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How to Charge $546 for Six Liters of Saltwater

nytimes.com

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Re: How to Charge $546 for Six Liters of Saltwater

#91

Post by mritun »

CamperBob2 wrote: post #76
DanBC wrote: post #68

Earlier quoted context omitted.

Cell phones are a great example of the terrible results from supposedly free markets. Plans are deliberately priced to be confusing to compare prices; plans are frequently updated to cause people to be stuck in win-optimal contracts; consumers are gouged on some items (see bizarre cost of sms in UK); and companies collude to defeat market mechanisms - see the use of area codes in auction bids as a method of communica…

Would this be the same free market that put a Cray 2-class computer in my pocket for $85/month?

... when I pay $11/month for a similar cray in a developing nation.

You are getting fleeced!

Re: How to Charge $546 for Six Liters of Saltwater

#92

Post by t0dd »

angersock wrote: post #62

There was a really, really good (depressing) article I'd read about a year or two ago talking about how group purchasing organizations worked to influence the costs of devices. The example case was a guy who'd developed an auto-retracting needle, and was screwed out of business by some major manufacturers pressuring hospitals not to buy it. Does anyone have a link to that article?

Is this the article you refer to?

"How the medical supply industry blocks device startups from selling to hospitals"

http://www.washingtonmonthly.com/features/2010/1007.blake.ht...

Re: How to Charge $546 for Six Liters of Saltwater

#93

Post by rogerbinns »

jdminhbg wrote: post #87
delinka wrote: post #84

Earlier quoted context omitted.

I wonder if, perhaps, you could provide a counterargument to nikatwork.

http://en.wikipedia.org/wiki/Medicare_%28United_States%29 http://en.wikipedia.org/wiki/Medicaid http://en.wikipedia.org/wiki/Hipaa http://en.wikipedia.org/wiki/Patient_Protection_and_Affordab... This is kind of like condescendingly asking someone to provide a counterargument to a proposition that the Earth is completely dry land.

http://en.wikipedia.org/wiki/Certificate_of_need

Re: How to Charge $546 for Six Liters of Saltwater

#94

Post by jes »

gnoway wrote: post #58
nikatwork wrote: post #36

Many in this thread are claiming that price fixing wouldn't occur in a "truly free" market. This is misty-eyed naivety. In a completely deregulated free market, it is even more in the hospitals' interest to form a price-fixing cartel. Any new player in the market trying to set reasonable market prices could be excluded through market pressure tactics (eg, tell distributors don't sell to them or our cartel will no lon…

Well you can hardly have a free market for healthcare in the first place. A functional market requires that consumers be vigilant and make good choices. That's hard enough without being sick or injured. I like to think of myself as a free markets guy, but driving healthcare via the market seems like the worst, most cynical application of the concept possible.

With respect, what is a functional market, and why does such a market require that consumers be vigilant and make good choices?

If consumers make bad choices, don't they eventually learn to make better choices?

Re: How to Charge $546 for Six Liters of Saltwater

#95

Post by joseph_cooney »

hop wrote: post #40

What a baffling industry. Wish great things to any startup that tries to get through the bureaucratic/legal/insurance hurdles to take a crack at some of this.

With centuries of regulatory capture, powerful, politically-connected vested interests with huge war-chests, and a deck full of trump-cards like 'safety' they can play, they might need more than just good wishes.

Re: How to Charge $546 for Six Liters of Saltwater

#96

Post by mpyne »

nikatwork wrote: post #71
jes wrote: post #57

Earlier quoted context omitted.

How do you explain other free markets that obviously deliver quality products at low prices? I don't feel gouged when I buy a television, a cell phone or lumber at Home Depot.

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.

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.

Re: How to Charge $546 for Six Liters of Saltwater

#97

Post by moocowduckquack »

coenhyde wrote: post #27

The problem with having healthcare under private enterprise is that these healthcare providers do not operate under the free market conditions we assume they do. There is no "perfect information" allowing consumers to choose the cheapest price. As the article points out the pricing structure is very opaque. Not to mention the "consumers" want the best product regardless of cost, after all we are talking about their l…

There is never perfect information in any market. The continual problem with free market economics is that according to the definition, there has never been a free market anywhere in history. It is ideology with a thin veneer of mathematics.

Re: How to Charge $546 for Six Liters of Saltwater

#98

Post by [deleted] »

delinka wrote: post #84
jdminhbg wrote: post #79

Earlier quoted context omitted.

> the US healthcare system ... a completely free market I have read a lot of wrong things on HN, ranging from the merely misinformed to the willfully ignorant, but this might take the cake.

I wonder if, perhaps, you could provide a counterargument to nikatwork.

[deleted]

Re: How to Charge $546 for Six Liters of Saltwater

#99

Post by abalone »

jdminhbg wrote: post #87
delinka wrote: post #84

Earlier quoted context omitted.

I wonder if, perhaps, you could provide a counterargument to nikatwork.

http://en.wikipedia.org/wiki/Medicare_%28United_States%29 http://en.wikipedia.org/wiki/Medicaid http://en.wikipedia.org/wiki/Hipaa http://en.wikipedia.org/wiki/Patient_Protection_and_Affordab... This is kind of like condescendingly asking someone to provide a counterargument to a proposition that the Earth is completely dry land.

Those are insurers. The article is about the hospital supply market. In particular, the completely unregulated part of the hospital supply chain.

So.. are you merely misinformed, or willfully ignorant?

Re: How to Charge $546 for Six Liters of Saltwater

#100

Post by mpyne »

jes wrote: post #94
gnoway wrote: post #58

Earlier quoted context omitted.

Well you can hardly have a free market for healthcare in the first place. A functional market requires that consumers be vigilant and make good choices. That's hard enough without being sick or injured. I like to think of myself as a free markets guy, but driving healthcare via the market seems like the worst, most cynical application of the concept possible.

With respect, what is a functional market, and why does such a market require that consumers be vigilant and make good choices? If consumers make bad choices, don't they eventually learn to make better choices?

> If consumers make bad choices, don't they eventually learn to make better choices?

Even if we assume that consumers will learn to make good choices, that would require that they understand their choice was a bad one.

This is an A-B-C problem (antecedent + behavior => consequence). The consumer must first recognize that a negative consequence has occurred, and then determine whether it was their behavior that was flawed (they made the wrong choice) or a flawed antecedent to that behavior (they'd made the right choice, had their assumed knowledge of the situation been accurate).

Consumers don't do this though. Studies have repeatedly proved this (e.g. the very large effect of marketing and advertising on selection of products of otherwise equal quality).

Consumers may make decisions that are non-harmful (i.e. they got about the same result but simply paid more) but they certainly do not make decisions that are optimal.

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