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Health care is turning into a consumer product

economist.com

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Re: Health care is turning into a consumer product

#221

Post by dr_orpheus »

mumblemumble wrote: post #189
dgb23 wrote: post #76

Earlier quoted context omitted.

I agree. The "everything is a market" ideology had a good run of almost half a century, but it should be heavily criticized in hindsight. Institutions like healthcare, education, public transport, prisons(!) and so on are more efficient, less corrupt and of higher quality when they are in large parts collectively and democratically organized and funded. The "in large parts" is important here: A community should agree…

One thing to note about US healthcare is that it seems almost deliberately engineered to not be a market. I've never received significant health care in another country, so I can't say how the US system differs from others with any expertise. But I can say how US health care differs from just about anything else I spend money on: 1. I don't really get to shop for health insurance providers. My employer picks one, may…

For #4 on your list, I remember the insane bills we got when our first child was born. It was also insane the sheer number of bills that we got.

First we received a bill for the stay in the hospital. And then we received a bill for the doctor performing the delivery. Okay, fine, it makes some amount of sense, that doctor supports multiple hospitals and isn't technically part of the hospital and staff at that maternity ward that is there 100% of the time.

And then the separate bill for lab work, and another for the pediatrician, and another for our baby's stay in the hospital (this one really got me, why?! we were all in the same room), and then another for the lactation consultant, and, and, and...

I don't remember each one specifically at this point, but I believe it was 7 separate bills.

Edit: typos

Re: Health care is turning into a consumer product

#222

Post by dr_orpheus »

cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

> Well, I guess it is more efficient if the expected outcome is a larger profit for different private companies and middlemen and not the well-being of the rest of the population.

My favorite example of this is when I had to get an MRI. The lab imaging said it would be $800 if they billed it through insurance, or it would be $600 to just pay for it directly out of pocket. So the cost of having to deal with my insurance (which always advertises the "discounts" they negotiate and the "lowest cost") was actually more than what the insurance would actually cover.

Re: Health care is turning into a consumer product

#223

Post by sophacles »

refurb wrote: post #14
ryanmccullagh wrote: post #12

Earlier quoted context omitted.

Sugar is a drug. Have you ever reflected on sugar cravings? It's actually as addicting as many scheduled drugs. But it's in EVERYTHING! Most things have added sugar in them.

Have you ever craved food? It's a drug too!

There is a difference between being hungry and needing something sweet to satisfy a craving even though you're full. The later is called hedonic hunger and is (IIUC) very similar to addiction neurologically.

Re: Health care is turning into a consumer product

#224

Post by 999900000999 »

Turning ?

In America this has always been the case. Anything that's not 100% your literally going to drop dead without it, isn't covered by insurance.

Therapy is essentially a luxury good, around here none take insurance so if you don't have 1200 to 1600$ a month sucks to be you. It's comical, say your spending is out if control, unless your excess spending exceeds 1200$ a month your better off with a "Stupid" line item in your budget.

As long as your spending less than 1200$ in the stupid category, your coming out ahead.

In this space we've seen tons of quasi legal startups trying to capitalize. Who cares if these therapists are licensed to operate in the same state as their clients, we got money to make and vC funding to raise.

Re: Health care is turning into a consumer product

#225

Post by mindslight »

vorpalhex wrote: post #176
netizen-936824 wrote: post #86

Earlier quoted context omitted.

So we should just expect people to be greedy and try to ruin systems for their own benefit. That raises the question of how to make these systems more robust to defend against that sort of attack.

That is the pro of a market system. A market with a malbehaving dominant party is liable to be upset by a new contender who will undercut them, thus depriving the misbehaving party of income.

This is true, but I haven't seen any coordinated efforts at market based healthcare reform. Some of the needed reforms are patently obvious (eg make arbitrary post-facto charges illegal, like every other industry), and yet there are no popular campaigns advocating for them. There are a few comments in this thread chiming in with lists of reforms, and I could write one of my own, but politically it's crickets (likely because the Parties are partially employed by the healthcare industry).

Instead I'm forced to reluctantly support single payer healthcare, despite it being a huge corporate giveaway. It's really saying something when "have the government take it over" is the clearest path to restoring a more functional market.

Re: Health care is turning into a consumer product

#226

Post by pg_bot »

ch4s3 wrote: post #207
nopenopenopeno wrote: post #178

Earlier quoted context omitted.

Employer-based healthcare was won by an alliance of corporate and healthcare industry lobbies against a state healthcare plan in the 1950s when the so-called “free market” healthcare system was failing the public. Prices were increasing and the New Deal corporate powers pacified the public with social security and employer-based healthcare. Edit: updated 1960s to 1950s per info in replies

In the US healthcare was intentionally tied to employment as a means of controlling wage inflation during the 1950s by Eisenhower. He had pushed for the "middle way" of private nonprofit health insurance that could be purchased individually or by employers. As inflation began to spike, the administration added new tax benefits to encourage employers to compete on providing benefits rather than higher base salaries. R…

It's not Eisenhower's administration that's to blame, it's FDR's. Employer based healthcare is a result of the stabilization act of 1942. Health benefits were offered as incentives to workers because employers could not raise wages.

Re: Health care is turning into a consumer product

#227

Post by ch4s3 »

pg_bot wrote: post #226
ch4s3 wrote: post #207

Earlier quoted context omitted.

In the US healthcare was intentionally tied to employment as a means of controlling wage inflation during the 1950s by Eisenhower. He had pushed for the "middle way" of private nonprofit health insurance that could be purchased individually or by employers. As inflation began to spike, the administration added new tax benefits to encourage employers to compete on providing benefits rather than higher base salaries. R…

It's not Eisenhower's administration that's to blame, it's FDR's. Employer based healthcare is a result of the stabilization act of 1942. Health benefits were offered as incentives to workers because employers could not raise wages.

Yeah, I realized on a second pass that I had jumbled the "middle way" stuff with the Roosevelt era bill.

Re: Health care is turning into a consumer product

#228

Post by TrispusAttucks »

cntainer wrote: post #44

It's interesting to see that "Health care consumes 18% of GDP in America" compared to ~10% in most developed countries. In my (non-american) opinion part of that difference comes from the fact that healthcare is already a consumer product in the US. Maybe not entirely, but much more than in Europe, where universal healthcare sponsored by the state is the norm. Another point is that US healthcare is considered the mos…

You hit the nail on the head.

> So you basically get the worst performing being also the most expensive. Which doesn't really fit the view that less government involvement results in a more efficient system. Well, I guess it is more efficient if the expected outcome is a larger profit for different private companies and middlemen and not the well-being of the rest of the population.

Healthcare and Big Pharma have captured regulators at various federal health institutions. The mission is maximizing profit outcomes not health outcomes.

Re: Health care is turning into a consumer product

#229

Post by swagasaurus-rex »

lostcolony wrote: post #210
tablespoon wrote: post #197

Earlier quoted context omitted.

> I suspect the argument is "Healthcare has never been allowed to be a market" Given how many legal restrictions are placed on it, I tend to agree. Emergency services aren't a good fit for markets. For markets to work, people really need the luxury to shop around with some leisure. Wasn't there some Roman oligarch that ran a private fire department, and basically just used it to extort property owners when they had a…

I will also comment that when we talk about "healthcare being a market", we need to separate out providers of healthcare, with insurers of healthcare. Insurers of healthcare are much closer to a market (in that I can generally find out what the cost of the insurance is, and what it covers), but providers aren't (in that prices lists are hidden, it's not clear what is covered vs what isn't, etc). We talk about the cos…

Here's a theory: Insurance companies argue and refuse to pay out to hospitals because it's an adversarial relationship.

Hospitals increase rates to cover the overhead of dealing with hostile insurance companies. Insurance companies raise rates to match increased hospital billing. Ironically both industries are incentivized to raise rates on customers while trying to gouge each other.

Is it any wonder healthcare is a scam?

Re: Health care is turning into a consumer product

#230

Post by dragonwriter »

pg_bot wrote: post #226
ch4s3 wrote: post #207

Earlier quoted context omitted.

In the US healthcare was intentionally tied to employment as a means of controlling wage inflation during the 1950s by Eisenhower. He had pushed for the "middle way" of private nonprofit health insurance that could be purchased individually or by employers. As inflation began to spike, the administration added new tax benefits to encourage employers to compete on providing benefits rather than higher base salaries. R…

It's not Eisenhower's administration that's to blame, it's FDR's. Employer based healthcare is a result of the stabilization act of 1942. Health benefits were offered as incentives to workers because employers could not raise wages.

> Employer based healthcare is a result of the stabilization act of 1942. Health benefits were offered as incentives to workers because employers could not raise wages.

Employers can raise wages, and have been able to for some time, so that's not why we still have it.

We still have it because of tax and other incentives, and because government keeps making policy decisions to protect, and even extend it (e.g., the ACA employer mandate), not because of the employers need to offer health benefits to compete because they can't offer more wages because of WWII-era wage controls.

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