[tomp]

Um, what?

In theory, free market healthcare should improve alignment.

Insurance companies pay procedures and make money when people are less sick. Hospitals make money when they perform procedures. Insurance companies are therefore incentivised to only pay procedures from competent hospitals, the ones that won’t result in more follow-up costs.

The problem is, of course, it’s not a free market - neither on the hospital side (prices are not public) nor on the insurance side (it’s much more affordable through employment)

[arcticbull]

'A key feature of free markets is the absence of coerced (forced) transactions or conditions on transactions.' [1] Healthcare is not such a market. If you have a stab wound and you're bleeding out, there's no supply and demand, there's no ability for you to have market participants compete for your business. It's 'pay me or die.' Ditto substantially any major medical issue. This is, in my opinion a coerced transaction, and therefore, not a free market.

This is true of prisons (you can't exactly have private prisons compete for your business). Of fire departments (I'm not going to call for quotes while my house burns down). Of police departments.

If it's not a free market, it should be socialized, imo.

[1] https://www.investopedia.com/terms/f/freemarket.asp

[tomp]

I’m a huge advocate for private (non-socialized) healthcare.

People always twist this into “you’d have to pay so much more for healthcare”.

No! I never had to pay anything substantial for healthcare. I pay for insurance. But I prefer private insurance (to improve competition, performance, quality, accessibility, …)

[ryathal]

The prices not being public is a problem, but really the big issue is the indirection in payments. No one really knows how much is getting paid to an insurance company for their insurance, and no one really knows how much an insurance company is paying out. Anyone that actually knows these numbers is isolated (and often hidden) from the patient and doctor.

[criddell]

> Insurance companies pay procedures and make money when people are less sick.

It's not as simple as that. Insurers are regulated. They can't keep any more than 20% of the money they collect. It sets up an incentive for them to collect and spend more money.