Earlier this year my family had a medical emergency that resulted in us being billed a truly staggering amount of money for services that were technically elective, somewhat unproven, and not necessarily even recommended by the standard of care, and for which the actual sticker price varies wildly from hospital to hospital. But, when an emergency happens, you don't get to shop for hospitals, and you more-or-less unthinkingly do what the care team recommends, because there's simply no opportunity to stop and do any sort of cost/benefit analysis. As luck would have it, we ended up at a hospital that both tends toward the more liberal end of the spectrum in terms of what they do, and tends toward the more expensive end of the price range.
Fortunately our financial hit won't be too bad, because we have decent employer-provided insurance, and that cushions the blow quite a bit. If there's a silver lining, it's that we hit our out of pocket expense limit in the first part of the year, so we basically get everything for free for the rest of the year. But that whole situation is also a big part of the problem. We're nominally in the driver's seat, but, in practice, we really aren't in charge. Because we don't have access to a lot of the information necessary to make informed decisions, but also because we've been insulated from some of the major factors that might motivate an informed decision.
Social criticism in the USA tends to revolve around the "theater" metaphor. We have security theater, we have hygiene theater. I would characterize the underlying principle of the USA's health care system as agency theater.
This even has a name: Medical Tourism.
I am downright surprised I haven't seen a YC startup that performs this sort of medical tourism brokerage to be honest. Take this business model! I'll be your first angel investment.
I know the insurance plan that Utah government employees are on will pay you to go to Mexico to get your prescriptions filled. Airfare, hotel, and medication costs are all covered. Free vacation just so the company doesn't have to pay the US prices for drugs.
Edit: This is true for India which is a top medical tourism place:
https://www.orfonline.org/expert-speak/implications-india-me...
https://scroll.in/article/931857/with-20-medical-professiona...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC404528
http://www.who.int/hrh/resources/16058health_workforce_India...
No, really: you just, flat out, made this up.
You have no way of knowing that demand for services in every single country with medical tourism outstrips supply of professionals. You just assumed it.
If it doesn't, which is just as likely (I think more, but I also don't know, and unlike you I won't pretend to know), then you're injecting money into the local economy, while getting medical/dental care at a lower price: win win.
The US has a uniquely onerous path of education and accreditation for medical professionals, with substantial supply-side limitation in the form of slots for medical school. Other places aren't so burdened.
Something to think about.
https://www.nytimes.com/2019/08/09/business/medical-tourism-...
Though, I'm not convinced that's the "correct" solution from a broad societal perspective.
MX has a free market in healthcare, this allows people to get better care and lower prices as all free markets do
The cost of care in the US is so high because of the layers and layers of regulations, tax code, and legal liabilities that compound to influence the market in ways that are Anti-Consumer and increase prices on the service
So is it your belief that other countries that have highly-regulated medical systems, complex tax codes and a high degree of legal liability also have health care as expensive as USA? Or do you think it's possible that there are other factors at play?
For example in the US most hospital beds are semi private where only 1 other patent is in the room. Where in many government run hospitals in other nations they was a Ward system where 10,20 or more patents are all lined up in a row. This reduces costs but I prefer our semi private system
US also leads the world in medical research both in new technical, and in drug development largely this has a direct impact on our healthcare costs as well as unlike the rest of the world we do not have the same government mandated price controls. I wonder if US succumb to the pressure and does go full government run with the same price controls what that will do to the advancement of medicine in the world
If you look at a wide range of actual care standards such as Cancer Survivability Rates, Wait times for Specialists, Wait times for things like getting a Heart Stint the US leads the world in health care outcomes. I am sure you will point to the ever misunderstood Life Expectancy and /or infant mortality rates which ARE NOT a proper judge of the health system itself but commentary on other factors in society (such as lifestyle choices)
I believe the free market provides for the best outcomes for the most people, and I believe centrally planned systems be them economic or healthcare provide the worst outcomes. With the free market you may sometimes have breadlines but with centrally planned economies you may sometimes have bread.
That said..
>> taxes
This can never be free market, and some taxes (aka income taxes) is just unethical theft
> FBI, police
Should be funded in a variety of ways but absolutely could be privatized
https://reason.com/video/dont-abolish-the-police-privatize-t...
> Maybe we should get rid of army and hire mercenaries?
That is a little more tricky and would require an analysis of what we think the proper role of the military would be, but there are several proposals that replace the standing army (which is unconstitutional anyway) with something like the national guard controlled by individual states not the federal government
If everything is free market, why do we need government?
I know the answer, do you?
No taxes are not a service. Taxes are a compulsory contribution to state revenue enforced by the threat of violence. One can not simply choose not to consume a service and thus not pay the "taxes" for that service.
The fact is that the government, like a mugger, says to a person: Your money, or your life. And many, if not most, taxes are paid under the compulsion of that threat.
The government does not, indeed, waylay a person in a lonely place, spring upon them from the road side, and, holding a pistol to his head, proceed to rifle his pockets. But the robbery is none the less a robbery on that account; and it is far more dastardly and shameful.
>>If everything is free market, why do we need government?
we do not need the modern "nanny state" central planning style of government, we need a basic frame work of law that is far far far more limited that what most consider the modern government to be and is based on lawful defense of life, liberty and property nothing more.
A person is composed of Life, faculties, & production aka individuality, liberty, & property
Each of us has a natural right to defend their person, their liberty, and their property. These are the three basic requirements of life, and the preservation of any one of them is completely dependent upon the preservation of the other two.
The law is the organization of the natural right of lawful defense. It is the substitution of a common force for individual forces. And this common force is to do only what the individual forces have a natural and lawful right to do: to protect persons, liberties, and properties; to maintain the right of each, and to cause justice to reign over us all.
Since an individual cannot lawfully use force against the person, liberty, or property of another individual, then the common force for the same reason cannot lawfully be used to destroy the person, liberty, or property of individuals or groups.
Governments that are granted more power / authority than the collective organization of lawful defense are unethical in their foundation and purpose
My employer pays probably a shit ton of money for my health insurance and what I get is the most subpar, confusing, broken and sometimes blatantly extortive service ever.
I live in Austin and sometimes I think if I really need a major procedure it would be just simpler to drive to Mexico and get it done there. In fact, that's what many people in South Texas do, so there's your benchmark for how broken is healthcare in the US.