[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.

[BobbyJo]

> by running around paying every hospital for opinions you're literally saying 'I'll pay anything you ask just fix me'

No you're not. You can choose which hospitals you're getting opinions from.

> 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.

No it doesn't. I've shopped around for PCP. It wasn't like that at all. Do you think every doctor works in an inner city ICU or something? I'm not sure where you're pulling this view from.

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

What point does it prove? I don't really see what point you're making. Is it the US system has major problems? If so, I agree. Is it that nationalized healthcare is the best choice? I haven't seen you make an argument for that at all other than conjuring your own personal ethical code.

> these two statements are functionally equivalent

I'm trying to make a coherent point, so that makes sense.

> not sure how you get to this idea. the point is you're hung up on the dying aspect which is basically immaterial...

So you agree with me now? Emergency care doesn't play a major role in the market?

> we already do. you can argue whatever you want but as a society we've already mandated this level of access

I'd like to see the mandate you're referencing. Sounds like you actually agree with codifying qualifying circumstances for care ;)

> every country with universal coverage disagrees with you

No they don't. Countries with nationalized healthcare routinely ration care. They recognize limited resources same as us, just through a bureaucratic system a oppose to a market system. Just because it's a man with an office deciding if you get to see the doctor rather than your bank account doesn't make it morally superior.

> If you want to discuss how to make a healthcare system that works, fine

This is the discussion I've been getting at the whole time. You're the one constantly conjuring some vague sense of morality as opposed to discussing which models may work better than others.

[jatone]

> No you're not. You can choose which hospitals you're getting opinions from.

you clearly don't understand how hospitals work. getting opinions costs money. just visiting and taking their time costs money.

you can get a hospital to quote you the cost of a procedure. but to actually get a doctor to diagnose you takes time, resources, and tests. this costs money. and without doing said work you have no idea what procedures to get a quote for.

and frankly the only reason to get multiple opinions is if the current doctor has failed to resolve your problem.

no one jumps doctor to doctor unless there is something wrong with the current one like a lack of progress on resolving the issue.

> You're the one constantly conjuring some vague sense of morality as opposed to discussing which models may work better than others.

without understanding the moral outcomes of an economic system makes any such discussion meaningless. You should checkout Albert Hirschman https://www.ias.edu/press-releases/albert-o-hirschman-1915%E...