Why can't the market deliver healthcare at a low cost?

Don't believe that. Drug Companies and Specialty Pharmacies and Insurance Companies make drugs that people cannot afford, affordable.

Hospitals will work with patients allowing them to make monthly payments they can afford. And physicians and surgeons will work with patients to make treatment affordable.

Did you know that Federal law makes reducing or waving patient patient co-payments illegal?

 

That's why all those Medicare supplemental plans exist. But all that's supposed to go away with Medicare for all. What do you think the hospitals will cut to make up the shortfall?

 

I am surrounded by people who charge as much as the market can bear. If my roof starts leaking, I have the option to just ignore it, but I know that's going to result in water damage which is going to cost me even more. The roofer is going to charge me as much as he thinks I am willing to pay.

Everything is based upon flensing the customer for as much skin as can possibly be obtained.

If you get a heart attack, guess what boss! I'm going to take you to the cleaners even before I figure out how much you have in your bank account and how much you can borrow on whatever you have.

I'm doing exactly what you do, only you don't like being taken to the same cleaners you take your customers to.

If I can put a lien on your dreams, I'll do that because you're having a heart attack, and that means I can charge whatever I want, and you will pay it!

Same as you! Whatever the hell you do, you will try to do the same to me, and that's expected. Just when that heart attack comes, you'll have to pay me whatever the hell I want to charge you.

 

I recall people accusing the old school mafia run unions such as the Teamsters of being crooked in terms of control of their bloated pension funds, but that is an entirely different subject altogether. That concept is not a knock on nonprofits, it is a knock on the Mafia. To accuse mostly church-run hospitals of the same is more than just a little bit disingenuous, and it is using a transitive property that does not exist.

On top of that, pointing to charge lists, while ignoring actual reimbursement rates is also disingenuous. Not to mention that you have clearly exaggerated the number as well.

 

Except that monopolies don't happen without government intervention. USPS has a government enforced monopoly and no motive for profit or efficiency. This means they aren't particularly worried about being keeping their prices low.

How does a private company achieve a monopoly? If they're the only company delivering mail, what would stop anyone else from competing with them? If the one company keeps prices as low as possible and innovates to give customers what they want that might dissuade competitors from entering the field. If they fail to meet demand or raise prices that provides opportunity for competitors to come in and take market share from the first company. That means no monopoly.

If many companies compete with a profit motive, they will necessarily provide as much service at as low a price as possible to keep their competitors from taking their customers and running them out of business. The will have to care about productivity and efficiency as well as providing a superior service to the customer or lose out to their competitors. The U.S. telephone system is a perfect example of this. For quite a long time "Ma Bell" was a government sanctioned monopoly and their prices, services and innovations were terrible. When the monopoly was broken up there was an explosion of innovation, improvements in service and lowering of prices. Its may be too late for that kind of change to occur in mail delivery as it has been made mostly obsolete by alternative messaging technology. I'm probably wrong about that though as I'm sure there are entrepreneurs that could come up with ideas to make snail mail viable again.

 

Now if you can just get the feds to quit mandating huge one size fits all policies covering things for which the overwhelming majority have little use and ignoring things they'd like to have.

 

No more data needed.
They live longer and pay less. The rest is just fluff.

 

What do they charge for a gall bladder surgery?

 

Yeah, it's interesting that UPS actually transfers to the post office for a lot of rural deliveries.

 

Clearly that would be beyond the normal scope of a primary care clinic but you could go to this place: https://texasfreemarketsurgery.com/ and pay this amount: https://texasfreemarketsurgery.com/pricing/laparoscopic-cholecystectomy-gallbladder-removal/. It would probably be worthwhile to have a high deductible insurance plan for those things not covered by the direct care clinic but if you don't you could still probably get the needed work done without breaking the bank at a free market surgery center like the one linked.

 

LOL.
If your roof leaks, you likely have dozens of choices to pick from.
In the case of healthcare, in many parts of the country, it's 1 choice.
In many parts there might be a few options for non emergency situations, but costs are NOT know.
There is not and never has been a free market in healthcare.

And NO, I won't take your or anyone to the cleaners. What good does that serve?

 

So you can't discuss the studies in an intellectual manner either. Bravo

 

I'm not sure I can trust a company that operates out of a suit in a strip mall.

 

I don't need to. Those two items tell it all. Don't need the fluff.

 

In a free market that can be part of the criteria you use to choose whether you will do business with a given company.

Personally I've had doctors that work out of their house, at my house (house calls when I was a kid), in strip malls, doc in the box clinics, medical buildings, military hospitals and commercial hospitals. I haven't found that the facility they're working in is particularly relevant to the quality of their work.

 

As Millions do.

I Love my Medicare !!!

 

Look, there is no comparison and it is completely relevant. Unlike other industries including the car industry, the healthcare industry is entirely focused on servicing peoples actual lives (as in whether they stay alive the next day). The car industry is not. Of course you can come up with some border case where having a car might save your life, but EVERY SINGLE healthcare service scenario is focused on a persons life (whether they live or die). This is where the line gets drawn that healthcare IS not a consumer good like a car or an ipad, etc. And when profits become a bigger factor than the person themselves, it becomes a major ethical issue. You can argue the logic of how efficient a minimally regulated market healthcare would be (with only anti trust laws) and how it worked in the 20's and I'd agree with you it is more efficient. It would be more efficient than what we have now.... and even more efficient than a single payer system. But, at the end of the day, it comes down to ethics and I completely disagree at that point. It's not ethical and peoples lives are not just cogs in a well oiled machine. Anyone can use logic to argue almost any point as long as its consistent, but that doesn't mean it's ethical or that its correct.

The reason a singe payer public option system is the best way to go is that it's a compromise between both sides of the argument. Those two sides being efficiency and ethics. There is also all this data from pretty much any other developed country in the world saying it works and works much better than our current middle man system where the customer can't even see what the prices are (there is nothing free market about this), which the extremists love to ignore again and again and again...

 

Everything that consumers want, that is scarce, is a good. The only things that aren't goods are those things that are available in such abundance they don't need to be bought. Healthcare is absolutely a consumer good and it gets ranked with all other consumer goods on consumer's value scales along with cars, houses, food clothes, cell phones, ipads and every other thing the consumer wants or needs. In any free market where there are multiple providers of the good in question, healthcare in this case, the providers want to maximize their profits and the consumers want to minimize their costs. This will cause an equilibrium price to be approached that balances the needs of the consumer to reduce his costs and the providers to maximize their profit within the constraint of the market. If the provider raises prices, the consumer will go to a different provider so the provider can't increase his profit beyond what the market will bear. This would be no different if the product discussed was cars, ipads or anything else on the consumer's list of goods. Profit is what drives the provider to sell his goods on the market. It is indispensable to the provision of a quality product at a competitive price. Do you think any of the goods you consume are provided because the provider cares if you live or die? Ranchers and farmers aren't sending over their steaks and potatoes because they want you to enjoy yourself. They produce them and sell them because they want to get paid. We can have a steak dinner or heart bypass surgery because someone wants to get paid. Its nice if they also don't want you to die but that isn't why they're providing the service.

In a free market the provider has to please the consumer and if they don't they go out of business. A private medical practice does care if their clients live or die because it affects their bottom line. That isn't to say they don't care about them on a personal level but if the client doesn't pay his bills he doesn't get the service. Clearly that is because the profit motive is more important than the personal interest. Today we have a heavily regulated market where the patient is rarely the client. This means the doctors, hospitals, insurance companies and government agencies are doing what is in their best interests, very often to the detriment of the patient. Get the government out of the business, return the insurance companies to their proper role of risk mitigation for major issues and let doctors and patients transact their business directly and costs would drop dramatically, services would improve equally dramatically. This is in fact the most ethical and the most efficient solution to the health insurance/healthcare problems in the U.S. today. Return control and responsibility to the individual on the consumer and provider sides of the transaction and remove the third party interference.

Single payer doesn't address both sides of the argument. Its a choice between a State controlled system and a more highly controlled State system. It exacerbates one of the primary causes of the current system in that it puts the decisions for costs and provision of services in the hands of bureaucrats that are interested in their own well being far more than that of any patient or doctor.

I've posted links several times in this thread that shows examples of successful, relatively (they're still operating in the current environment) free market clinics. These places provide direct primary care for very reasonable, published prices.

This site will allow you to find DPC clinics in your area if there are any: https://www.dpcare.org/
This is the website of a random clinic (this one is in Colorado Springs and Denver) I found on the dpcare.org mapping page: https://www.peakmed.com/
Their prices and benefits are listed on the website. The cost is 89 dollars for seniors, 79 for adults and 49 for children. For that monthly fee they offer unlimited office visits for routine issues like physicals, chronic disease management, blood draws, etc, discount prices on meds and included specialist consults in a variety of areas. That is less than 1200 dollars a year for what amounts to about 90 percent of healthcare needs. The responsible citizen should also have a high deductible insurance plan for catastrophic health issues but that would be their decision to make.

 

If you want to remain ignorant of studies who's results you claim, yes.

 

All the data shows single payer systems are more efficient, provide better care and does so at a fraction of the cost of our system.

Single payer is objectively superior to our for profit system.

 

This entire statement tells me you have no idea how single payer systems work and I'm not going to bother explaining it again in depth,being that there are many versions of them you could look up yourself. The government has NO role in the provision of services with single payer. They do though have a large role in negotiating prices and paying the doctors. Hence the compromise. You still can get private insurance but you have that public option as a citizen and there is still that competition you were talking about in your "free market" idealized scenario. Our CURRENT system is a perfect example of crony capitalism where effectively the customer has zero ability to negotiate prices, plus government mandates of the insurance companies give them even more incentive to raise costs. If a single payer system were to be implemented it would require a complete overhaul and reversal of many of the current regulations as they'd be redundant. I'm thinking your statement applies more to a national health system like the VA.

As for the consumer goods thing, you know the point I was making. I know what consumer goods are, but there really isn't a term for what I was trying to say. The point is, the healthcare industry requires more regulation than others. Some things, like cellphones require virtually no regulation. And there are obvious reasons why that is. It's similar to the food industry, but still even more prone to harmful exploitation of the consumer by the industry. If your citizens are committing suicide because they can't pay their medical bills, plus according to the facts the US has one of the worst healthcare systems in the developed world costwise and in certain cases even by outcomes, that tells you we aren't doing a very good job at providing equal opportunity or providing for the general welfare. Having a healthy population is a stimulus for the economy.

"that are interested in their own well being far more than that of any patient or doctor." If government employees are required to be on the public option, doesn't their bias pretty much go away? Working on making the system more efficient would also be working on making the system better for every citizen (their well being becomes the citizens well being). If we were to adopt a public option, I would be for making it a requirement that all civil servants be on it and not be paying into other private insurance plans. All single payer is, in the simplest terms is a public insurance option which every citizen can opt into. Getting rid of medicaid and just expanding medicare is the most popular plan.

I agree with you partially, that is about getting rid of all the harmful mandates and regulations we currently have in our system like requiring full time employers to provide insurance. Obamacare, even with the expansion of medicaid did more harm than any good by stupidly mandating insurance companies. Those plans look pretty interesting and I'm sure would be even better if you were to reform our current system.

 

My list of the current causes of high healthcare costs:

Liability Laws
Virtual inability to negotiate drug prices
The hospital drug dealer problem (trying to give patients overly expensive drugs and procedures they do not need)
Draconian Health Insurance Minimal Coverage Mandates
Inability to compare the costs of basic procedures and drugs before getting treatment
No real choice between basic procedures and drugs (life threatening situations)
Requiring Employers to provide a health insurance option to full time employees

I wonder if someone could expand on these or tell me where I'm wrong here

 

I'll throw in a couple of things.
There is no way to control price fixing in the provider base.
There is no way to exert downward pricing pressure.
Insurance profit is reduced with single payer.
Even with all the problems in the current system Medicare is about 1/2 the cost of private insurance.
That is because it sets cost for treatment and eliminates profit. It also has lower overhead.

 

If they don't change those two things they are just fluff for some rightie to try and hide behind.