Sure, that makes sense.

We should also acknowledge that it costs money to deliver and we live in a resource constrained world.

The cost of the thing is effectively irrelevant if you both need it and don't get the bills for weeks/months. If patients are expected to self-ration, they need the info up front...

That doesn't seem to have stopped most other countries from having free or near-free healthcare. You shouldn't even have to think about money when dealing with hospitals.

This language isn't very helpful. It is likely paid for from general tax revenue. That might be a better implementation but it certainly isn't "free". And if it isn't explicitly paid for via tax revenue it will end up being paid for via inflation if the government spending is out of line with its revenue.

By "free" I meant "free at the time of treatment". Of course nothing is free. Traffic lights aren't free. Road maintenance isn't free.

Many people really don't connect the dots between tax policies and health care insurance/payment policies. Saying that health care/insurance is "free" makes it difficult to have a coherent policy discussion.

I know the ship has sailed on this but it I continue to see people truly believe that they are not paying for health care and that sort of misguided understanding of economics shouldn't be encouraged as it makes it difficult to have coherent discussions about many different public policies.

    College education should be free...
    College loans should be free (even when they weren't when the loan was taken out)...
    Income should be free (UBI schemes)...

If you switch to "subsidized" from "free" the list expands exponentially.

The language is fine because that's what the word "free" means. Do you complain that a cloud provider's free tier isn't really free because it's paid for by other customers?

It seems it's only with healthcare people forget the meaning of the word.

As is common in these discussions, I’ll reference the French system as I experienced it.

If you have to go to the hospital, that’s not billed to you.

If you see your GP, they charge you up front. There’s no copay as in the US system, the doctor just charges what they want. The doctor doesn’t keep any significant medicine on prem. If you need a vaccine, they write a script that you take to the pharmacy and return with. In either case, you submit your paperwork after the fact and get reimbursed. For office visits it’s 80% of the “reasonable and customary” changes. For medicine it’s usually 50-60%.

You can purchase additional insurance that covers more of these costs, but I didn’t see any value in it for my situation.

When I left, French insurance companies were setting up US style networks with doctors. If you saw an in-network provider, you were reimbursed more.

Only the truly indigent get “free” healthcare under the French system.

Government restricts the resources available for health care with the idea that it costs to much to have extra.

So my local hospital just does whatever and charges Medicare their CAH rates, doesn't matter a lot if they suck or could be cheaper, no one else can open a hospital (both by state law and because Medicare probably wouldn't agree to pay them).

Is most medical care urgent? I dislike asking for citations, but that is quite the claim!

Are you saying the majority of patient-practitioner encounters are emergency visits, or that the majority of spending is on emergency care, or something else?

I'd expect the majority of people's encounters with big medical bills from hospitals before old age are either emergency, or childbirth related, so those are the two things you'll see young and middle-aged people complain about.

But the biggest bills are probably near end-of-life, and mostly not emergency care.

Most medical care is not urgent. In fact, emergency care is a tiny fraction of all medical spending.

Thus the ability to "shop around" and thus subjectivity of medical care to price competition definitely exists in the majority of cases. If the system were setup to incentivize and support this. But due to lack of price transparency and skin in the game, there is no competitive pressure on pricing in practice.

https://www.politifact.com/factchecks/2013/oct/28/nick-gille...

Your link doesn't support your claim about shopping around.

Most health insured patients can "shop around" in their network, which is a list of pre-negotiated priced providers that the insurance company has approved. Providers that are already vetted to be the lower cost for insurance, created through purchase power. And that's assuming it isn't an HMO, for which there is no shopping around.

There are not enough options for real market competition in healthcare.

My comment's point was that it's theoretically possible for healthcare to allow for shopping around, but in practice it's not. Due to lack of price transparency and lack of incentives for consumers to care (max out of pocket)

I love how we go to theory instead of looking at other nations where healthcare works, like Australia. American exceptionalism at it's finest.

America didn’t become great by copying Europe. Or Australia.

There are obvious flaws in the healthcare system that are apparent from first principles. No need to blindly copy others.

Removing incentives for people to use the system efficiently leads to poor outcomes in different ways

I never said blindly, but I do love that you admit to thinking America is great. What other countries do you think are great?

More people want to move here than anywhere else in the world, enough evidence for me.

It's evidence for more migration being permitted from places that are worse off. That is not evidence of greatness.

Out of the frying pan, into the fire.

I think if you visit a place like Australia you'll realize it's much more of a melting pot than here.

Believe it or not, you were raised by American education to believe this is the best country in the world. Take some trips, you'll change your mind if you get out into the world.

Just like how we can shop around for our internet here :)

It's wild to me how folks will continue to support the predatory healthcare industry here.

Yes, increasing competition will lead to better results for society, in all markets.

Through competitive pressures which drive down cost and encourage increases in quality.

There is very little competitive pressure in healthcare from the consumer due to the issues already mentioned above

You're not wrong that competition helps, but you're being naive if you think healthcare is a market, or that it would not eventually be captured like so much else in the USA.

In fact, I think you'll find most of healthcare has already been captured by private equity, resulting in worse outcomes for the both doctors and patients.

Bingo

Healthcare is inefficient for many reasons, most of which stem from poor laws/controls, lack of individual incentives, and poor transparency. All of which can be solved trivially via well structured laws without radically overhauling the healthcare system.

Protectionism limiting the number of doctors inflates wages, lack of price transparency removes ability to comparison shop, max out of pocket plans remove incentives to consider cost in care. All of these are easy to solve once they're identified and understood as problems.

When you look at disciplines where pricing is transparent and insurance isn't generally involved, like cosmetics/plastic surgery, the costs are quite cheap. Because it actually acts as a competitive market with incentive for consumers to comparison shop

Dang, that must be why everyone flies overseas for hair transplants.

Or maybe. . . maybe you're talking out your ass.

https://us-uk.bookimed.com/article/where-to-get-cheap-plasti...

If you're not going to bother to be right about that, I can't take you seriously saying that our situation is trivial to solve, but that also the solutions that work in other countries won't work here. Call be crazy.

Elective plastic surgery is hardly inexpensive in the U.S., or representative of healthcare in general. I don't know why you're so hung up on price transparency, it simply isn't the silver bullet you think it is for reasons repeated throughout this thread.

This is the entire purpose of this legislation. It requires hospitals to publish their prices for these specific “shoppable” services.

The problem with this legislation is that prices at one hospital are only useful in comparison to another hospital’s prices. Since the law doesn’t provide a facility for comparison, even the compliant hospital’s data is nearly useless. There needs to be a centralized database with compatible definitions for each procedure that allows consumers not just to see the prices, but to directly compare them.