[bfieidhbrjr]

There's no "market" in healthcare in the US.

Long ago, it became illegal to open a hospital without a 'certificate of need' from the State. That's why so many towns have only one hospital - it's a government granted monopoly like cable companies in the 80s.

Differential pricing is also illegal. You fly cheap on Sunday at 3am, expensive on Monday at 9am. Healthcare providers are not allowed to charge less when it's cheap to do so, for example allowing you to do an MRI cheaper at 3am.

Your employer picks a monopoly insurer for you to chose a plan from.

The list goes on and on. There's no market here, it's a set of monopolies. It should be legal to open a hospital. Differential pricing should be legal. Your employer should let you chose from at least two insurers.

[andy_ppp]

I find this idea interesting, but I'm extremely skeptical. If we are thinking about this as being a startup, how can we outsource the cost of building the hospital to the doctors and nurses? That way you might be able to build a billion dollar business by tricking people into owning all the downsides while you own all of the profits?

I'm just joking of course... the idea that the market can optimise every problem is simply incorrect. There isn't a move fast and break things for doing startup hospitals, it's simply a problem that central planning can organise effectively. Unfortunately, the American allergy to government means your healthcare system costs twice as much per capita for the same outcomes.

[pxeboot]

>how can we outsource the cost of building the hospital to the doctors and nurses?

This is almost reality in the US. Lookup "Ambulatory Surgical Center" investments.

[telchar]

Free market principles fail for healthcare for reasons entirely unrelated to those things, as has been pointed out up-thread. You're advocating for regulations to be eliminated as if that would fix unrelated problems. Do you care if healthcare is improved, or do you just want to see free-market-style reforms for their own sake?

[roenxi]

In 2013, 64% of health spending was paid for by the government [0]. The non-profit hospitals share of total hospital capacity has remained relatively stable (about 70%) for decades [0]. The regulation section of Wikipedia is a litany of anti-free-market policies [0].

You can argue that free market principles fail in healthcare, and I will happily disagree and we can all have a cheerful time. But the US hasn't tried a free market approach to healthcare in at least decades. The free marketeers lost the argument; all the dials were set to non-free market and people argued that the quality/access to healthcare would rise to offset the cost of regulation. I'm not totally sure why people keep buying that argument.

In a free market:

1) Employment status would be irrelevant to healthcare.

2) People would be legally allowed to provide healthcare as long as treatment met whatever minimum quality standards the government sets on healthcare.

Saying "it became illegal to open a hospital" is unrelated to high costs is a serious failure of imagination. A ban on allowing people to provide competing services is a serious concern.

Also, people arguing for socialised healthcare aren't arguing to bring down the absurd costs, they are mostly arguing that the absurd costs should be shouldered by the middle & upper classes instead of the people consuming healthcare. It is unfair to first being in policies that inflate the costs, then dump the costs on taxpayers. If the argument is dump the costs on someone else then a decent effort should be made to reduce those costs.

[0] https://en.wikipedia.org/wiki/Health_care_in_the_United_Stat...

[8note]

People arguing for socialized medicine are arguing for bringing down the absurd costs, by virtue of having a very strong negotiating position and economies of scale.

Canada's single payer system is an example of that.

In a free market, employment status would still be related to your healthcare, eg. through credit checks to see if you're moral enough to get surgery. Theres no reason companies would stop providing healthcare coverage, and for providers to bump costs to match the extra spending power

[roenxi]

> a very strong negotiating position and economies of scale

Pretty sure that the US Federal government is the most indebted entity on the planet, and they'd be subject to exactly the same forces that have currently made them upregulate the cost of healthcare.

There is no reason to think they'd use a good bargaining position to bring down costs - the US Federal government is the most cost insensitive entity in history. And a free market is totally capable of finding economies of scale if it is cheaper.

[schoolornot]

Are most of the costs even accumulated in hospitals? I'd imagine the price gouging certainly is. We arbitrarily restrict the number of MD students so why shouldn't we expect $1000/hr. bills for care?

[vkou]

Every country in the world restricts the number of MD students, bit only the US has truly mind-blowing billing practices, and care costs, and puts the average freshly minted doctor half a million dollars in student debt.

[8note]

I don't think Cuba does?

They instead send their extra doctors out to other countries

[StreamBright]

Exactly. Many people think that free market healthcare is bad because the US healthcare system. Once you are pointing out it is not a free market system they are surprised. The 20% profit cap also not very open market like.

[StreamBright]

"Health care in the United States is provided by many distinct organizations. Health care facilities are largely owned and operated by private sector businesses. 58% of community hospitals in the United States are non-profit, 21% are government-owned, and 21% are for-profit."

Makes me wonder, why people think it is free market healthcare?

https://en.wikipedia.org/wiki/Health_care_in_the_United_Stat...

[what2build]

The so-called by many, Father of Capitalism, Adam Smith, only defined market in terms of a free labor market.

He also wrote that whatever type of government existed in a nation, it would likely need to enforce equality of condition to avoid what we’d call monopoly of labors agency.

He was openly hostile to extreme division of labor, paraphrasing, it would turn humans into the dumbest creatures to ever exist.

Labor hardly seems free when Fed policy has been to tighten screws on workers, growing worker insecurity, to keep them circling back to that cubicle every morning: https://www.nytimes.com/1997/02/27/business/job-insecurity-o...

Look at that. Hundreds of years ago humans realized exactly what humans are capable of emotionally and warned against it.

Reminds of me of the ancient Greeks who, again paraphrasing, wrote they hope the rubes do not some day realize there are no gods atop Olympus. Just men on thrones manipulating their fears.