[beaconstudios]

isn't forcing hospitals to post prices a form of regulation? In a free market (I'm interpreting this to mean laissez-faire - a market setup maximise competition and consumer choice must be regulated) nobody will post prices unless they have to or the procedures are elective, like plastic surgery is.

[adam_arthur]

Yes, I'm not advocating a free market, but a competitive market.

Fully free markets can lead to negative externalities like monopolies, pollution etc.

What leads to good societal outcomes is competitive markets. It just happens that free and competitive overlap a lot of the time. Information hiding makes a market less competitive, but is permitted under a full free market mentality. This is an area where regulations are warranted and useful.

Competitive capitalism should be the goal for most areas in modern society. Which in almost all cases only requires light regulation.

[mchusma]

I actually think requiring to give prices is consistent with libertarian approaches. I like good clear contract law. I think being able to give prices is basically required for good contracts. This is why every other industry does this, and nobody just says "we will charge you whatever we like".

If you were in another industry, and went to a judge and said "this person defaulted on their agreement to pay me whatever I want." Then I think the judge would basically tell you to get lost. And that is a good thing. The only oddness here is that somehow the medical industry has been getting away with this for a long time.

That is what the fix should be too, IMO. Basically, legislation that states unless someone expressly agrees to a price for a medical procedure, they are not liable for it.

[adam_arthur]

Yup, there's a lot that can be done to foster more competition in the medical space. Important that consumers have some skin in the game too. Another big problem is that the structure of insurance plans often warp incentives such that people either under or over-consume care.

Certainly there's a good case to be made for having safety nets for those that can't afford, but for the vast majority of people, a competitive system would bring down costs substantially. The US actually pays the most for healthcare per capita than any other country, I believe. Largely goes to inefficiencies rather than health outcomes. A truly well structured and competitively designed healthcare system could greatly improve QOL for the public.

Whether it's "libertarian" or not is a matter of semantics. The free market extreme would have no regulations at all... but clearly that can lead to certain negative outcomes (monopoly being classic example). Certainly there are different flavors of libertarian... and I would consider myself one, but am in favor of regulations that encourage competition between businesses. However, not needed in most spaces, healthcare in particular seems very warped/not rationally structured.

A rule of thumb for whether a sector is competitive/efficient are whether margins are broadly high across the board. I'm definitely a capitalist and not anti-business, but in a competitive market you should expect margins to be relatively constrained in the long run. Of course first movers, and those that truly out compete the rest can attain high margins... but over time these advantages should erode as new and better players come along.

Certain SaaS is pretty interesting example, because cost of switching can be high, creating "utility-like" businesses. DocuSign, for example, is really easy to dump for a competitor, low cost of switching. But something like AWS is much more difficult... need to invest potentially millions of dollars and months of time to rewrite your systems/design learn a new cloud environment, very high and painful costs of switching. It's often cheap to choose one of many competitors, but then you're entrenched in that environment.

Anyway, long tangent, but I expect law to recognize these kind of things eventually...