The general public doesn’t have enough information to make informed decisions when it comes to healthcare. This alone completely removes the usual market forces from providing any benefit when it comes to healthcare.
Cancer treatments don’t inherently cost that much money, the systems to ensure people are actually getting useful treatments are expensive. You can’t trust companies selling cures. You can’t trust every doctor when they have financial incentives to offer treatments. Insurance companies are in an adversarial relationship with providing treatments, which doesn’t result in efficient supervision here. Lawsuits offer some protection, but at extreme cost to everyone involved. Etc etc.
The net result of all these poor incentives is single payer systems end up being way more efficient, resulting in people living longer and spending less on healthcare.
Why is it always "the general public" and not "I". Do you have enough information about decisions? Can I take away some of your rights? No, of course not. Everyone else is dumb except me.
I'm sorry but I refuse to believe some unelected, anonymous bureaucrat has my best interests in mind or can even know me anything about me such that I want to allow them to make health decisions for me.
I'm sorry to tell you that this is, but unelected bureaucrats are constantly making health decisions on your behalf. You may not want government bureaucrats, but bureaucrats already work in your employer's HR department, deciding on which insurer to partner with, and with what benefits. They are at your insurance company, doctors office, and hospital administration, negotiating and deciding which procedures and drugs are available to you without ever asking for your opinion. Bureaucrats you didn't vote for infest drug company's research and finance offices, determining the availability and cost of your present and future care. None of these even pretend to act in your interests.
I'd rather have some government bureaucrat preside over all the other predatory bureaucrats. I sure as hell wouldn't be make well-informed decisions in the ER, or after getting a cancer diagnosis. Further, it is impossible to compare provider quality and final costs for elective, cosmetic procedures when I'm under no time pressure or stress.
I have no problem with bureaucrats. I want a choice. If I come in one day to find the shelves empty, I go somewhere else. If they make it difficult for me to check out, or are too expensive, I change. I just want choice.
You can choose to listen to the same unelected anonymous bureaucrats. Just log on to FDA or whatever, and follow their advice (e.g. follow the food pyramid). Only one of us wants to remove choice from the other, and that's the difference.
I trust government staff far more than the decision of unregulated, greedy corporations who literally exist to extract the most money from whatever process they're trying to sell you.
I have trouble believing empowering people who have no risk of losing their job and no one knows they exist is the best model for making decisions for other people.
EDIT: Also the whole VA system.
You mean like the (non-medical doctors) third-parties contracted by my private insurance provider who routinely deny important care[0] and even reject pre-approvals for antibiotics for MRSA infections even after multiple interactions with several medical doctors confirming both the diagnosis (with accompanying pathology) and the appropriate course of treatment.
Yeah, you keep that rolled up newspaper handy so you can "Gub'mint bad! Bad Gub'mint!"
I hope you never have to deal with a life-threatening situation where your insurer flatly refuses to cover treatment until after you're dead or have body parts amputated.
Every single product and service I am using in my life is made by a corporation. The clothes I wear, the food I eat, the car I drive, the PC I am making my living on.
Government?! Decaying infrastructure, lines at the DMV, crappy schools and killer hospitals.
You may trust the government if you want, but I will never. However, you are the only one pushing your choice onto me and reducing my options. I am fine with you using private or governmental services but you won't allow me this freedom.
Me personally, No.
I don’t have enough information to make informed decisions here and you don’t either. Off the top of your head, how well educated is your dentist? You after all made an informed decision picking them. So how well did their background compare to others in your area. What where your concerns about their dental programs weaknesses and how was that offset by… Except no let me guess that never entered your mind did it.
My dentist cleans my teeth. If it's painful every time I come or I keep getting cavities I consider changing dentists. If they suggest I replace my teeth with veneers or something extreme, I consider someone else. And I'll do a few google searches.
It seems pretty normal. You don't do this?
So you don’t need to continue, you just proved my point.
This is basically a religious belief at this point. It's how a perfectly ideal free market might work, but we don't have any of these, especially in healthcare.
Probably 99% of what I consume comes from private companies and the services generally get better over time, with some exceptions. Compare that to an experience with the TSA.
You're adorable! Do you believe in Santa and the tooth fairy too?
Or come here in Eastern Europe where we had the "pleasure" of trying both systems and see how free markets pulled us out of utter poverty.
Collusion and cartels never work on the long run. It's an unstable equilibrium, the incentive to reduce prices to capture more market is too great.
> What is it that still makes you believe
Competition. It's the only force keeping humans honest. That's why we must treat any barriers of entry in a market with extreme care. The only "failed" or "captured" market is a strongly regulated one.
For example, while the Phoebus cartel only really lasted from 1925 through to 1939, 1000hr incandescent light bulbs remain the standard offering till present day. Profitable market manipulations are sticky.
The whole notion that markets are efficient is just a mathematical construct that has become very dogmatic for people. But if you look into the details, markets are efficient under the assumptions of perfect information and infinite time. Neither of those conditions are present in the real world: we neither have perfect information nor infinite time.
> 1000hr incandescent light bulbs remain the standard offering till present day
This proves in fact that all the cartel did was establish a standard, an optimal average between various tradeoffs when building an incandescent lightbulb: brightness, cost, efficiency and life span. Yes, the cartel behaved anti-competitively. The effect on the market? Nil.
> perfect information and infinite time
There is absolutely no requirement for this for markets to work. Markets work just fine with partial information and just-in time. When new information and new market participants appear, markets will self-correct. The only way to prevent markets from working is through government intervention.
In facts, free markets are the only system we have that works with incomplete info and reacts in real-time. Central planning will happily decide on incomplete info then never adapt. We saw that during communism when the Party decided allocate X resources for production of Y and it always resulted in a glut or shortages. Central planning doesn't work.
Define "long run" - they have been already proven to have worked for years and in some cases even decades.
Pure misanthropic fantasy pretending to be sophisticated economics.
It's the obvious reality around me here in Eastern Europe. We were starving under communism before 1990 but are now enjoying the amazing wealth capitalism brought.
This is simply not true. Healthcare in the US is comparatively much more expensive than countries offering subsidized healthcare with comparable or better outcomes(1).
> it's largely due to regulation and third party payer system
Capitalism can't work in a market that's completely consolidated, and where people can't offer to not buy your service. Healthcare in publicly subsidized countries is much less expensive because it's regulated. Compare the price of simple drugs like insulin or asthma medicine if you need an easy example. Pharma companies still happily sell there, which is to say that the difference is pure profit on the back of sick people who don't have a choice.
My biggest grief against this individual payment system is moral though. I don't see the virtue in a system where kids have to put on a show to receive care. Or anyone for that matter, you'll give to a kid because they're cute and generate empathy, does it make someone ugly with no family less deserving of getting cured from cancer?
1: https://www.healthsystemtracker.org/chart-collection/health-...
So it is a highly asymmetric bargaining situation where all the incentives are poorly aligned. Of course it is exploitative.
And now your death will have a meaningful change to the career bureaucrat or politician that made the decision that led to your death.
Because power of an individual vote is much more powerful than the power to take your business elsewhere. That's if you can find out the responsible party that makes these decisions and they're not appointed but elected, otherwise you'd have to mount an influence campaign on the politicians with 90% re-election rate to change said bureaucratic leader.
Makes a lot of sense.
But seems some prefer to believe a theoretical argument with no evidence to back it up.
“The Party told you to reject the evidence of your eyes and ears. It was their final, most essential command.”
Agreed. Also, all empirical evidence shows that free-markets work better, producing far better outcomes at lower cost than either. Just look around at any less-regulated and thus free-er markets. Or just "reject the evidence" - your choice.
> die
I am middle-aged so I used plenty of health services in my life. I always had choices when in came to price and level of care and treatment. None of them were for the "dying" case. But I do have an insurance specifically for that case. I am a rational being so I plan in advance. No need for a government bureaucrat to decide my health care for me just in case some day I may be incapacitated.
To put another way, if I were facing some terminal illness I would want to have full control of picking the service even if it costs money. Sure, I would want "the best" specific to me and have someone else pick up the tab, but that's a fantasy, because no system or third party has as much skin in the game as me. That's why things like elective surgery are so cheap and competitive.
The problem is why do these treatments cost so much? What prevents competition and innovation. And my argument it's largely due to regulation and third party payer system