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Comment by TheOtherHobbes | Hacker News Reader

It's an efficient market. It's efficient at collecting money from customers who little or no choice, and at not providing those customers with a service - because providing a service costs money, which takes a cut out of profits.

This is what markets do. They amplify political and financial inequality.

Anyone who thinks that competition will somehow magically fix this isn't paying attention to how markets actually work.

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You are conflating markets with meta-markets. The market for healthcare has been corrupted by activities outside of the market.

The market has been intentionally manipulated to set up little choice for individuals and even worse, little transparency on cost and benefits.

Markets DO work, but you have to set them up to succeed. Customers need to be able to choose between providers, customers need to know what the full cost of healthcare is prior to committing, and customers need to be able to walk away or find an alternative if a price is unattractive.

So markets work in theory, kind of like communism.

ha ha that's exactly how i play it to my friends.

> Anyone who thinks that competition will somehow magically fix this isn't paying attention to how markets actually work.

If you allowed foreign doctors to come and practice in USA the problem would get fixed extremely quickly. Competition is the solution. The problem isn't the free market here, but that the incumbents gets to control legalization and hence stifle competition. I'm not sure why private money has so much more influence in USA than other western countries, but it is the main source of this problem.

Aren't drugs very expensive in the US, too?

Isn't it illegal to move drugs across the border? Importing other goods seems much simpler. I mean, according to this you can only import drugs into USA if you are the manufacturer, meaning USA doesn't permit global market forces.

https://www.kff.org/medicare/issue-brief/10-faqs-on-prescrip...

drugs are very expensive everywhere it's possible, and implicitly expensive drugs are not available where they're unaffordable (and hence no market at the high price). This leads to bigger group buying programs and a focus on generics, but has the unfortunate effect of shifting the focus of drug companies to very high price, small-market specialty drugs and lifestyle & vanity drugs that a broad, public healthcare system would never cover.

Say you have a drug that you need to charge $100 to make it worth your time. Other countries say they will only pay $20 for it. Since the US doesn't have price controls, they will charge $180 here to make up for missing revenue in other countries. So in effect, the US subsidizes countries with universal healthcare.

we can both complain about the final outcome and disagree on how we got here. I think it's a stretch to call healthcare an efficient market. There are huge upfront and switching costs for almost every component making it rife with opportunities (intentional) and mistakes (mistakes) that erode efficiency. I also feel you conflate what markets can do with what their intent is. You seem to imply that markets have no role in a huge swath of our economy and lives, yet I look at my medical experiences in Canada (almost 100% public) and wonder if many people actually know how it works and what the outcomes look like. In a nutshell it's both harder to die and harder to get better under our system, and I think markets could help with the later without hurting the former.

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