Hacker News Reader

Comment by PeterisP | Hacker News Reader

That's kind of cool, though the devil is in the details and I'm not sure about the details for this case.

Essentially, free market relies on certain assumptions under which the supply/demand 'invisible hand' works properly and the benefits of free market are realized - the key economics 101 assumptions are (1) large amount of both suppliers and buyers; (2) small barriers of entry and exit; and (3) full and truthful information about market conditions. The further we get from these assumptions, the less free (and usually worse for the people) the market becomes, and often we need gov't intervention to ensure that these assumptions stay true and the market behavior stays close to theoretical free market instead of degenerating into an exploitative uncompetitive monopolistic market with hidden information - as the USA medical market is doing, and seems to need such intervention.

View on HN

The healthcare market isn't even close to free, it's the most tightly regulated industry. Until that changes, nothing will get better.

People I know who have worked in commercial aviation have claimed that it takes more paperwork to put a bolt on a plane than into a human body. While this may or may not be true, commercial aviation is a counter example of a tightly regulated industry that very much a free market that challenges your assumption that regulation alone are the reason for issues in healthcare.

Commercial aviation may be a "free market", but it is full of its own problems.

Some regulation is key, like HIPPA or the drug approval process, or the lack of approval of medical devices leading to issues. We will never have a loosely regulated healthcare industry if we want privacy and safety for patients.

Whatever the system, the goal should be cost effective betterment of public health.

> The healthcare market isn't even close to free, it's the most tightly regulated industry. Until that changes, nothing will get better.

Agreed. I feel like people just like using the "socialism will solve everything" argument while not acknowledging that right or wrong - healthcare in the USA is anything but free market.

Tell that to anyone needing trailing edge tech medicine that's seen exponential price increases in recent years, for no reason other than greed.

(4) buyers capable of making informed decisions (a) several nearby hospitals (b) enough expertise or impartial advice (c) not in an emergency situation, in pain, unconscious, intoxicated or otherwise unable to make good decisions (d) in a position where the price matters - not too poor, not too rich.

Since much of the above is not true in real life, a patient centered market for Healthcare does not work well.

The overwhelming majority of healthcare dollars are not spent in emergency situations. If you decide to go to the doctor because of some pain in your neck that's not an emergency decision. If the doctor tells you to get tests that's not an emergency decision, etc, etc.

You can go from healthy to cancer to treatment to more cancer (wash rinse repeat until you or the cancer is dead) without a single decision made under any meaningful time pressure.

And the guy who goes to the ER with a serious heart problem gets admitted and leaves bankrupt? Seems important to avoid that. Even for the cancer - you're in the most stressful situation of your life, you want to evaluate prices? What about your vulnerable grampa?

In the UK, where I'm originally from, I've never met anyone who wishes they had a role in evaluating healthcare pricing. In the US, I personally don't either.

Making 90% of healthcare situations better, using transparent prices, is still a very good thing, even if it doesn't help with the 10% of edge cases.

Reply on news.ycombinator.com