This is a false dichotomy. Public v private is so often framed as a political agency versus free-market bonanza. In reality, we have independent agencies and public-private partnerships. But on the private side, we also co-operatives, a model which seems well-suited for community hospitals.
Taking "profit" from keeping people "not dead" seems as close to extortion as you can get without actually being so.
“If the public health goal is to improve hospital care, then focusing on things like for-profit or nonprofit status is a distraction” [1].
> Taking "profit" from keeping people "not dead" seems as close to extortion
Modern medicine is expensive. For profit or not, expenses must be covered.
We’re better off incentivising people to become doctors and nurses and pharmaceutical researchers. The problem is all the nonsense being eaten up in administration, administration largely paid for by price obfuscation.
[1] https://www.hsph.harvard.edu/news/press-releases/hospitals-c...
Fair enough. So let's just ban for-profit healthcare so we can stop being distracted by that whole thing.
There's a ton of bullshit that goes into "medical expenses" in the US. Not the least of which is the inability for people to pay for care and end up in the ER for urgent non-emergency services because ER services are required to be provided. Hospitals need to foot the costs of those people that literally can't pay. Those costs get amortized over every other service (plus plain old margin and gauging) increasing the overall costs.
Besides eliminating unpaid emergency service public health coverage would let people get regular medical care without plunging into debt so they'd go sooner before conditions become acute. Private insurance could even still exist, but as a premium add-on to statutory coverage.
More doctors and nurses is just supply side economics applied to healthcare. Those jobs will appear naturally with the entire population completely covered. Rural hospitals could even open back up since they'd be serving people with actual coverage.
Even in those situations it's not guaranteed. Markets seem to arise at or duplicate similar solutions and even if it's inefficient it's not worth he risk to find better alternatives for consumers because the competitive edge vs risk vs reward just isn't a winning mix worth pursing.
I'm increasingly convinced that most forms of free market systems work best once we have commoditization of a solution and it's just a matter of reproducing that solution, and doing so isn't too capital intensive. As you start to move away from these parameters, markets get more and more consumer hostile and self focused making the argument for them increasingly weak.
It’s almost the opposite. Free markets didn’t work in the pre-industrial era because everything was commoditised. That made returns on capital paltry, which in turn made it more “profitable” to conquer capital than build it.
After industrialisation, we repeatedly saw innovation—though not necessarily creativity—in market economies outperform that in centralised ones.
But it is possible that if you pay to build out an entirely new network to a place where Comcast has a monopoly, and the customers would rather pay Comcast $5 less than whatever the lowest price you can charge is, then you would see negative returns by paying to build that network (since the cost of building out a network like that is so astronomical, and Comcast obviously does not have to pay it so their COGS is much lower).
The last candidate who ran on small donors and wore a proud badge of being anti-corporate interests lost twice. Politicians are figuring out how much money can be made by both acquiring legislative influence and power and accepting donations to steer their platforms, as well as passing legislation and policy that helps siphon public funds into private companies that said politicians have a financial stake in.
Changing private equity power requires benevolence, and there’s very little of that left amongst those with political power in the US.
But do you know what? I used to pay 1/4 the price for electricity when i lived in an area with a local county run power company compared to my new nearby location that has PG&E as the only option. As in government run utilities were literally 1/4 the price per kwh and yet i'm supposed to buy into this "GOVERNMENT IS INEFFICIENT LOL COMMUNISM" propaganda that just doesn't appear true in the slightest. I mean this is consistent across the board.
I know the baby boomer generation were vulnerable to this anti-socialism propaganda but can we please start looking at things objectively and push back against this privatization that is almost always a way for politicians to enrich themselves. Sigh.
The government creates the conditions for PGE to be so bad. I’m defecting from the grid this year, PGE’s high prices mean my s system will pay for itself in less than a year and will likely be more reliable.
battery and solar companies saved me from PGE and they can save you. The government perhaps can but likely won’t. Extrapolate for yourself what this means about the world and what organizations should command the most resources.
Same as attempts to privatize social security. You got a cash flow of $1.4T/year and it drives the lords of capital bonkers they can't get their hands on it.
People used to have choice but now due to 1950s tax code, your employer chooses a health conglomerate which chooses an insurance company which influences the billing allowances which influences the hospital profitability which is now so complicated that often only PE firms are willing to take the investment risk.
The incentives and market feedback is now so distorted that there is little to no signal. Healthcare in the US is often used as an example of failed free markets, but it is very far from a free market.
American lifestyles especially in certain states are generally not conducive to good outcomes but the US healthcare system itself is still generally world-renowned for cutting edge procedures.
Analyzing from a cost POV it's quite bad, but in many ways healthcare is the ultimate marginal good so people are willing to spend what they have.