[ambicapter]

The mandated low margin is part of the problem. When your margins are regulated, the only way to increase profits is to just make everything more expensive. More revenue, same margin, more profits. Humane health care is incompatible with free market economics.

[wqaatwt]

Perhaps its not compatible. But that’s tangential to the situation in the US, at the very minimum you need to have price transparency in any ‘free market’ system.

[saghm]

I think the point is that we might as well just give up the pretense of a free market healthcare solution and just focus on what's humane.

[nradov]

Is it humane to leave a patient to die in an ambulance when a single-payer nationalized healthcare system is over capacity?

https://www.theguardian.com/society/2025/apr/06/englands-nhs...

I'm not trying to be snarky here, the point is that there is no easy solution and optimizing based on what politicians subjectively consider "humane" isn't going to get us anywhere. If we want to actually fix the problem then we need to focus on what's economically feasible rather than low-effort hot takes and sound bites. Free markets, with reasonable limits, can be part of that solution by revealing consumer preferences and allowing for efficient allocation of limited resources.

[ux266478]

> Is it humane to leave a patient to die in an ambulance when a single-payer nationalized healthcare system is over capacity?

I think painting the inhumanity of that as a consequence of the structure of the healthcare system is disengenuous at best, especially as the implicit solution you're proposing is to artificially lower utilization rate and access. Deflecting patient deaths into "technically not our fault, they didn't try to get help" by exploiting economics is in no small terms extremely inhumane.

The answer to that is that near universally in the world, our labor pool of medical personnel is too small, and almost all of it has to deal with an arbitrary restriction of labor supply. Stupidly, I have felt this many times in America, so trivially it's a problem no matter the structure of the healthcare system. Optimizing towards maximizing the number of nurses, doctors, pharmacists, the whole spread, in a society is underdiscussed but obviously beneficial (for everybody but those who profit off of the labor scarcity)

[ratelimitsteve]

is it humane to solve that problem by excluding people based on income? that's what your proposing, as that's how markets solve problems like this: if more people need a product/service than the market can provide prices go up and the poor are excluded. also not trying to be snarky but that's the choice in front of us. part of the problem with free market solutions to healthcare is the feasibility of walking away from a bad deal. in every other space prices are regulated downward by the buyers' ability to either buy something else or do without but there is no doing without emergency care and doing without preventive care is just deferring the cost until it's emergency care at punitive interest.

[nradov]

Stop lying, I haven't proposed anything of the kind. Free market solutions often include giving cash subsidies to certain participants (and you would be aware of this if you had bothered to do even basic research on serious healthcare system reform proposals before commenting). I'm simply pointing out that it's a complex problem with multiple causes and there is no simple solution.

[throwway120385]

Even cash subsidies can be a kind of chain. Why wouldn't we just subsidize the whole thing for everyone then? And if the purpose of a health insurance plan is to collect groups of people into "risk pools," then why wouldn't we just put everyone in a global risk pool? And if the purpose of a health insurance plan is to negotiate rates on behalf of a bunch of people, why wouldn't we have someone like CMS determine those rates? And if the purpose of a health insurance plan is to make sure everyone has health care, why would we create a system where people are excluded by means-testing?

[ratelimitsteve]

Free market solutions, by definition, exclude external interference. Subsidies, by definition, are market interference by an external actor.

[saghm]

They're not lying any more than you were when you responded to my suggestion that we should prioritize what's humane with some sort of interpretation that I was saying something about politicians.

[saghm]

> I'm not trying to be snarky here, the point is that there is no easy solution and optimizing based on what politicians subjectively consider "humane" isn't going to get us anywhere.

On the contrary, most politicians seem very adamantly against what I'm proposing. I don't know why you think I'm suggesting that we delegate how we determine what's humane to politicans.

[nradov]

That is the inevitable consequence of your suggestion. In any national healthcare system, it's ultimately the politicians who have to make choices about the incentives that drive the behavior of every other participant.

Is it humane to spend $100K of public funds to extend the life of a terminal cancer patient by 6 weeks? Some would say yes, others no. Those are real choices that have to be made and in the most expensive parts of the healthcare system there is no clear consensus on what is "humane".