In the US, I think one problem is have too much mixing of public and private. We give the public sector a lot of decision making power relatively free of consequences, and leave massive profit opportunities for anyone in the private sector who manages to buy enough influence. Healthcare was far from a free market already before ObamaCare. But if we're going to regulate it as heavily as we do, I think we need to just step up and socialize it entirely.

I think the issue is political. Completely socializing it is still a hot potato for many, but healthcare as an industry needs to have stringent regulations in general. For example, strong rules around patient rights and patient privacy. But "socialized medicine" is a really dirty world in many parts of the country.

So you have a highly regulated free market that is neither a free market nor does it have the advantages of complete regulation similar to Europe. It just ends up being a really inefficient system.

It's a very US problem where we somehow managed to get the worst of both worlds.

>"We give the public sector a lot of decision making power relatively free of consequences, and leave massive profit opportunities for anyone in the private sector who manages to buy enough influence."

What would be an example of giving the public sector much decision making power "relatively free from consequence?" Would this be the FCC in this context? I ask because I'm genuinely interested in the point your making. Is there a relationship between this and and opportunistic private sector? Would this be the cell carriers in this context?

I had actually entirely forgotten I was still on the FCC thread after reading the comment I replied to, but sure, the FCC is also a good example of this. Take net neutrality for instance. That whole debate was centered on what the FCC would do - very little talk about legislative action. It is de-facto up to one agency that answers to an executive with all-time-low levels of public confidence, that also has an abnormally strong reputation for being in bed with industry. The current chairman has joked about it and been investigated for corruption, the prior chairman was formerly a major lobbyist for telco. There's other examples, like the revolving door between the FDA and Monsanto's board (I'm like 90% sure I'm correctly remembering the agency and the company - I'd double-check myself but I need to get back to a work issue and wanted to answer you soon-ish).

Nah, we just need to regulate prices, and disband insurance entirely.

Trump forced all hospitals to be transparent about their prices, there’s no reason on this planet that the shit they’re peddling should cost the amount it does, and if the overhead is on the hospital then we need to regulate further up the ladder. The pharmaceutical companies and suppliers who are basically extorting everyone.

Over regulation is a bad thing, but some regulation, especially with an industry as corrupt as American healthcare is good.

Unfortunately completely socializing the healthcare system would tank the economy thats why no serious person in washington is pro universal healthcare.

"a new study [0] from the Political Economy Research Institute (PERI) at the University of Massachusetts-Amherst finds that single-payer health care will save the US $5.1 trillion over a decade while drastically cutting working-class Americans’ health spending." [1]

"Blahous’s paper[2], titled “The Costs of a National Single-Payer Healthcare System,” estimates total national health expenditures. Even though his cost-saving estimates are more conservative than others, he acknowledges that Sanders’s “Medicare for All” plan would yield a $482 billion reduction in health care spending, and over $1.5 trillion in administrative savings, for a total of $2 trillion less in overall health care expenditures between 2022 and 2031, compared to current spending." [3]

[0] https://www.peri.umass.edu/publication/item/1127-economic-an...

[1] https://www.jacobinmag.com/2018/12/medicare-for-all-study-pe...

[2] https://www.mercatus.org/system/files/blahous-costs-medicare...

[3] https://theintercept.com/2018/07/30/medicare-for-all-cost-he...

I have no doubt it would save money. But my point was that healthcare companies would no longer be seeing that 5.1 trillion dollars and as a result those companies would lose value and tank the economy.

I just counted 62 Healthcare companies in the S&P 500. 5.1 trillion of lost revenue to those companies would be detrimental to the economy.

My own back of the napkin calculation:

5.1T / 10 Years = .51T / Year

Current US Stock Market Cap: 153% of 21T = 53T [0][1]

.51T of 53T = 0.9%

For reference; the 2000s bubble had the stock market decrease by 36% over 3 years, the 2008 bubble 45% over 2 years [0].

I'd say "tank the economy" is an overstatement. I'm glad to be shown otherwise _with sources_

[0]https://fred.stlouisfed.org/series/DDDM01USA156NWDB

[1]https://fred.stlouisfed.org/series/GDP

I'll be the first the admit this is an opinion i've completely come up with it by myself with no research or statistics to prove other wise.

Studies like these are worse than worthless. Just look at any recent major public works project for an example of cost overruns.

Here's how we could lower costs for Americans overnight: Allow importation of prescription medicines.

Medicare for all will lead to doctors for none. It's really hard to get appointments from places that accept Medicare, it's just not worth the hassle for many doctors to deal with them.

"This study is worthless, but here's my unsubstantiated opinion instead" is a weird argument.

Not really. It's pretty evident at this point that most publications are basically worthless.

You've said the same thing with zero evidence, again.

[citation needed]

Many countries have universal healthcare without a completely socialized healthcare system.

There are many serious people in Washington talking about the universal healthcare, just not many talking about government takeover of providers.

You would not call Bernie Sanders's plan socializing the healthcare system? (Serious question.)

As far as I know, people are only talking about socializing the health insurance system, not the actual health care providers.

I think the two are pretty closely coupled, if you have a giant insurance provider then they can dictate prices -- if the pharmaceutical companies haven't purchased the agency that does it, of course. It seems to work well enough elsewhere anyway.

You are one of the few people I have ever seen articulate the problem online. Free marketeers are always conflating a free market with an efficient market. We are aiming for efficient not necessarily free. The two only overlap as you described--basically when all participants have no power and good information. Those circumstances are rarely present.

Another analogy I like to give blind conservatives has to do with referees in their favorite sport. Yes, you don't love referees, but when they are doing a good job and seem to be calling it squarely, you know the overall game is better for have their involvement.

It helps but orthodoxy is hard to break.

Some additional resources:

Efficient Market Hypothesis[0]: "The efficient-market hypothesis was developed by Eugene Fama who argued that stocks always trade at their fair value, making it impossible for investors to either purchase undervalued stocks or sell stocks for inflated prices. As such, it should be impossible to outperform the overall market through expert stock selection or market timing, and that the only way an investor can possibly obtain higher returns is by chance or by purchasing riskier investments."

Investment theory of party competition [1]: "[...] if voters cannot bear the cost of becoming informed about public affairs they have little hope of successfully supervising government."

[0] https://en.wikipedia.org/wiki/Efficient-market_hypothesis

[1] https://en.wikipedia.org/wiki/Investment_theory_of_party_com...

Not sure why you're getting downvoted; I agree. One can't have all the freedoms, as they conflict. E.g., my freedom to burn things for fun may clash with other people's freedom to own a house. Free markets are very free on certain dimensions, while very constrained on others.

As an example, I used to work for financial traders. The exchanges were in key ways extremely free markets; anybody with the dough could buy the commodities they wanted quickly, cheaply, and easily. But the exchanges self-regulated very strongly. It was very clear to everybody at the company that making an exchange mad was Very Bad; rules had to be followed. And even getting allowed to trade on the exchange was a difficult and complicated process.