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Which firms profit most from America’s health-care system (2018)

economist.com

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Re: Which firms profit most from America’s health-care system (2018)

#31

Earlier quoted context omitted.

If we fixed our diet problems, I’m not sure if we’d either have e or healthcare costs, or if the industry would find other ways to fill in the gap

I'd argue it's unfixable for low income workers. Excessive sugar in all the cheap food is a trap they can't avoid. They don't have money to buy better food and don't have time to shop and cook for themselves. That's assuming they recognize this problem at all.

A) don’t subsidise sugar B) tax sugar

Re: Which firms profit most from America’s health-care system (2018)

#32
post #21
post #2

from Wikipedia: The classic example of rent-seeking, according to Robert Shiller, is that of a feudal lord who installs a chain across a river that flows through his land and then hires a collector to charge passing boats a fee to lower the chain. There is nothing productive about the chain or the collector. The lord has made no improvements to the river and is not adding value in any way, directly or indirectly, exc…

This feudal lord probably have invested in an upkeep of few knights who enforce that chains stays in place. And then lobbied at the court against complaints from merchants and peasants. He might have also have to bribe few judges. Also historically feudal lords had been constantly in debt spending more on representation then they have earned. Some moneylenders might have taken all this rent from river chain. Or the f…

If I offer you the opportunity of not having your kneecaps broken in exchange for only $100/month, is this potentially completely fine because I could spend the money on "stimulating demand"?

Re: Which firms profit most from America’s health-care system (2018)

#33
post #21
post #2

from Wikipedia: The classic example of rent-seeking, according to Robert Shiller, is that of a feudal lord who installs a chain across a river that flows through his land and then hires a collector to charge passing boats a fee to lower the chain. There is nothing productive about the chain or the collector. The lord has made no improvements to the river and is not adding value in any way, directly or indirectly, exc…

This feudal lord probably have invested in an upkeep of few knights who enforce that chains stays in place. And then lobbied at the court against complaints from merchants and peasants. He might have also have to bribe few judges. Also historically feudal lords had been constantly in debt spending more on representation then they have earned. Some moneylenders might have taken all this rent from river chain. Or the f…

Stupid Economists, already making your points for you:

> An example of rent-seeking in a modern economy is spending money on lobbying for government subsidies in order to be given wealth that has already been created, or to impose regulations on competitors, in order to increase market share.

> The concept of rent-seeking would also apply to corruption of bureaucrats who solicit and extract "bribe" or "rent" for applying their legal but discretionary authority for awarding legitimate or illegitimate benefits to clients.

What is it about a feudal lord or moneylender that the way they spend money is better than the way the merchants would have spent it? Further, just because the money has downstream effects doesn't mean that it was rightfully earned. All of your arguments could equally apply to pirates or bankrobbers.

[1] https://en.wikipedia.org/wiki/Rent-seeking

Re: Which firms profit most from America’s health-care system (2018)

#34

The U.S. health system is what happens when corruption goes on so long you just call it the culture. "All professions are a conspiracy against the layman." was said by either G.B. Shaw or Ambrose Bierce, depending on your reference point. It's a form of business that is orthogonal to producing things people want, where instead it's mainly in the business of depriving people of what they need. Rent seeking is what pro…

> either G.B. Shaw or Ambrose Bierce, depending on your reference point.

I googled it, it's from Shaw's Doctor's Dilemma. (I'm a big fan of both those guys.) Only 3 hits on the internet saying it was Bierce - all 3 are your comments on HN! hehe.

Re: Which firms profit most from America’s health-care system (2018)

#35

Earlier quoted context omitted.

A counter argument I see sometimes is that the reason Americans spend more on healthcare compared to other rich countries is that American consumers spend more on just about everything than most other rich countries (and also earn more money). I don’t really know how much merit the argument has.

And as a result we have bigger homes, bigger cars, bigger TVs.... but worse healthcare outcomes? Seems like some of that excess spending yields us more returns than others.

The things you mentioned are almost all inversely related to better healthcare outcomes, to grossly oversimplify a contributing factor.

* Bigger homes means you feel more comfortable being lazy and spending all your time indoors

* Bigger cars means you are incentivized to drive 20 miles to a restaurant in comfort instead of walking over to a closer one

* Bigger TVs means you spend all day "watching the game" instead of going out and playing a sport.

Once again, these are grossly oversimplified, but should drive home the central point that spending on some things can actually worsen outcomes of others.

Re: Which firms profit most from America’s health-care system (2018)

#36

Just got the bill yesterday for my "free" Covid test. $250, insurance pays $105, you owe $145. (The test was free, the office visit was not.)

Who is to blame? The government for not collecting taxes from you and using that money to pay the doctor? The doctor for billing too high for the visit? The insurance company for not covering more of the price? Personally I would seek to understand why the doctor is billing so much and how that can become more fair for everyone involved.

A big element here is that the free market is being choked out. Consumers walk into healthcare facilities without any idea what they will be paying when they walk out, and therefore have no ability to choose one facility over another based on price.

Because that ability doesn't exist, there is no downwards price pressure anywhere at the consumer level for medical services.

I think we'd see a lot more results if we asked 'why aren't these facilities putting more efforts into reducing costs' rather than asking 'what makes this so expensive?'

Re: Which firms profit most from America’s health-care system (2018)

#37
post #5

> Every year America spends about $5,000 more per person on health care than other rich countries do. Yet its people are not any healthier. I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 b…

The most expensive conditions in terms of direct health care costs are diabetes, Alzheimer’s, and osteoarthritis. The most common chronic health conditions in the U.S. are hypertension (high blood pressure), dyslipidemia, and osteoarthritis. Obesity is by far the greatest risk factor contributing to the burden of chronic diseases in the U.S. [1]

1. https://milkeninstitute.org/reports/costs-chronic-disease-us....

Re: Which firms profit most from America’s health-care system (2018)

#38

Earlier quoted context omitted.

I'd argue it's unfixable for low income workers. Excessive sugar in all the cheap food is a trap they can't avoid. They don't have money to buy better food and don't have time to shop and cook for themselves. That's assuming they recognize this problem at all.

A) don’t subsidise sugar B) tax sugar

> B

It was tried and rolled back in chicago because it was deemed as unfairly targeting the poor.

Re: Which firms profit most from America’s health-care system (2018)

#39
post #5

> Every year America spends about $5,000 more per person on health care than other rich countries do. Yet its people are not any healthier. I think part of the reason Americans spend more on healthcare is precisely because they're unhealthy. According to the American CDC the obesity rate has reached a staggering 42.4% of adults[0], which brings with it a slew of health problems. This accounts for an additional $147 b…

Personally I'm way more inclined to believe Americans are unhealthy because their health care system is too expensive, rather than the other way around. Obesity is treatable.

> Obesity is treatable.

How?

Re: Which firms profit most from America’s health-care system (2018)

#40

Just got the bill yesterday for my "free" Covid test. $250, insurance pays $105, you owe $145. (The test was free, the office visit was not.)

Who is to blame? The government for not collecting taxes from you and using that money to pay the doctor? The doctor for billing too high for the visit? The insurance company for not covering more of the price? Personally I would seek to understand why the doctor is billing so much and how that can become more fair for everyone involved.

> Personally I would seek to understand why the doctor is billing so much and how that can become more fair for everyone involved.

For the same reason a McDonald’s worker bills closer to minimum wage - because that is the most the buyers are willing to pay. Solution to bringing prices down is to increase supply and/or decrease demand, and increase price transparency.

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