[barking]

It's worth noting that there is no relationship between a U.S. hospital bill and the actual cost of the service

If this is true (and I don't know that it is) then it sounds to me that the free market is not working in this area in the USA.

If it's not working then that may be because of supply restrictions because of limited numbers of places and/or high costs at medical schools and excessive restrictions on foreign trained medical professionals entering the US.

On the other hand becoming a doctor requires a high degreee of intelligence, high tuition fees and years of long hours as a junior at low pay while you continue to study and do further exams. When you finally get to the promised land you have large debts and a relatively short career ahead of you. You also have rare skills and are a person who has delayed gratification to an extent that few others would be prepared to. You are also in a highly responsible job and are likely to be subjected several stressful lawsuits during your career.

In a society where no limit seems to be placed on the earnings of sports stars and others in their early twenties, why should doctors be expected to restrict themselves to less than their market can bear?

[dietrichepp]

I don't see how a correctly-working free market would lead to a different situation here. The market is necessarily inefficient:

1. Consumers don't have the skills required to estimate the value of medical care.

2. Consumers don't have the time to negotiate prices: if you're dying, you can't wait.

The question here is not doctor's salaries, that's a red herring. The question is why someone without insurance pays so much more than someone with insurance, if the care received is the same. It's because the insurance companies have the time and skills to negotiate prices, and individual consumers are under duress. It's the same reason that workers in unions earn better wages -- although the numbers are different: Wikipedia puts the gap between union and non-union wages at 21-32% in the US, and the gap between the cost of insured and non-insured care is much higher.

I say we have a moral duty to replace the current, broken, free-market system. Evidence from countries other than the US supports the theory that socialized health-care can be more efficient.

[droidist2]

It's true the free market isn't functioning in healthcare. You mentioned doctor supply. During the late 1990s the American Medical Association convinced the government there was going to be a "doctor glut" so the American taxpayer subsidized medical schools in exchange for not graduating doctors, $100,000 for each doctor not trained.

[NoPiece]

You give a good example but it is worth clarifying that more than it being a non-functioning free market, it is absolutely not even close to being a free market. The Federal government is the biggest spender in the market, and with that comes a mountain of regulation and price controls. The states are probably the second biggest players in the market. Even things that almost everyone would agree with make it a less free market, like licensing doctors, certifying medical schools, and approving drugs. I think you could make the case that either a much freer market, or a completely state controlled system would lead to lower costs. The current situation reminds me of the pseudo deregulation of power in California that ended in catastrophe.

[plaguuuuuu]

>In a society where no limit seems to be placed on the earnings of sports stars and others in their early twenties, why should doctors be expected to restrict themselves to less than their market can bear?

Because setting a price for maximum profitability means that whoever can't afford medical treatment dies

People not dying is probably more important than profit/free market/ensuring people can buy mercs or giant yachts or whatever, socially/politically/morally speaking. though if your opinion differs and you have a good argument for it, I'm happy to hear it.

[coldtea]

>If this is true (and I don't know that it is) then it sounds to me that the free market is not working in this area in the USA.

There is no "free market". That's a 19th century superstition. For example, if something as basic as the price you pay for oil is determined by the wars your country fights then there's no free market. If your government prints inflated money at will. No free market. If the banking sector gets a 1 trillion dollar bailout. No free market. If a company or a lobby can buy several senators. No free market. If there is copyright and intellectual property rights. No free market. If your country can force others via military and diplomatic might to enforce favorable trade agreements. No free market. Heck, even if recreational drugs are illegal: no free market.

And even if it was, it wouldn't be working in this area. When you're dying you don't negotiate prices.