like any private insurer the government can negotiate for lower prices when multiple providers exist and subsidise the cost when they do not. I also see no problem with limiting monopoly control over life saving substances. That's why we have governments. To act in the best collective interest.

tptacek 12y ago
Nothing in this comment thread warranted personal attacks.
- gradstudent 12y ago
  That's a bit unfair. I wasn't making a personal attack; just posting a sardonic rebuttal to a poster who seems to me more interested in pushing a specific ideology than posting a considered response to what I have been saying.
msandford 12y ago
> Way to miss my point. Well done guy. Fight that good fight for unfettered capitalism. Americans don't need no stinking commie health system, amirite? This is what bugs me. You're arguing against what you THINK I'm arguing, not against what I'm ACTUALLY arguing. I'm not saying that American healthcare is a paragon of efficiency and low cost. Nor am I arguing against "commie health system" but instead that the idea that having a SINGLE purchaser of medical care will quite likely result in less good information about prices and as a result less efficiency. Right now in the US we have a problem where not enough price information is known: almost no doctors list prices anywhere that a person can find PRIOR to going to a doctor. How could that be remotely efficient? Wanna buy some Microsoft stock? OK just call up a million people who may or may not tell you how much they want for their shares. Depressed yet? That's how terrible the price information is in the medical world. It's no wonder everything is so damn expensive. http://well.blogs.nytimes.com/2014/08/05/why-we-should-know-the-price-of-medical-tests/?_php=true&_type=blogs&partner=rss&emc=rss&_r=0 http://well.blogs.nytimes.com/2014/08/05/why-we-should-know-... http://www.nytimes.com/2013/05/08/business/hospital-billing-varies-wildly-us-data-shows.html?pagewanted=all http://www.nytimes.com/2013/05/08/business/hospital-billing-... Yes you can trot out the tired old trope about "but medical care isn't something you can't shop around for!" which is true really only in trauma cases where minutes are the difference between life and death. Got a cold? You've got time. The flu? You can check around. Broken bone? Uncomfortable yes but realistically you could spend 15 minutes on doctor-yelp so long as it's not a blood-gushing compound fracture. Mess up a joint like say an ACL? They're not going to operate on you the same day anyhow so might as well spend an hour reading reviews. Having a kid? Guess what, there's a roughly 9 month lead time on that one. You could spend a week shopping around. > Once again: universal health doesn't mean price regulation. If the government is the only buyer of medical care and they "negotiate" for discounts and don't do business with people who "charge too much" then that's EFFECTIVELY regulation. It might not be in the technical sense; there might be no law saying "an ACL surgery costs $4200" but if the sole purchaser of ACL surgeries says it's not willing to pay more than $4200 that kinda-sorta sets the price. You can argue 'til you're blue in the face on technicalities and whatnot but if it walks like a duck and quacks like a duck most people will agree that its a duck.
- gradstudent 12y ago
  > I'm not saying that American healthcare is a paragon of efficiency and low cost. Good. Because it isn't. American healthcare is a laughing stock in the developed world. Per capita, Americans spend more of their income on healthcare than countries with universal health. Ironically, health outcomes for Americans are actually worse. http://www.stiglitz-sen-fitoussi.fr/documents/overview-eng.pdf http://www.stiglitz-sen-fitoussi.fr/documents/overview-eng.p... > You could spend a week shopping around. You can shop around for elective procedures. If you are sick however, shopping around is a terrible and exploitative burden. You're sick. Your primary concern should be to get help and get better, not whether or not you can afford it. > If the government is the only buyer of medical care and they "negotiate" for discounts and don't do business with people who "charge too much" then that's EFFECTIVELY regulation. It might not be in the technical sense; there might be no law saying "an ACL surgery costs $4200" but if the sole purchaser of ACL surgeries says it's not willing to pay more than $4200 that kinda-sorta sets the price. This isn't what I'm saying at all. Firstly, I'm not saying the government is the sole buyer of healthcare services because experiences the world over (UK, Australia etc) have shown there's plenty of room for private insurers. Secondly, I'm not saying that prices are kinda-sorta fixed. What I am saying is that if the government decides apriori that ACL surgeries (whatever that is) are something that's important to universal health, and something everyone should have access to, they subsidise the cost. Period. Whatever it is. If multiple providers exist, they opt for the cheaper option. If they're getting stiffed by all the private providers then the government has two options: (i) they can decide to offer ACL surgeries in public hospitals for a lower price; (ii) (in the case ACL surgeries depend on some very expensive bit of licensed kit controlled by a single supplier) they can set limits on the amount of time that supplier can wield exclusive control over this technology. Break the monopoly, lower the price. Recall that they've decided beforehand ACL surgery is something everyone should access to.

tptacek 12y ago

Nothing in this comment thread warranted personal attacks.

gradstudent 12y ago
That's a bit unfair. I wasn't making a personal attack; just posting a sardonic rebuttal to a poster who seems to me more interested in pushing a specific ideology than posting a considered response to what I have been saying.

msandford 12y ago

> Way to miss my point. Well done guy. Fight that good fight for unfettered capitalism. Americans don't need no stinking commie health system, amirite? This is what bugs me. You're arguing against what you THINK I'm arguing, not against what I'm ACTUALLY arguing. I'm not saying that American healthcare is a paragon of efficiency and low cost. Nor am I arguing against "commie health system" but instead that the idea that having a SINGLE purchaser of medical care will quite likely result in less good information about prices and as a result less efficiency. Right now in the US we have a problem where not enough price information is known: almost no doctors list prices anywhere that a person can find PRIOR to going to a doctor. How could that be remotely efficient? Wanna buy some Microsoft stock? OK just call up a million people who may or may not tell you how much they want for their shares. Depressed yet? That's how terrible the price information is in the medical world. It's no wonder everything is so damn expensive. http://well.blogs.nytimes.com/2014/08/05/why-we-should-know-the-price-of-medical-tests/?_php=true&_type=blogs&partner=rss&emc=rss&_r=0 http://well.blogs.nytimes.com/2014/08/05/why-we-should-know-... http://www.nytimes.com/2013/05/08/business/hospital-billing-varies-wildly-us-data-shows.html?pagewanted=all http://www.nytimes.com/2013/05/08/business/hospital-billing-... Yes you can trot out the tired old trope about "but medical care isn't something you can't shop around for!" which is true really only in trauma cases where minutes are the difference between life and death. Got a cold? You've got time. The flu? You can check around. Broken bone? Uncomfortable yes but realistically you could spend 15 minutes on doctor-yelp so long as it's not a blood-gushing compound fracture. Mess up a joint like say an ACL? They're not going to operate on you the same day anyhow so might as well spend an hour reading reviews. Having a kid? Guess what, there's a roughly 9 month lead time on that one. You could spend a week shopping around. > Once again: universal health doesn't mean price regulation. If the government is the only buyer of medical care and they "negotiate" for discounts and don't do business with people who "charge too much" then that's EFFECTIVELY regulation. It might not be in the technical sense; there might be no law saying "an ACL surgery costs $4200" but if the sole purchaser of ACL surgeries says it's not willing to pay more than $4200 that kinda-sorta sets the price. You can argue 'til you're blue in the face on technicalities and whatnot but if it walks like a duck and quacks like a duck most people will agree that its a duck.

gradstudent 12y ago
> I'm not saying that American healthcare is a paragon of efficiency and low cost. Good. Because it isn't. American healthcare is a laughing stock in the developed world. Per capita, Americans spend more of their income on healthcare than countries with universal health. Ironically, health outcomes for Americans are actually worse. http://www.stiglitz-sen-fitoussi.fr/documents/overview-eng.pdf http://www.stiglitz-sen-fitoussi.fr/documents/overview-eng.p... > You could spend a week shopping around. You can shop around for elective procedures. If you are sick however, shopping around is a terrible and exploitative burden. You're sick. Your primary concern should be to get help and get better, not whether or not you can afford it. > If the government is the only buyer of medical care and they "negotiate" for discounts and don't do business with people who "charge too much" then that's EFFECTIVELY regulation. It might not be in the technical sense; there might be no law saying "an ACL surgery costs $4200" but if the sole purchaser of ACL surgeries says it's not willing to pay more than $4200 that kinda-sorta sets the price. This isn't what I'm saying at all. Firstly, I'm not saying the government is the sole buyer of healthcare services because experiences the world over (UK, Australia etc) have shown there's plenty of room for private insurers. Secondly, I'm not saying that prices are kinda-sorta fixed. What I am saying is that if the government decides apriori that ACL surgeries (whatever that is) are something that's important to universal health, and something everyone should have access to, they subsidise the cost. Period. Whatever it is. If multiple providers exist, they opt for the cheaper option. If they're getting stiffed by all the private providers then the government has two options: (i) they can decide to offer ACL surgeries in public hospitals for a lower price; (ii) (in the case ACL surgeries depend on some very expensive bit of licensed kit controlled by a single supplier) they can set limits on the amount of time that supplier can wield exclusive control over this technology. Break the monopoly, lower the price. Recall that they've decided beforehand ACL surgery is something everyone should access to.