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Comment by taxicabjesus | Hacker News Reader

The title for this submission is taken from the bottom of the post itself. The original title is "Which Interventions Can Be Paid For: The Explanatory Power of Prasad’s Law'", which doesn't seem to adequately convey that the blog post is about health care interventions, and how US healthcare happily pays for marginally-effective interventions (ex: chemotherapy) before providing things that people actually need (home assistance, meal delivery, rides, etc).

This blog makes points that seem to get to the heart of my own observations of the United States' health system problems. Some months ago I responded here to say "IMHO, health care in the United States is used as a job project, to provide jobs for all the people who used to build stuff" [1].

I think 'wealth transfer' is a better explanation than 'job project' to explain why the US health system is dysfunctional.

[1] https://news.ycombinator.com/item?id=20313720

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This is unfortunately something that every generation rediscovers, but it's far from a secret. In fact, the seminal analysis on this won the Pulitzer,

Paul Starr. The Social Transfomation of American Medicine. Basic Books, 1984. (A must read for the health insurance debate)

Also, if anyone ever finds it online, please post, Hugh Long at Tulane has a great presentation about how the numbers stack up over time. It's just devastating.

Ironically, the submitted title was so “clickbait”y that I didn’t follow the link. But after reading your comment, my interest was peaked and I found it enjoyable

WordBot: Did you mean: “piqued”?

The capitalist way to participate in a market is to put money into a system expecting to get that money plus some additional money out.

That additional amount must come from somewhere. Typically from wage labor, but in medicine that money can also be effectively removed from the patient.

The American system enables the wealthy to effectively take money from the sick and their caregivers alike. And the more they take, the more they can invest in the system. It's a positive feedback loop.

In any just system, the sick and the workers would be realizing those benefits.

The problem with a pure "free market" approach to healthcare is that the market does not function for the benefits of all because healthcare is inherently imbalanced in terms of relative power between consumers and producers.

For example, how much is someone willing to pay to receive cancer treatment? This is a relatively urgent life and death situation so the answer is obviously likely to be "any price". As such, treatment costs are expected to go through the roof.

I agree with you 100%. The problem truly lies not where what someone "is willing" (which of course is almost anything) but where what some "actually can" pay to receive treatment. It's a terrible distinction between the two.

Totally agree with you. I'd also argue that free markets in general have large power imbalances, but healthcare certainly more so.

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