There is no market for the electricity I buy. Yet, most are happy with the utilities. Markets have value when the products are easily "shopped" Health care, except the very elective stuff, cannot be shopped.
All your examples of problems with "the system" =NON SYSTEM, have to do with the fractured vision of how health care should be provided. The family docs doing concierge love their lifestyle and argue the market solves our problems. The single mom in a trailer with a sick kid denied Medicaid becuase she makes too much, or couldn't document her work hours...
You are right, the complexity, the patches to the weak "system" are just bizarre. If we all thought of healthcare as a utility, something we all got and paid a reasonable fee for, the US system would be much less of a suck on our productivity, economy. Instead, we think of it as some special gift our employer or the government grants.
We pay our electric bill, or they shut it off. Health care could be done the same.
Insurance fundamentally makes sense for healthcare because people experience rare and expensive health events.
But a free market in insurance doesn't work because those who buy insurance disproportionately will tend to be those who require the most care. That drives the price higher (since the insurer expects to pay out more for those people). As the price rises, regular folks drop out of the insurance pool, making it even more adversely selected from the insurer's point of view. It's a death spiral until most of your population is uninsured except for a few very sick, very rich people.
Furthermore, healthcare is often purchased under duress, making it harder to price-shop.
Most healthcare transactions don’t need insurance. There are a billion elective clinic visits a year. Hundreds of millions of lab tests, x rays, and generic meds. These things are predictable and, if paid for without third parties, incredibly cheap.
This is a very easy problem to fix, and one that all other insurance types have fixed. You have two choices: just actually have an insurance mandate (pre birth) or repeal the law requiring treatment regardless of ability to pay.
If everyone gets insurance before they acquire expensive conditions, it works just fine.
You might like this one
https://danjschmidt.substack.com/p/coding-mastodons-doctor-story?utm_source=publication-search
There is no market for the electricity I buy. Yet, most are happy with the utilities. Markets have value when the products are easily "shopped" Health care, except the very elective stuff, cannot be shopped.
All your examples of problems with "the system" =NON SYSTEM, have to do with the fractured vision of how health care should be provided. The family docs doing concierge love their lifestyle and argue the market solves our problems. The single mom in a trailer with a sick kid denied Medicaid becuase she makes too much, or couldn't document her work hours...
You are right, the complexity, the patches to the weak "system" are just bizarre. If we all thought of healthcare as a utility, something we all got and paid a reasonable fee for, the US system would be much less of a suck on our productivity, economy. Instead, we think of it as some special gift our employer or the government grants.
We pay our electric bill, or they shut it off. Health care could be done the same.
Insurance fundamentally makes sense for healthcare because people experience rare and expensive health events.
But a free market in insurance doesn't work because those who buy insurance disproportionately will tend to be those who require the most care. That drives the price higher (since the insurer expects to pay out more for those people). As the price rises, regular folks drop out of the insurance pool, making it even more adversely selected from the insurer's point of view. It's a death spiral until most of your population is uninsured except for a few very sick, very rich people.
Furthermore, healthcare is often purchased under duress, making it harder to price-shop.
I don't see any easy solutions. Right now we have an unholy hybrid of government and private sector actors which doesn't have the advantage of either approach. Given the complexity of getting healthcare right, perhaps we should just copy countries which do it well such as Switzerland: https://www.nytimes.com/interactive/2017/09/18/upshot/best-health-care-system-country-bracket.html
Most healthcare transactions don’t need insurance. There are a billion elective clinic visits a year. Hundreds of millions of lab tests, x rays, and generic meds. These things are predictable and, if paid for without third parties, incredibly cheap.
So what happens when a 10-year-old gets cancer? Lots of tests and procedures to pay for.
Insuring a 10 year old for major illnesses is very very cheap. The healthcare coat problem is largely:
1. Bureaucratic bloat as OP describes
2. People live longer and accumulate lots of expensive care in their last years of life
3. People over medicalizing those last years instead of hospice
4. New awesome drugs that are expensive
This is a very easy problem to fix, and one that all other insurance types have fixed. You have two choices: just actually have an insurance mandate (pre birth) or repeal the law requiring treatment regardless of ability to pay.
If everyone gets insurance before they acquire expensive conditions, it works just fine.
Yep, looks like that's how it works in Switzerland.