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Comment by dmm | Hacker News Reader

Lots of people seemed opposed to ACA and a single-payer in the US but I never hear anyone talk about free market alternatives. What we have right now in the US is nothing like a market. Markets are supposed to provide price discovery. How can they do that when no one knows the price until after the work is done? It's insane and no one should be surprised that people want change.

What's the alternative to socialized healthcare? Everything staying the same? That's not going to fly.

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Investments into price discovery mechanisms. You know, like what the ACA does.

http://www.huffingtonpost.com/2013/05/08/hospital-prices-cos...

https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

The US has begun to track health care costs, and is beginning to make it public. Oklahoma Hospitals are publishing prices, leading to a free-market solution.

http://newsok.com/article/5434353

You no longer have to leave the US to take advantage of Medical Tourism! Furthermore, health care plans are now required to have some degree of out-of-network costs under the ACA, so you know that even in the worst case, medical tourism to Oklahoma will lead to clear and consistent pricing. Or if you have good out-of-network costs (ie: More typical of the higher-cost Gold or Platinum plans), medical tourism might be a very good idea for you.

Hopefully, other hospitals will notice the beneficial (and profitable) effects of medical tourism, and will join the hospital free market association. At which point, they'll start publishing health-care prices online to capture marketshare in the growing medical tourism industry.

It will take years before the market builds out the infrastructure, but America is actually well on its way to fixing the problem. I think we should hold the course with Obamacare. Lets not go left (Bernie) or right (Repeal), lets keep steady and see what happens.

That's interesting. Thanks a lot. I really don't know enough to have an opinion on this stuff. I was just trying to express my bewilderment at the opposition to the ACA which didn't seem to offer any alternatives other than going back to what we had.

ACA is a surprisingly right-wing idea. Obama is a moderate for pushing it so hard. ACA will only work if the free-market steps up its game to rectify the price-discovery problem.

Its mind-boggling to me that the right-wing doesn't like Obamacare in general. The major 'left wing' portions are:

1. Individual Mandate (but all Republicans agree that pre-existing conditions are bad, but they have no idea how to get rid of it)

2. The health care exchange website (Republicans don't seem to like new government programs at all)

And... that's about it. Everything else attempts to leverage the free market infrastructure to solve the problem.

I believe a lot (perhaps most) of the opposition to the ACA was from people that do not benefit (or were actually adversely impacted) from it. For those people, there is no need to offer any alternative because going back to what we had is better for them.

>How can they do that when no one knows the price until after the work is done?

The sad part is that it is even more insane than that. For most things we buy, we have the ability to either walk away and say no or we have the ability to wait. For health care, there are many times when the service is an immediate need, so there is rarely an ability to even refuse it (I mean, you could opt for letting a potential problem kill you, but at that point we have basically gutted the meaning of 'need').

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