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Comment by jQueryIsAwesome | Hacker News Reader

> and encouraging more competition to go for those treatments because they can make it profitable at a lower cost.

They can make it more profitable but only helps a smaller subset of people because is better to sell 1000 $10 needless than 10000 $1 needles (transportation, packaging, liability, etc); plus is a strong incentive to use any procedure that makes the patient believe that he is getting better even if he actually don't; because ultimately is the profit margin that matters. And that is not an exception; is the number one rule for business.

And data also goes against your view; the country I am talking is Denmark, the health system is 100% subsidized by the government itself; it haves a 95% health services satisfaction rate because all those events generated from the need to generate profits are non-existent.

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"They can make it more profitable but only helps a smaller subset of people because is better to sell 1000 $10 needless than 10000 $1 needles (transportation, packaging, liability, etc);"

You implicitly make the error that the same person faces the choice of selling a few expensive needles or lots of cheap ones. In a free market, if one person tries the former, someone else can do the latter.

The medical market is not very free, unfortunately, and the proposed solutions to the resulting problems are always to make it even less free. The results are so boringly predictable it hardly seems sporting to talk about them. Shortages, inefficiencies, you name the usual consequence of centralized planning and meddling and our medical systems are full of them, but ever and always the solution is to increase centralization. Pity we must once again grind ourselves to dust on the alter of government control en masse again.

The data I see does not match your assertion. For all people bitch about the US, and for all our neutering of the free market advantages we are desperately trying to jam into our system to keep up with the Euro-Joneses, it still has better outcomes than Europe in many key areas. I'm sure that will change soon enough, though.

To make it short, where !=> mean "does not imply":

satisfaction != efficient

satisfaction !=> result

results !=> efficient

profit = efficiency => results => satisfaction

To keep it short too.

assert patients.satisfaction.relevance > efficiency.relevance

investment.efficiency => profit

investment.efficiency !=> patients.efficiency

investment.efficiency !=> patients.health

Long version:

I am living the consequences of this in my country itself; they make you wait months for one date, even if they suspect cancer; you know why they make you wait so much time? Because they want to make sure you health insurance payments are the ones pre-paying for the specialist service (or at least a good part of it) before you stop paying or before you die. There is people with cancer standing long hours in queues just because some guys through it was really smart to overprice common medical resources and lobby in the congress for laws that help them abuse their clients (aka patients) and government subsidies.

"they make you wait months for one date" - that is unacceptable, just like overpricing is.

The medical market has far too much friction and rent seeking behaviour. I do not agree with the short version, but I agree with your long version.

I dream about the day when (if?) the medical market become a perfect market in the economical sense - price taking behaviour, pure and perfect competition, factors of production being paid at their marginal productivity

I believe that, among other things, the financial incentives are a step forward. We apparently have different ways, but a same goal.

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