[RandomLensman]

How would develop the "trust" and why would it be correct? How would you diagnose yourself or others before selecting a hospital if those have different trust for different things? How do you balance urgency vs different trust levels if the hospitals are not all the same distance?

[mikeyouse]

It also ignores that huge swaths of the country have no choice at all and the only hospital within a hundred miles is only viable due to huge Federal subsidies. We’ve been helping a close family member navigate that scenario and sure, he could vote with his dollars but it would involve a three hour drive to a neighboring state for an 80-yr old. I’d rather just enforce minimum quality standards on everyone like most other civilized countries rather then relying on “the free market” which so far in my experience has just led to PE goliaths swallowing entire health systems to focus on bill collection and union busting.

[nradov]

CMS does enforce minimum clinical quality standards on hospitals (at least those that accept Medicare). The problems in areas without meaningful competition tend to be more around shortages of qualified practitioners, high prices, and abusive billing policies.

[whatshisface]

I can't imagine anyone would object to minimum quality standards for anything receiving federal subsidies.

[collingreen]

edit: didn't realize I was feeding a troll. Feel free to ignore.

I expect the objections are in how quality is measured and enforced.

It reminds me of education system in the US - most people (project 2025 aside) think it's good to have a public education system; having a pipeline of skilled workers makes it easier to build an economy filled with a diverse set of businesses.

However, the attacks start to fly when there is disagreement about who should be allowed to teach, how they should be measured, and how they should be paid.

[whatshisface]

Settling everyone's differences about rural medical subsidies might be a good stepping stone to an NHS.

[whatshisface]

You could ask the same questions about grocery shopping or buying a PC.

[unethical_ban]

Just to be clear: You're asserting that the average citizen

  * has the same capacity to research an unknown number of medical procedures and the doctors performing them as they do researching onion prices or CPU specs

  * faces a similar scale of consequences when failing to properly analyze medical procedures as they do when they fail to properly price-compare onions or PC services

  * has the same freedom of choice to "purchase their preference" in an emergency, life-threatening situation as they have when shopping for PCs or groceries

[whatshisface]

Dietary and metabolic problems are an epidemic that outweights malpractice in terms of quality and quantity of life by more than two orders of magnitude - so yes, I am saying people face "shopping problems" of life or death magnitude every day.

[RandomLensman]

A mis-assessment there might be far less consequential and those also do not require a medical diagnosis before making a decision where to go.

[whatshisface]

I've never needed a medical diagnosis to decide between calling my GP and going to an urgent care. It's just a bit surreal to hear everyone else say my ordinary survival skills are impossible and more than could be asked of anybody!

[RandomLensman]

You said you have a hospital selected you trust (by whatever your metric is). Hospitals tend not be all equal for all things, so trust should probably be differential - how do you assess yourself as a patient then to decide on where to go? And if you do not differentiate the trust any further than to a single hospital regardless of what the issue is: why is that sufficient?

I think it is fine to have some preferences for a hospital, but not sure how much benefit that confers outside of some narrow situations.

[whatshisface]

Sinply replace hospital with any other service, take your own answers and then translate it back. In economic terms I researched medical facilities until the expected marginal benefit of the information fell below the marginal cost. There are a lot of reasons to reform the US healthcare system but you can't argue that consumer choice is too complex to be realized.

[RandomLensman]

I don't know the US system well enough to say much about it.