Post-apocalyptic life in American health care

> I would argue that food escapes its measure of utility because otherwise, we would all be eating only the cheapest and healthiest option all the time

Economic utility is subjective; while it includes health effects, to be sure, it also includes things like the taste and other enjoyment factors. It absolutely is not the case that, were food a perfect example of rational choice, we would only be buying options that cost-effectively optimized healthiness.

> Its true healthcare has less frequency so you cant be a sophisticated consumer: but its more frequent than a car

“Healthcare” is a broad class of different products and services, many of which are far less frequently purchased than autos (if you buy open heart surgery more often than you buy a car, you are way out in a tail of frequency-of-purchase distribution of at least one of those items.)

OTOH, cars are also a market in which purchasers take a number of steps to counteract the low frequency. No one is test driving a variety of different surgerical interventions before choosing one.

The author concludes that communal or relational modes of interaction will become more common as systems fail. It would have added a lot to the article if he gave some tips on talking to the various providers and bureaucrats in the system (the only advice is working in a medical office and "having charm").

Once you've seen it, the communal/relational mode of interaction is immediately easy to spot and is actually a very rewarding way to interact with people. Although it doesn't happen as often in large cities except among large families or tight-knit ethnic groups, I think a well-functioning workplace should have some of it. People helping others out, getting to know each other, and so on. The problem is the conflict between the way the health care system presents itself and is organized (systematic/transactional) and the way it really works.

Tips on seeing the communal mode and maybe practicing a bit: Note how your group of friends relates when they're camping or otherwise on a trip of some kind. Spend some time in a smaller town where you know at least a couple people. Spend time with lower-income people from a similar background to you, who have to rely on each other more versus their bank accounts. Outside large cities, ask people at the stores or wherever how they're doing and actually care about what their response is.

I was responding to a comment that starts "It's amazing that someone can go through this and come to the conclusion, at the end, that the solution is that this is a business opportunity that would make a lot of money if someone could just make it more efficient." It's a pretty direct critique of the use of capitalism in the healthcare industry. How did I make it any more of a generic ideological argument than my parent comment?

edit: Upon review of my recent comments, I'll admit that their quality is poor. I'll try to avoid ideological squabble in the future. If you could still answer my question on this particular post, though, I'd appreciate it.

> Definitely agree that there are degrees of freedom, I'm just not confident that a removal of regulations in the healthcare market would lead to a positive outcome (higher quality/less expensive healthcare).

Economists have a high degree of confidence that some of the rules that are restrictive of a free market account for sizable chunks of the cost: not being able to import pharma and immigrant restriction on doctors being quintessential.

Not being able to import pharma is denounced both by Bernie Sanders and Rand Paul (whereas the first wants to socialize medicine, and the latter remove regulations).

Doctor's immigration restrictions are large but also very hard to politically fight. Also the high cost and restrictions of medical licensing. Friedman was very unsuccessful in turning the public against them.

> I was actually thinking about when medical treatment is being received. Once you're under a hospitals care you're largely subject to their pricing for services (e.g. I can't choose to use the cheaper MRI machine down the street).

This applies only to emergency care: if you have cancer, for example, you have plenty of time to choose going to the cheaper chemo. And even a smaller fraction of emergency care: breaking a leg is painful but it does not incapacitate you to choose one hospital or the other: in fact, we do that all the time by picking which one is closest (choice that must indubitable be made in comparison to another option).

And after that, you have an insurable market, which means that you have all the time in the world to choose between options.

> you agree to a particular payment structure for services without knowing what the cost of the services are or which services you'll be receiving when checking into a hospital, this opacity in hospital pricing also means that different parties are paying different rates for the same service at the discretion of the billing department.

Same as car insurance, or mal practice insurance, or house fire insurance, or renters insurance. Not knowing what you will get is at the core of the insurance service models.

I see a struggle to find what makes heealthcare unique to falter in two regards: first, that finding that quality that makes healthcare a unique market does not show anything other than identity: it might be the quality found points to private healthcare instead of public. But also, the extreme difficulty to find a qualitative difference between health and other markets is due to the fact that it might actually not be qualitatively different at all.