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Comment by savanaly | Hacker News Reader

>customers have relatively little ability to choose providers or price shop, and they often don't really understand what they're being asked to buy.

I don't agree that these are good reasons to make healthcare not a market. It's true that customers don't necessarily have a lot of ability to choose providers or price shop under our current system, but that's certainly not an inherent trait of healthcare. It could be otherwise.

As for not understanding what they're being asked to buy, what I'll say about that argument is it proves too much. Why do the markets for computer repair, automobile repair, etc. not have the problems that you claim would be inherent to a free market in human body repair? Understanding of the subtleties in those areas is equally out of reach to understanding of healthcare.

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You are ignoring the part about not having a choice of whether to buy or not. If I buy a car or something else about which I know next to nothing, I can ultimately decide not to buy, if I feel like I'm being scammed. If I get injured or sick, I can't realistically choose not to get treated.

People are injured or killed by cars. People lose their life's work when their hard drives go bad (yeah, backups, but it still happens).

I agree that they aren't perfect analogs, but we're talking tangerines and oranges, not apples and oranges.

EDIT: Downvoters care to comment on where they disagree?

This is one of those comments that will later be quoted in some Buzzfeed article about why HN is a soulless libertarian shit hole. And, quite frankly, I’d have to agree. The only redeemable counter argument is: it never got taken seriously, just downvoted, so it’s not representative of the tone of discussion.

Although it’s awfully close to some of the other threads here, I’m happy we collectively chose to draw the line at an argument honestly comparing computer repair to health care. (I can’t even believe I’m typing this; please don’t ever ask me to explain that again).

That's a very irrational thought process, but thanks for not leaving me in the dark.

I was just comparing the aspect of non-experts making big decisions based on expert advice. I wasn't saying a wiped hard drive is the same as cancer.

But it's also not true that any health problem (getting the flu, cutting your finger pitting an avocado) is worse than any computer problem (losing the only copy of your dissertation, getting phished for thousands of dollars).

Part of the way out of the dialectic gridlock we're having is to stop treating every health issue like it's both confusing and life threatening. But there are certainly edge cases. Nobody wants people dying of cancer due to bad advice or lack of funds.

> I’m happy we collectively chose to draw the line at an argument honestly comparing computer repair to health care

People not listening to people isn't the most human (or soulful) option on the table.

I see what you mean.

To be honest, my problem with the original comment was the lack of clarification and contextualisation. When it comes to sensitive issues (like health and people losing their actual lives), I think it's not OK to forego acknowledging the human aspect and focus on numbers or economic theory alone.

A good point can be made poorly, and it can hurt and alienate a lot of people in the process. Flatly "telling it like it is" does not always benefit mutual understanding or societal healing; it risks driving us further apart. Which is an ironic thing for me to say, because I put my foot in my mouth every other day. I guess it really does take one to know one :)

What you're saying is you don't have a proper response, and therefore choose to disparage the comment in some imaginary meta-context. Buzzfeed? Seriously? Who cares what Buzzfeed thinks?

The market for auto repair is also regularly cited as one of the more scammy, consumer-unfriendly experiences around - because consumers have a very difficult time assessing quality of service, and incremental charges often pop up mid-purchase.

This is why consumers love warranties and extended-warranties on their vehicles so much - it means they leave this problem to their insurer. It's easier to insure cars than people, though - your risk is essentially bounded by the market value of the car.

Inelastic demand, information asymmetry, and principal-agency make it difficult for markets to have much impact on healthcare costs, unfortunately.

"Inelastic demand, information asymmetry, and principal-agency make it difficult for markets to..."

The order of causation here is wrong. Many of those problems exist because the market for healthcare is vastly inefficient in the United States.

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