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by monkeyprojects 3088 days ago
Health care is the absolute prime example of a Veblen good as people are willing to pay for perceived quality. After all would you prefer the heart surgeon who charges $5000 or the one who can charge $25000
5 comments

> Health care is the absolute prime example of a Veblen good

"Veblen Good: A good for which demand increases as the price increases, because of its exclusive nature and appeal as a status symbol."

I'm not following. Heart surgery demand is based on having a heart problem. Taking a step back, health care encompasses more than just picking a heart surgeon. Most practitioners won't tell you the dollar price of a service beforehand even if you ask. Standard behavior is to go see whoever is covered by your insurance.

> Standard behavior is to go see whoever is covered by your insurance.

Standard behavior is to see the best provider covered by your insurance.

It's a small textual difference, but a massive actual difference (and what makes it a Veblen good).

This. I moved to Switzerland a while ago and noticed that they are suffering from the same issue: Switzerland is one of the richest countries in Europe and just like the US, they are also faced with health care costs that are completely getting out of hand.

Another example is day care for children, which is also disproportionally expensive here. Both are cases when people just don't want to cut on money, they want to have the best option for their health or their children, the costs are only a secondary consideration. Which means that the health care market has not much of a competition on prices and as a result everything that is health related is expensive. Even basic things like nutrition supplements are around 5 times more expensive than in other European countries.

You'd probably find most people would go with the $5,000 guy.

We're not talking Drunk Eddie suddenly being allowed to practice as a surgeon, the $5k guy will still have standards and steady hands.

The risk differential is probably not worth a cheap car.

A concrete example: Private health insurance in the UK is cheap, because it excludes a lot of the basics - you use the NHS for that, and only call your private insurer if you e.g. need a specialist or if you can't get an appointment with your GP.

Yet only 10% opt for it, because the NHS is generally good enough. And of those 10% a lot only have it because it's offered as a mostly free perk by their employer.

But I do think that there is a segment - part of those 10% who opt for private insurance - that will always pay extra to get "the best" whether or not there is a major difference.

Especially if you can only borrow 5k
Seems like a bad example. All board certified cardiothoracic surgeons have to report their mortality rates from procedures (there are problems with that, but one could easily look this up). Not to mention most work for a hospital and therefore have a fixed salary. On top of this, most healthcare consumers in America are directed by their insurance provider as to who they can even go to for these sort of procedures.
> Not to mention most work for a hospital and therefore have a fixed salary.

Unless you have knowledge to the contrary, I'd dispute this. Most physicians, and specialists in hospitals in at least the Pacific North West are NOT hospital employees.

This is how you can get into ridiculous situations where your hospital is "in network", but your provider is not (because of course, you get a choice on the physician you are assigned at a hospital, especially in ED...).

Mortality rate is a poor metric.

First, it "penalizes" doctors/hospitals that take on the most severe cases. There is no objective metric for "we saved X people who would have died at an average facility." Do you want a metric that would encourage a doctor/hospital to deny an aggressive procedure for fear of taking a hit in its mortality metrics?

Secondly, it ignores ongoing quality of life. A cardiac surgery can have a later death that does not count in its mortality rate, even if it was due to a complication caused by, or significantly contributed to, by inferior medicine.

Oh, I'm in agreement, and should have made my point about this more clear. The reason I brought it up at all is that there are other external factors that influence a patients decision, or lack thereof, in choosing a CT surgeon for their non urgent (or emergency I guess, but there's even less choice there) procedure.
I'm in the UK not the US. The example is actually a friend who has watched his private practice (1 day a week) expand as he tried to reduce demand by increasing his rates.
Oh, I see. I figured you were talking about the US due to the article. Your friend works one day a week?? That's awesome.
4 days NHS (the day job), 1 day private practice. That's typical for Consultants in the UK...
After I posted the comment I figured that was the case.
Well, unfortunately both surgeons charge the same, which is the maximum what your insurance pays. Capitalism doesn't work here.