Submission Statement: Populists mistakenly believe they can disrupt price signals by setting price controls, but it inevitably backfires by creating inefficiencies and moving costs elsewhere. The US has the world’s most expensive healthcare, but if we adopted Friedrich Hayek’s stance on government healthcare that could change.
hypsignathus on
Oh I read this earlier today.
I think the authors miss what a lot of commenters* pointed out–the health care “market” doesn’t really exist as such. There is little consumer choice. Maybe there should be more? I have no idea how to get there, though. I’ll be honest, I’m pretty convinced that US health care needs a full revamp and more socialization.
*NYT commenters are not exactly a font of good ideas, but I do think this is a point that free market health care advocates often elide to make their arguments easier.
Price caps on healthcare, like anything, do not solve the underlying problem. True.
As of right now, we’re not even close to solving the underlying problem in healthcare. This is a marginal reform to ease the pain of a clearly broken system, like many price controls.
I understand why policy researchers would be against it, but if you asked them what the alternative is you’d hear a roadmap which leads into a quagmire or off a cliff with the hope the landing doesn’t kill too many people.
hibikir_40k on
Any relevant reform of the US healthcare system breaks the horrible incentive chain that is what keeps it escalating, and stops anyone from actually pushing for marginal cost control to increase profits, along with competition that shrinks them.
But when doctors have no unemployment, hospitals can only be built when other providers are OK with it, pharmacy is centralized, and insurance companies end up in the middle of everyhting, adding complexity, nothing can work. Any good fix will be traumatic, and will get all the people who lose their jobs (because they are waste) to vote for the other party. Therefore, we’ll keep going towards the abyss until there’s disruption that legislation cannot practically ban
12kkarmagotbanned on
We need universal catastrophic coverage with no premiums and the complete removal of the ESI deduction
ChillnShill on
“A better agenda would attack the causes of unjustifiably high prices. That means blocking hospital mergers and [contracts](https://jhmhp.amegroups.org/article/view/8976/html)that hinder competition, and [fewer rules](https://pmc.ncbi.nlm.nih.gov/articles/PMC7427974/)that protect existing providers from new rivals. It also means giving patients and employers real choices: transparent pricing and insurance designs that [reward consumers](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2434733) who discover more affordable care. When patients who choose lower-priced care can share in the savings, they put pressure on prices in a way no bureaucracy policing thousands of services can match.”
Yeah I don’t think anybody actually disagrees with this, but it requires that we actually enforce anti-trust laws and ensure that hospitals don’t have market concentration power over insurers and that insurers actually pass savings on to customers in form of lower premiums.
Even if we did all of this, you’d still have the issue of unpredictable catastrophes and information asymmetry. It’s hard for patients to truly judge the quality and necessity of care even in non-emergencies. Once you’re established with a provider or clinic, it’s hard to go through the same process of finding another one if you don’t like them. We can have every market reform under the sun and we’d still likely have to have government step in in some form or fashion.
Adminisnotadmin on
Reposting this from another thread:
The United States does not have a complex medical care system. It has 6.
We have
1. Canadian Single Payer for the elderly and those with End-Stage Renal Disease.
2. UK NHS for veterans.
3. German model for the employed with benefits.
4. Swiss model for those who must buy private.
5. Singapore model at the county level for those too poor or unable to get healthcare coverage
6. The ER and its $100K hospital bills for everyone else who falls through the cracks
Literally picking a single path of any of these would drive down costs, but because healthcare is A) incredibly complex and B ) the only growing sector of the economy, no one wants to touch it anymore.
If you with Obamacare on Steroids (The Swiss Model) by nuking the employer health insurance tax deduction, workers get “raises” they see and costs they hate, but it completely removes job lock. Combine it with subsidies, and we actually get more economic incentives for jobs and business growth.
The opaque patchwork system is shuffling costs around for no benefit to any consumer or taxpayer, and no market can even exist to satisfy Hayek when both insurers and medical providers are locked in a game of strategic bureaucratic battle.
We pay more and get less because those who need care the most are often the ones unable to get it until it is catastrophically costly.
A lot of pharmaceutical R&D is only funded thanks to the US healthcare system and a government imposed price cap is going to kill this R&D engine which fosters innovations, helps to save lives, and cure previously incurable diseases.
10 Comments
Submission Statement: Populists mistakenly believe they can disrupt price signals by setting price controls, but it inevitably backfires by creating inefficiencies and moving costs elsewhere. The US has the world’s most expensive healthcare, but if we adopted Friedrich Hayek’s stance on government healthcare that could change.
Oh I read this earlier today.
I think the authors miss what a lot of commenters* pointed out–the health care “market” doesn’t really exist as such. There is little consumer choice. Maybe there should be more? I have no idea how to get there, though. I’ll be honest, I’m pretty convinced that US health care needs a full revamp and more socialization.
*NYT commenters are not exactly a font of good ideas, but I do think this is a point that free market health care advocates often elide to make their arguments easier.
Average normie on healthcare price caps
https://preview.redd.it/gmrv2ugh7feh1.jpeg?width=300&format=pjpg&auto=webp&s=684626830f3fa390625ccd75b13cc2d45df8572c
Price caps on healthcare, like anything, do not solve the underlying problem. True.
As of right now, we’re not even close to solving the underlying problem in healthcare. This is a marginal reform to ease the pain of a clearly broken system, like many price controls.
I understand why policy researchers would be against it, but if you asked them what the alternative is you’d hear a roadmap which leads into a quagmire or off a cliff with the hope the landing doesn’t kill too many people.
Any relevant reform of the US healthcare system breaks the horrible incentive chain that is what keeps it escalating, and stops anyone from actually pushing for marginal cost control to increase profits, along with competition that shrinks them.
But when doctors have no unemployment, hospitals can only be built when other providers are OK with it, pharmacy is centralized, and insurance companies end up in the middle of everyhting, adding complexity, nothing can work. Any good fix will be traumatic, and will get all the people who lose their jobs (because they are waste) to vote for the other party. Therefore, we’ll keep going towards the abyss until there’s disruption that legislation cannot practically ban
We need universal catastrophic coverage with no premiums and the complete removal of the ESI deduction
“A better agenda would attack the causes of unjustifiably high prices. That means blocking hospital mergers and [contracts](https://jhmhp.amegroups.org/article/view/8976/html)that hinder competition, and [fewer rules](https://pmc.ncbi.nlm.nih.gov/articles/PMC7427974/)that protect existing providers from new rivals. It also means giving patients and employers real choices: transparent pricing and insurance designs that [reward consumers](https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2434733) who discover more affordable care. When patients who choose lower-priced care can share in the savings, they put pressure on prices in a way no bureaucracy policing thousands of services can match.”
Yeah I don’t think anybody actually disagrees with this, but it requires that we actually enforce anti-trust laws and ensure that hospitals don’t have market concentration power over insurers and that insurers actually pass savings on to customers in form of lower premiums.
Even if we did all of this, you’d still have the issue of unpredictable catastrophes and information asymmetry. It’s hard for patients to truly judge the quality and necessity of care even in non-emergencies. Once you’re established with a provider or clinic, it’s hard to go through the same process of finding another one if you don’t like them. We can have every market reform under the sun and we’d still likely have to have government step in in some form or fashion.
Reposting this from another thread:
The United States does not have a complex medical care system. It has 6.
We have
1. Canadian Single Payer for the elderly and those with End-Stage Renal Disease.
2. UK NHS for veterans.
3. German model for the employed with benefits.
4. Swiss model for those who must buy private.
5. Singapore model at the county level for those too poor or unable to get healthcare coverage
6. The ER and its $100K hospital bills for everyone else who falls through the cracks
Literally picking a single path of any of these would drive down costs, but because healthcare is A) incredibly complex and B ) the only growing sector of the economy, no one wants to touch it anymore.
If you with Obamacare on Steroids (The Swiss Model) by nuking the employer health insurance tax deduction, workers get “raises” they see and costs they hate, but it completely removes job lock. Combine it with subsidies, and we actually get more economic incentives for jobs and business growth.
The opaque patchwork system is shuffling costs around for no benefit to any consumer or taxpayer, and no market can even exist to satisfy Hayek when both insurers and medical providers are locked in a game of strategic bureaucratic battle.
We pay more and get less because those who need care the most are often the ones unable to get it until it is catastrophically costly.
Literally just pick one at this point.
Yes, but a system designed around capping the total costs of what families pay themselves can be good: https://www.niskanencenter.org/wp-content/uploads/old_uploads/2019/06/Final_Universal-Catastrophic-Coverage.pdf
I agree.
A lot of pharmaceutical R&D is only funded thanks to the US healthcare system and a government imposed price cap is going to kill this R&D engine which fosters innovations, helps to save lives, and cure previously incurable diseases.