[conanbatt]

> What I'd say is that the US is pretty terrible at both and that's sad.

Right, inefficiency tends to harm both equitability and value/cost(loose efficiency definition), but the US market is not what it is because it is efficient or because it is equitable, which is a classic dichotomy of microeconomics.

> Some evidence that shows that mostly private healthcare systems generally function better than mostly public ones or some evidence that healthcare regulation in the US has led to worse outcomes and not better ones would at least give me a jumping point.

I see. So the challenge here is that we can only compare apples to oranges over and over again: we could try to see east germand and west germany, but for other reasons the economics were different. We can compare same country public and private like Germany and Argentina, and get to different conclusions (in germany, private is for the rich, in argentina, public is for the poor). We can compare England to the US, but how do you adjust for cultural and income differences?

For example, healthcare in the US was relatively very cheap 50 years ago, where it was still private. What happened in the middle?

Instead of looking so broadly at private vs public, its better i think to focus on why its expensive. And I can assure you that the top 5 reasons why healthcare in the us is expensive is due to government irresponsibilities. If the government cant even fix its own mistakes, how is it going to handle a much larger responsibility?

> But I'd also ask you to answer your own question here.

I did.

[frgtpsswrdlame]

>Right, inefficiency tends to harm both equitability and value/cost(loose efficiency definition)

Well no... Inefficiency is totally independent of equitability.

>For example, healthcare in the US was relatively very cheap 50 years ago, where it was still private.

This increase in healthcare expenditure across time has happened in all western countries has it not?

>Instead of looking so broadly at private vs public, its better i think to focus on why its expensive.

Broadly looking at private vs public is a very good way to guide our focus to what makes our healthcare in the US so expensive.

>And I can assure you that the top 5 reasons why healthcare in the us is expensive is due to government irresponsibilities.

You mean how the government has failed to regulate more? How the government has failed to de-privatize certain portions of the American healthcare system? How the government has hamstringed public options (like Medicare) to prevent the american public from realizing how much cheaper the government can provide care than can a private system? Totally agreed!

>If the government cant even fix its own mistakes, how is it going to handle a much larger responsibility?

What are you talking about? Private healthcare companies make mistakes all the damn time. The reason we trust government is because we get a voice in it. If your point is that american government needs to be more democratic and responsive to the wishes of individuals and cut the crap when it comes to sponsorship by large insurance conglomerates then I'm all with you.

>I did.

Did I miss it? Maybe you could post it again here. I'm just looking for what could change your mind.

[conanbatt]

> Well no... Inefficiency is totally independent of equitability.

The reason why inefficiency is tied to equitability in the real world is because equitability is enforced, which means you spend resources to achieve it, and that is the successful case of enforcement. i.e. forcing everyone to take insurance to give coverage to the sickest can increase sickness because there is no economical consequence to unhealthiness.

> This increase in healthcare expenditure across time has happened in all western countries has it not?

No..if it had, we wouldnt be talking about a problem of healthcare in the US. Its grown disproportionately here. But the whole point is that 50-60 years ago, healthcare was cheap and it was private.

> You mean how the government has failed to regulate more? How the government has failed to de-privatize certain portions of the American healthcare system? How the government has hamstringed public options (like Medicare) to prevent the american public from realizing how much cheaper the government can provide care than can a private system? Totally agreed!

I will be more practical then. What do you think are the top 3 issues that make healthcare expensive? Concretely, not abstractly. What are the 3 things that if didn't happen, healthcare would be much cheaper, and I challenge that all 3 of them are the result of regulation. That is, the government made it expensive.

> Did I miss it? Maybe you could post it again here. I'm just looking for what could change your mind.

->

> what would change your mind in the general? > Mine is that lightly regulated free healthcare markets will be efficient (though might not be equitable).

[frgtpsswrdlame]

>The reason why inefficiency is tied to equitability in the real world is because equitability is enforced, which means you spend resources to achieve it

Now you're switching around your causality. Earlier you said: "inefficiency tends to harm both equitability and value/cost"

So you don't believe that inefficiency causes equitability, just that equitability causes inefficiency?

>No..if it had, we wouldnt be talking about a problem of healthcare in the US. Its grown disproportionately here. But the whole point is that 50-60 years ago, healthcare was cheap and it was private.

So, in response to demographic changes across the western world (like an aging population) a bunch of countries made their systems more public and were able to keep costs down and the US has kept theirs more private and costs have ballooned. Maybe the answer is self-evident.

>I will be more practical then. What do you think are the top 3 issues that make healthcare expensive?

I think there is basically one cause: the existence of for-profit insurance companies. In a public system where government provided healthcare there would be a large monolithic body which could assert it's power to keep prices down. In a market with multiple insurance companies, they'll never have enough individual power to keep prices low. That's how the market is supposed to work by keeping power divided, it's just that healthcare is a terrible place for markets.

>Mine is that lightly regulated free healthcare markets will be efficient (though might not be equitable).

So to get you to change your mind that public systems are better than private equitability never comes into play? What is the point of efficiency if not to help people? If the point of efficiency is to help people then how is equitability not important?

[conanbatt]

> So, in response to demographic changes across the western world (like an aging population) a bunch of countries made their systems more public and were able to keep costs down and the US has kept theirs more private and costs have ballooned. Maybe the answer is self-evident.

I've had private insurance my entire life in a western country with free public healthcare. I have practical experience of the trade-offs of public vs private as a consumer and a tax-payer. The demographics changes hit my home country just like any other, but it didnt make public more efficient than private, nor more effective.

> I think there is basically one cause: the existence of for-profit insurance companies.

I have mentioned 2 counter examples: my home country (argentina) and historical US. You can also see Germany also has public/private mix systems. Health insurance companies actually have very low profit margins. Lower than the general market, lower than insurance companies, etc etc. They are not raking it in. The ones that are raking it in are providers.

> In a public system where government provided healthcare there would be a large monolithic body which could assert it's power to keep prices down. In a market with multiple insurance companies, they'll never have enough individual power to keep prices low. That's how the market is supposed to work by keeping power divided, it's just that healthcare is a terrible place for markets.

There is some contradiction in the previous statement (for profit) vs this one. You are arguing insurance companies cant negotiate prices down because they are not a monopoly, not because they are for profit. If there were only 1 insurer, they could definitely keep prices down, particularly the price of providers. But its hard to think a monopoly is the solution to a market problem.

Moreover, you say the state would have the power to drive prices down. This contradicts reality today, where Medicare by law cant negotiate prices. The government is eager to put itself a restriction on negotiating, and is politically unable to remove it. If it cant change medicare when its a fraction of the market, do you think it will change more when its 10 times its size?

The state can, in 24 hours, reduce healthcare prices by just removing economic consented bad regulation. Read what the healthcare economists say: allow free trade for drugs and doctor immigration and you solve such a massive part of the cost immediately. The government has full power today to solve those problems and it cant. Doesn't that make you lose any faith in the government's capacity to solve healthcare?

Do you remember the Obamacare website debacle? Do you think medicare will make a kickass insurance website?

[frgtpsswrdlame]

>I've had private insurance my entire life in a western country with free public healthcare. I have practical experience of the trade-offs of public vs private as a consumer and a tax-payer. The demographics changes hit my home country just like any other, but it didnt make public more efficient than private, nor more effective.

...wait wait wait. How much experience do you have with the American system?

[conanbatt]

More than the median american. But even if I had never touched US soil, all the arguments previously presented still hold.