[Jabanga]

>And health care and education are matter of life and death for most people, so yeah, high prices

Food is also a matter of life and death.

The difference between food and healthcare/education is that the former is not as heavily subsidised as the latter.

>And health care and education are matter of life and death for most people, so yeah, high prices, unless there is a big factor that will put an end to that (which happens outside the U.S. through regulation and government price negotiation).

This is incorrect. The cost disease is a global phenomenon affecting most advanced economies.

[taneq]

> Food is also a matter of life and death.

And we have a pretty well established cultural understanding that you don't let people starve, no matter how poor they are. And yet somehow the equivalent understanding that you don't let people die of preventable diseases, no matter how poor they are, is somehow controversial.

[Jabanga]

It's not the preventable diseases that are the most costly to treat. But regardless of semantics, I know what you mean. The reason is that the consequences of guaranteeing everyone enough food are different than the consequences of guaranteeing everyone top-of-the-line (i.e. doing everything we can to keep sick people alive) healthcare.

Food has become so cheap that almost everyone can afford enough to eat without direct subsidies (e.g. indirect subsidies, like welfare payments, are enough). So such an understanding doesn't result in the creation of pervasive government programs that utterly dominate the market for food and inflict it with the cost disease.

[js8]

> Food is also a matter of life and death.

I think that's because you can grow your own food, and you can also buy it from abroad. Not so much with health care or education (because it's a service, not a physical product).

So you can be (at least in the U.S.) screwed less over food than over health care.

I agree that I don't have a complete picture, but at least, people should consider evidence for this theory.

> The cost disease is a global phenomenon affecting most advanced economies.

The problem is, the economies that have strong government actor working on behalf of consumers (either in the form of regulation, or a public corporation that competes in the market too) are actually affected less.

[Jabanga]

>The problem is, the economies that have strong government actor working on behalf of consumers (either in the form of regulation, or a public corporation that competes in the market too) are actually affected less.

I don't see any evidence for that. A couple counter-examples: Singapore and developing countries like India and China have more market based healthcare systems than Western Europe and the US, and spend far less on healthcare as a percentage of GDP. India and China are making significant gains in life expectancy, but that may be explained away by the fact that they're starting from a lower level. Singapore however has a higher life expectancy than European countries.

The US is the outlier, with approximately half of healthcare spending being private, yet spending a very high percentage of GDP on healthcare. But I would argue that much of this 'private' is quasi public, as it's a manufactured outcome as a result of significant intervention by state and federal governments, like tax incentives for employers to provide healthcare through large insurance companies, and state mandates requiring health insurance to be comprehensive.

The fields of medicine in the US less subsidized via these kinds of interventions; cosmetic and laser eye surgery, have seen prices increase at below the rate of inflation.

The key is that people pay out of pocket for cosmetic and laser eye surgery:

http://healthblog.ncpa.org/why-cant-the-market-for-medical-c...

The government intervention in the private US healthcare system encourages exactly the opposite.

Also with respect to US healthcare spending, it's worth mentioning the US is a higher income country than other OECD countries, and there seems to be a trend toward healthcare spending as a percentage of GDP increasing with level of wealth, independent of all other factors. The US does have a more capitalised healthcare system, with more diagnostic equipment and advanced treatment centres for things like neonatal care. Often not mentioned is that the US has some of the best cancer survival rates in the world.

Mind you, the US is definitely suffering from the cost disease in healthcare, but the relatively higher wealth level of the US may explain the difference with Europe.

[redy]

It's also worth noting Singapore is certainly not a market-based system. Singapore's healtcare efficiency is completely the result of mandatory saving programs, a government funded insurance scheme for the poor and strict price controls[1].

As for China frankly I don't think anybody would seriously want to replicate what passed for healthcare in China. It's disturbingly common for patients to die because they cannot afford even routine surgeries in China.

[1] https://en.wikipedia.org/wiki/Healthcare_in_Singapore#Fundin...

[Jabanga]

Singapore's healthcare system is more market based than the EU's, and other than the guarantee of government coverage (despite spending much less per capita on its public healthcare program than the US), than the US's.

The mandatory health savings accounts are not redistributive. Each account is funded by the individual that makes use of it. And the individual decides how much to spend out of it, and with which provider, so it turns the individual into a price-conscious consumer. In the US, leftists would call such a program 'regressive' and a form of privatisation.

So for the reasons mentioned, I think it's reasonable to suspect that the relative efficiency of Singapore's healthcare system is due to the greater role that market forces play in it.

[js8]

I am not all that familiar with Singapore's health care, but just a cursory look at Wikipedia reveals that it's not really that much market-based, it looks quite similar to most European countries, really.

> there seems to be a trend toward healthcare spending as a percentage of GDP increasing with level of wealth

This can be expected under my model, too. The monopolistic prices depend on the demand curve, which depends on the level of wealth.

[Jabanga]

Private spending constitutes a larger portion of healthcare spending in Singapore than in the US. Also, much of that private spending is out of pocket:

https://thehearttruths.files.wordpress.com/2013/10/slide4-1....

Which is very unlike the US, where, as a result of government intervention, spending through insurance companies is the norm.

[taneq]

> A couple counter-examples: Singapore and developing countries like India and China have more market based healthcare systems than Western Europe and the US, and spend far less on healthcare as a percentage of GDP.

I think this is far more to do with the fact that they're developing countries than the economic structure of their healthcare systems.

[Jabanga]

I mention that possibility in the very next sentence and also point out that Singapore has a higher life expectancy than EU countries.