[corrral]

Not just Europe—price controls (de jure or de facto, the latter via e.g. establishing a monopsony) are, as best I can tell, the main unifying factor in healthcare systems in the entire OECD except the US. Those systems differ a lot, but at some point and on some level, they all fall back on price controls, apparently to good effect.

[paisawalla]

Just looking through the OECD's datasets [0], I see a lot of health care quality and utilization measures missing for the US and many other OECD countries. How are you defining "good effect"?

[0] https://stats.oecd.org/Index.aspx?QueryId=49344#

I was able to find some incomplete data that suggests the US is pretty good on the metric of wait time, compared to many European countries and Canada:

https://www.oecd-ilibrary.org/sites/242e3c8c-en/1/3/2/index....

[corrral]

I wrote a lot longer explanation but deleted it. Suffice it to say other systems are good enough that functionally no-one wishes they had the US system instead, and it'd sure be weird if every single other OECD state had been relying on price controls this long if they weren't having some beneficial effect.

My short-version argument would be—and I'm a little annoyed at having to explain this, because I've been explaining it to people on the Internet for 20 damn years, it's so not-hard to find this info that it's kinda difficult not to have been exposed to it, and it seems like it should be common knowledge at this point and like some folks are going way out of their way not to understand it—that the "good effect" is precisely that the US spends 50-100% more than any of these countries, per capita, and does not smoke the rest on practically every metric, instead doing a little better in some areas, a little worse in others, middle-of-the pack on others still. It sure as hell looks like we're paying a huge premium for similar outcomes, which also explains why there aren't a lot of people in other countries begging their governments to adopt a system like ours (a fact one has to explain when cherry-picking metrics to make the US look good—OK, so why aren't others rushing to copy us? At least some of them should be, if we actually do have an unambiguously better system).

The "good effect" is that other health care systems spend far less, and also don't bankrupt people over medical bills, while achieving roughly comparable results.

If I came to you and told you I had a process to produce a Tesla knock-off that produced a car a little better in some ways, a little worse in others, but pretty damn comparable, at 50-70% of what it costs Tesla to produce a car, and then showed you dozens of factories I'd already built that were demonstrably doing exactly that, you wouldn't ask me how I was defining "good effect" when I used that to describe the results of the One Weird Trick of my process. It's obvious.

Were you not aware of the vast differences in costs & accessibility between OECD healthcare systems? By which I mostly mean between the US and everyone else.

[paisawalla]

I am asking you to define "good effect" precisely because it seems to be subject to the kind of cherry picking you don't like.

I'm a median to upper-middle American, and I get great value from my healthcare. It's not obvious to me that a system that raises the experience for mean, or even the bottom end, of the distribution would be a good thing for me in many respects: emergency wait time, access to top percentile specialists, out of pocket costs, just to name a few. It also seems to me that you neglect to factor in that people of means, the world over, come to the US to access care from world leading treatments in many conditions. So they might not want American care in their country, but plenty surely want it for their own bodies.

Put simply: your "good effect" often smuggles in assumptions about which part of the curve to treat, and implicitly undervalues degradation of the status quo for others. You, as is the habit of liberals, would like to have a debate wherein your moral values about who deserves what and who should be deprived, is taken for granted. I'm sorry, it's not immediately obvious to me that a system where 10,000 people wait 6-12 months for lifesaving operations is better than one where 1,000 people can get the operation in a month and the other 9,000 might have to go into debt to do the same.

[corrral]

> It's not obvious to me that a system that raises the experience for mean, or even the bottom end, of the distribution would be a good thing for me in many respects

Ah—I usually assume the Rawlsian "Veil of Ignorance" POV when it comes public policy issues, personally, as I think is fairly common. Sure, if that's your perspective, literally nothing matters except how a policy affects you, personally, right now, so my analysis may not hold—but that's not an especially useful perspective from which to consider public policy when discussing it with strangers, and I'm not really sure why you'd even engage on this in public if the only thing you care about is whether a policy is good for you, right this second (circumstances are subject to change, after all)

At least you're up-front about it, rather than hiding it. I don't mind that when it's made explicit—I just also, again, don't get why you'd engage, and wonder whether you might have guessed in advance the sort of more-typical POV I was taking, so really could have understood what I meant by "good effect" without my needing to explain it. What were you trying to accomplish here?

[paisawalla]

Do you have anything other than unearned moral condescension? It is not my experience that clicking your tongue at people and badgering them to prioritize the collective over their own individual health outcomes in a healthcare policy is compelling.

So why would I engage? Because you seem to be advocating policies that would directly (and potentially negatively) affect my health outcomes, and your justification is "but you're just a statistic".

[corrral]

I was about to explain, but from my selfish POV it's actually better if you keep posting like this. So... carry on.