The US probably has the best, most efficient private sector of any developed country.

All you have to do is look at healthcare to realize this is (at least a) questionable assertion. I mean, it's dogmatic to believe so as an American but it's at least worth a proper look at.

I would argue that because healthcare is so regulated its more of a public sector thing. Also, an enormous amount of money going into the healthcare sector comes from public sources (medicare, medicaid, obamacare, etc.)

Note: I'm not saying regulation is bad. Just making the point that healthcare is really not a free-market in this country and never has been.

Almost nothing is a free market - so you have to be careful of the no true Scotsman fallacy.

Except that's nowhere close to a no true Scotman context.

The US healthcare system is extremely far away from being a free market style system. Healthcare hardly even crosses state lines. It's absurdly regulated. It's about as regressive in terms of markets as it gets these days. Over half the US system is government healthcare now, either directly or indirectly; eg heavy subsidies, SSD, Medicare, Medicaid, CHIP, VA, numerous other programs.

Part of the reason for the vast cost inflation, is that the system has gradually spread out to cover a lot more people over the last 30 years. 5% of people are half of the cost in the US system. In a market system, if you focus on covering the other far healthier 95%, the system is dramatically cheaper - that's how it worked in the 1970s-1990s, and US healthcare was radically less expensive. 50% of people in the system (in terms of cost) are only 3% of the total cost of all healthcare in the US, you can cover those people for extremely inexpensively in a free market system.

By changing the system as they have, such that you commingle government and quasi-private systems, you risk dramatically screwing up a private market system and the government system simultaneously. Ultimately you can do one or the other, you can't do both at the same time and in the same phone booth where they constantly collide. You get the worst aspects of both worlds, which is what the US now has.

I think you missed the point I was attempting to make. So I’ll try again. Yes, the healthcare system is very distorted - but that is entirely common for the US.

The Scotsman here in particular is a truly free market.

No True Scotsman is about moving goalposts within a conversation. Bringing up, say, a lack of transparent pricing for commodity services (x-rays or pregnancy tests, for example) isn't a No True Scotsman fallacy.

Ok, it my be pushing it a little bit - but the point is that the US economy is chock full of things like the healthcare system. You can’t easily argue that these are just outliers and the “real” economy is extremely free market. They are, in fact, completely normal parts of how the economy works.

Arguing the converse would be precisely the no true Scotsman fallacy.

Who's arguing that the American economy is exceptionally free market? It's certainly not centrally controlled as much as in other places, but I'm not sure "free market" is any more accurate. Large sectors (probably even a majority) of the economy is heavily regulated, monopolistic, monopsonistic, oligopolistic, etc.

The original point, that it's not fair to blame the free market for the dysfunction in the American healthcare system, is still a valid one. A main point is that "shopping around", even for commodity procedures, isn't really possible. Also, there aren't many remedies for consumers caught in undesirable contracts with health insurers. Quitting a job or moving states to fire an insurer is wholly unreasonable.

Actually the original point was that “best, most efficient” is not a feature of many significant parts of the US economy. Of which healthcare is only one example. Not sure why that caused confusion.

You're mixing free market and laissez faire. Any market without monopolistic forces and where prices are set freely by the balance of supply and demand and competitive forces is essentially a free market.

No, I’m not. Your description here is fine, but it does not fit a huge chunk of the real economy, which was the point. Healthcare is just one example of many (agriculture, energy, telecom, etc.)

> Healthcare is just one example of many (agriculture, energy, telecom, etc.)

That depends on the country. Energy and telecom are quite free markets in many countries, especially with local loop unbundling and separation of generation, transmission and distribution.

And compare that to "Almost nothing is a free market" which you claimed. Now it's the opposite: most markets are free, but some, which depend on restricted physical infrastructure, are not.

Very different from your claim.

No - My claim was narrower than that. In essence, that while we tend to think of the USA as very free market, in fact a huge fraction of the US economy is very much not free market. Enough so that any claim about free markets leading to strength in US economy is at least worth a second look.

At any rate I’m obviously not big articulate in the time I have for here, so I’ll leqve it at that.

You literally said: "Almost nothing is a free market".

> in fact a huge fraction of the US economy is very much not free market

Indeed, many industries depend on highly limited resources, such as land, natural resources and so on.

  You literally said: "Almost nothing is a free market".

Yes I did, in a broader context, which it is commonly assumed the reader is following.

The things distorting these markets in the US are typically nothing as simple as land, natural resources, etc... more they are policy decisions and politics. Suggesting otherwise is facile.

That really is the last I'll say on the issue.

> Yes I did, in a broader context, which it is commonly assumed the reader is following.

What does "Almost nothing is a free market" means "in a broader context"?

The context of a subthread that was specifically about the US economy?

We’re not going anywhere where useful now.

> All you have to do is look at healthcare to realize this is (at least a) questionable assertion.

Healthcare companies are more profitable in the US than anywhere else in the world.

Yep, "most efficient private sector" still applies.

You realize that’s not what efficient means, right?

Oh, it is, it extracts profits like nobody else.

I'm not talking about efficiency as in providing the best bang for the buck to consumers, companies and investors don't care about that. I'm talking about returns. Cold, hard cash.

The US public sector is actually middle of the pack [1].

1. https://www.fraserinstitute.org/sites/default/files/PublicSe...

The US spends 80%-90% of what Germany, Netherlands and Switzerland spend per capita PPP, yet the public services and social welfare in the US are abysmally bad.

Here's one issue with your source:

> The United States is one of the most efficient countries because no other country achieves its level of public sector performance with less government spending.

This is an unfair comparison, since public spending in other countries include national health systems, national pension systems, etc. A fair comparison would be the US vs. other countries including only the same expenditures as the US.

The indicators also seem weird, the US has a higher Education indicator than Germany and Switzerland, a higher infrastructure indicator than Belgium.

Also, the study is from 2007, using data up to 2005. Things changed dramatically in the past 10 years. Take a look at all the government shut-downs, etc.

Dunno about the rest of the metrics, but the relative rankings in "infrastructure outcomes" seem deeply off-kilter, based on my own experience (I work in infrastructure planning and have spent time in most of those countries). Would really like to see that measurement explained.

I don't really see why we should expect any tradeoff between the two. Most efficiency innovations would transfer.

It isn't about "enfficiency innovations". You always have to make tradeoffs between the collective and the individual, the private and the public.

Allowing private companies to extract economic rents from the public is good for the private sector, bad for the public. And vice-versa.

Take social expenditures, for example. The US spends 80%-90% of what Germany, Netherlands and Switzerland spend per capita PPP, yet the public services and social welfare in the US are abysmally bad.

Economic rents benefit owners of entrenched corporations, but they don't make them more efficient. They also don't explain why US corporate practices make foreign companies more efficient when they are exported. And you haven't addressed the difference in public service efficiency since 10% in scale is not nearly large enough to explain order-unity inefficiencies in the US public sector. (And in absolute terms the US is larger, anyways.)

> Economic rents benefit owners of entrenched corporations, but they don't make them more efficient.

Efficient at extracting rents and higher profits, yes.

> And you haven't addressed the difference in public service efficiency since 10% in scale is not nearly large enough to explain order-unity inefficiencies in the US public sector. (And in absolute terms the US is larger, anyways.)

Wait, you do know how good social services are in Germany and Switzerland, and how bad they are in the US, right?

If I had to rate social services in DE and CH, I'd give, let's say, an 8 and a 9.

Now in the US, well, maybe a 4 if you're lucky.

And they cost about the same per capita.

Lots wrong with your comment, but in particular note that we are discussing public sectors, not just social services.

> Lots wrong with your comment

Such as?

> in particular note that we are discussing public sectors, not just social services

Sure, let's discuss government-owned companies. And let's discuss infrastructure investment. And research spending. Oh, education too.

Pick one. The US is far less efficient than most of its peers in healthcare spending, government-owned companies, infrastructure investment, military spending, education, taxing, etc.

Please, tell me, where is the US government so efficient?

> And the worst, most inefficient public sector of any developed country.

I'm pretty sure most who live in their own developed country think their own public sector is the most inefficient. Well, maybe not the Swiss.

I’m pretty sure that’s not the case. My understanding is that the Scandinavian countries generally like their government and its level of efficiency as well.

The US spends 80%-90% of what Germany, Netherlands and Switzerland spend per capita PPP, yet the public services and social welfare in the US are abysmally bad.

> Well, maybe not the Swiss.

Yep, reasonably true.

Nor the Germans, Danes, Dutch or Scandinavians...

Few weeks back, while commuting to work the E and M lines weren't running. There were 3-5 MTAs finest per platform exit, hallways instructing riders "The E and the M lines are not running!" I took another route only to find same amount of MTA agents at the other station. You count the number of stations. The overtime paid that day would have gone a long way paying for a decent electronic information boards that rest of the world seems to have. As a taxpayer, this abuse of tax funds infuriates me.

We enter public sector with the expectations of the private one. Every public sector worker 'deserves' to be high middle class, which today is defined as 300k+ income easily, and we strive to have as many public sector workers as possible.

Most any definition of upper middle class you find will say that it’s over 100k per family.

Important to remember that when comparing SV tech salaries to the rest of the country.