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Comment by ryandrake | Hacker News Reader

> The thing that doesn't get mentioned much

This gets mentioned every time. The regulation boogeyman always shows up. If only there were fewer rules... everyone could make more money, the little guy would be able to enter and play fast and loose, and nobody would do the wrongdoing those rules were meant to correct/prevent. Yes, there are regulations in health care. There are regulations in almost every industry, and yes, they can be a pain to deal with. Yet people still start businesses, make money, grumble endlessly about those regulations, and society marches on. As part of the general public, who are often the victims of business's negative externalities, I'm grateful that our government still manages to regulate businesses.

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Or maybe regulation is in fact a problem. In my country there is less regulation in healthcare services. I can walk into multiple private facilities in my town, get full blood panel with almost everything you can think of included (hormones, vitamins/mineral levels, liver markers etc) for around 100$. The results are going to be available online the same day (with the exception of those that require more lab time). This is fully private enterprise which has nothing to do with "universal healthcare" my country has.

I don't need prescription or doctor recommendation to get it done. I can also take my own urine/hair/swabs, walk into a lab, pay and have the requests results online in a few days.

If I need MRI I can usually schedule it for the next day in multiple private points and again the results are going to be there the same day. The price is around 200 bucks for say cervical spine.

How is it in your country? Do you know how much is required to get those basic services in other countries?

In the US you can have similar labs done at Labcorp or Quest. Prices are similar or slightly higher. MRIs are prescription only and higher priced. One main difference is that most labs here require a prescription, which means you need to go to a different provider just to get the piece of paper and pay them. Of course these providers are both massive chains. Not sure if either are PI owned.

Quest and Labcorp have started doing many tests for a direct fee. You just pay upfront and get it done, no prescription/insurance needed.

It’s not all the tests I think, but many.

Exactly what I was saying. The majority of tests still need a prescription, but there a a few dozen out of the few hundred total.

200 dollars for an MRI with no referring reason is inexpensive for sure. Where is that?

Poland. For all the faults of my country healthcare is actually run pretty well. There is a public option where you have to wait but people are free to run private practices/labs/facilities.

Because the public option exists they can't run the prices up however they want so it's usually very competitive.

Which country are you in?

>Yet people still start businesses, make money, grumble endlessly about those regulations, and society marches on.

One such regulation is "certificate of need" laws, where you effectively need to ask the incumbent for permission to open your would-be competitor.

https://spn.org/articles/certificate-of-need-laws/

Then maybe the government (i.e. the public) should pay for more of these regulations, as opposed to unfunded mandates, which small operators cannot afford.

In the example of the individual doctor's office, perhaps the government should provide software and billing systems to adhere to their mandated processes, inspectors, fund regulatory agencies, legislative support, etc.

Otherwise regulatory capture can drive out much of the competition, potentially leaving us worse off than we could be otherwise.

> Yet people still start businesses, make money, grumble endlessly about those regulations, and society marches on.

But that's the problem, isn't it? They don't. The smaller providers actually do go out of business or get bought up by private equity and then the quality of care suffers -- which is the thing the regulations were sold as improving.

"This gets mentioned every time."

No, this gets mentioned in other healthcare conversations but rarely in PI takeover conversations.

Everyone knows the US healthcare system sucks. But the United states medical system is not uniquely under regulated compared to the rest of the world. It's uniquely poorly regulated.

Tell me you don't know anything about healthcare without telling me...

Sheesh.

Doctors are medical technicians, not lawyers, and the more you bury them in (largely billing) regulations, the worse care you get and the less time with that doctor you get, and the more money you pay for worse healthcare.

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