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Comment by boxy310 | Hacker News Reader

We have lots of examples of governments doing this with ranges from poor to fair to good results. To my knowledge, the US is the only widescale attempt at market-based health care, with results of 2x the OECD average of health care cost per capita [1].

[1] https://read.oecd-ilibrary.org/social-issues-migration-healt...

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But it’s hardly a market-based system with the third party payers. Consumers aren’t making informed decisions about what they buy, have little ability to comparison shop, and state-level regulations intentionally limit the number of providers in a market. With those attributes, the poor outcome of the “market” system is entirely predictable. We need to go in one direction or the other, but having the worst elements of centrally managed care and the worst elements of a market solution makes for rotten outcomes.

How do I make an informed decision when I'm bleeding out in the back of an ambulance?

Lots of ER visits aren't that dire. There are three hospitals within range if I broke my arm. I'd totally comparison shop if it were even remotely possible to call each up and ask how much. But getting even an estimated price for x-ray and bone set over the phone? Hahahahaha.

In which country in the world do patients regularly call up 3 hospitals to inquire about the price of setting your broken bone?

A lot of the regulations are there to protect existing players in the market as well. It seems that the market-based approach degrades when it comes into contact with democracy, probably because the equilibrium the market is trying to achieve is incompatible with our values.

The US is required to treat all critical condition patients under EMTALA since 1986. So the market does not currently decide in the current setting.

What would you propose as being a "market-decides" approach to health care, beyond abolishing any-party insurers and revert to a 19th-century model?

19th century healthcare was relatively affordable, or at least the costs were streamlined and transparent.

Perhaps keep 3rd party insurance but ban it as an employment perk, that would incentivize the market to play to the greater public instead of just white collar salaried employees.

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