[andi999]

The demand price curve is different. If housing gets more expensive you could (although) difficult move into a smaller apartment, or different region. (Similiar with food up to a certain amount). This allows the market to find the best/right price by supply and demand. (I think this is called inelastic demand)

If you have cancer though than basicall the market cannot find a price, and it would tend towards to: 'give me all you have'.

[tryptophan]

> If you have cancer though than basicall the market cannot find a price, and it would tend towards to: 'give me all you have'.

Yes it can... there is more than one oncologist in the world. Competition exists.

As for if youre talking about the chemo drugs, you don't have to use the latest-and-greatest on-patent treatment. There are now decades of drugs that are off patent. They may not be as good, but then again, it is your life so many choose to pay for the new better ones. If it was illegal to pay more for better drugs than they would never exist (and don't talk to me about government funding; not a single socialized medicine country has innovated any drug of value in the past 50 years, and yes, they do steal from us in the USA by taking our IP and not paying for it).

[soneil]

The first covid vaccines came out of the UK and Germany. Whoever told you we're just stealing from the US has their head firmly in the sand.

[beerandt]

Medical prices being inelastic (to the extent they are) has much more to do with medicare/medicaid/FDA regulations, govt & insurance allowable reimbursement rate lists, and costly govt requirements to even participate in a govt funded plan (like electronic medical records).

Proof? Services not typically covered, like plastic surgery or cosmetic dermatology. Clearly listed and even advertised prices for their services, openly discussed up front.

But if the govt reimbursement rate for an annual checkup is $x, why would anyone need to list that price up front, or have reason to ever charge any less?

[refurb]

Your last comment is the reason for the massive gap between list price versus net price in the US system.

The US has a rule about “usual & customary price”. That’s a legal definition and providers can’t charge any customer more than that.

If you’re looking to price discriminate, you set your U&C price as high as possible, maybe 2-5x what you’d accept. That way if you find a customer willing to pay 4X, you’re not running afoul of the law.

For everyone else, you negotiate a much more reasonable net price, typically through insurance.

The people who get screwed in the end are ones without insurance. They get billed the imaginary number nobody ever intended anyone to pay.

[BobbyJo]

> The demand price curve is different. If housing gets more expensive you could (although) difficult move into a smaller apartment, or different region. (Similiar with food up to a certain amount). This allows the market to find the best/right price by supply and demand. (I think this is called inelastic demand)

Changing housing situations is exactly as easy as changing hospitals and emergency rooms no? Since the latter are mostly decided by where you live. In fact, most mid to large cities feature many hospitals near any given residence, so it is actually easier. I would also point out that the demand curve for housing, energy and food are far more inelastic than for medicine.

> If you have cancer though than basicall the market cannot find a price, and it would tend towards to: 'give me all you have'.

Why couldn't the market find a price? Cancer actually seems like the worse example possible. The people I've known who've been diagnosed with cancer have shopped around for care from many different hospitals. It would seem that cancer would be the perfect candidate for market forces to lower prices since a diagnosis generally affords a bit of time to find and decide on treatment options. Even in the extreme case of 'you have months to live' people tend to spend a few weeks collecting different opinions.

[jatone]

You're choices are: die, or pay whatever cost is associated. its not a choice that can be negotiated. markets don't deal with this situation well. changing hospitals don't change the baseline costs for providing health care in a significant manner for there to be competition nor are many hospitals in a competitive market (often there is only one hospital for an entire rural region).

that's before even getting into pharma. which can charge millions of dollars for life saving/changing drugs for single course treatments. hell take a look at what happened with epipens. there is no protection against profiteering via nebulous 'markets' when your choices are 'purchase or die'.

[BobbyJo]

> You're choices are: die, or pay whatever cost is associated. its not a choice that can be negotiated

This account, or at least should account, for a very small minority of interactions with healthcare facilities. Saying that's why the whole market is defunct is recklessly reductionist.

> markets don't deal with this situation well.

They don't deal with it at all. Imagine if some people needed bread or they'd die, would that change the price on the shelf? No, because the bread didn't get there because of that niche market, it got there because most people eat it. It is the same with healthcare. If a hospital exists because people routinely visit the doctor, some people needing their life saved isn't going to suddenly change prices.

> that's before even getting into pharma. which can charge millions of dollars for life saving/changing drugs for single course treatments. hell take a look at what happened with epipens. there is no protection against profiteering via nebulous 'markets' when your choices are 'purchase or die'.

Totally agree. The issue there is regulation and how we allow companies to be a position of no competition. If the government stepped in and payed those prices for you, it wouldn't solve the problem.

[jatone]

> This account, or at least should account, for a very small minority of interactions with healthcare facilities.

sadly its not. you're in pain? you need to visit a medical facility to figure out whats wrong. without knowing how serious it is it can lead to a life long issue. again you don't really have choices here. pay the healthcare tax or risk long term issues.

there is a reason preventative medicine is cheaper (overall) than delaying care until a condition has progressed.

the capitalists idea of a market simply doesn't apply to healthcare.

> If a hospital exists because people routinely visit the doctor.

this isn't true. we fund hospitals in rural areas because there literally isnt enough people to keep one operating via patient care.

you're also asserting that if the populace can't sustain the healthcare system then it shouldn't be available to people. which is fairly cruel and immoral.

[BobbyJo]

> sadly its not. you're in pain? you need to visit a medical facility to figure out whats wrong. without knowing how serious it is it can lead to a life long issue. again you don't really have choices here. pay the healthcare tax or risk long term issues.

I don't see how that is a congruent thought. The 'sadly it's not' doesn't follow from your statement after. If you are in pain without knowing how serious it is, you would likely get opinions from several doctors. You're not going to walk into the first hospital you find and say "I'll pay anything you ask just fix me."

> the capitalists idea of a market simply doesn't apply to healthcare.

You still haven't made a logically coherent argument as to why it doesn't. The vast majority of healthcare transactions are made between two lucid and consenting parties.

> this isn't true. we fund hospitals in rural areas because there literally isnt enough people to keep one operating via patient care.

That backs my point, right? Those hospitals aren't funded by emergency care either, which means the point about costs being a one sided negotiation while the other party is dying is still inaccurate.

> you're also asserting that if the populace can't sustain the healthcare system then it shouldn't be available to people. which is fairly cruel and immoral.

I don't think recognizing the limits of a given resource is cruel or immoral, it's reality. Us not having perfectly clean energy is killing us all, but it isn't cruel and immoral, it's a problem that needs solving. If a town can't afford a hospital, and you want to live in a town with a hospital, move, right? I don't see any reason why taxpayers should pay so a small mountain town in the middle of nowhere can have a staff of doctors and nurses to support a population of 100 people. If someone wants to live in the mountains of Oregon, I don't see how we have a responsibility to pay for a medical care facility to follow them up.

[jatone]

> If you are in pain without knowing how serious it is, you would likely get opinions from several doctors.

> You're not going to walk into the first hospital you find and say "I'll pay anything you ask just fix me."

these two statements are functionally equivalent. by running around paying every hospital for opinions you're literally saying 'I'll pay anything you ask just fix me'. It also tracks with my statement that medical pricing isn't influenced by rational markets which are what is required for a capitalist free market to 'work'. people need to be able to say 'this is unnecessary' which never happens in health care.

In healthcare you have two modes: 1. I can afford the care, price is fairly immaterial make me better. 2. I can't afford the care, doesn't matter what the price is.

> that backs my point, right? Those hospitals aren't funded by emergency care either, which means the point about costs being a one sided negotiation while the other party is dying is still inaccurate.

not sure how you get to this idea. the point is you're hung up on the dying aspect which is basically immaterial. I can torture you and get you to say anything I want. medical care is basically the same thought process for those who need care. The only thing that prevents people from paying any price is literally not being able to afford it. Otherwise people will 100% bankrupt themselves to make pain go away.

Given that the majority of bankruptcies in the US are due to health care just proves this point.

There is no way to make this kind of market work in a 'free' market system.

> I don't see any reason why taxpayers should pay so a small mountain town

we already do. you can argue whatever you want but as a society we've already mandated this level of access. for the same reason we've mandate fire and police coverage. its a public safety issue and a tax payer in bum fuck no where have the same right to have their taxes ensure they're covered as joe shmoe in NYC.

There are MANY reasons why this is economically a good thing via 2nd/3rd order effects that more than pays for itself.

> I don't think recognizing the limits of a given resource is cruel or immoral, it's reality.

every country with universal coverage disagrees with you. I'm not going to belabor this point further. Reality has proven otherwise. The US system is just completely dysfunctional. and thinking otherwise DOES make you cruel and immoral. If you want to discuss how to make a healthcare system that works, fine, but I'm not going to moralize with you on a clearly disgusting world view.