(01-31-2019, 04:10 AM)jj82284 Wrote:

(01-30-2019, 10:23 PM)mikesez Wrote: Consumers lacking the ability to understand their own healthcare is one reason that the free market does not improve healthcare.
Involving the government more will not suddenly make people understand stuff that you need years of medical school to understand, I agree. I don't think the government would fix that problem.
But involving them more will help prevent people from buying stuff that will not improve their lives, and it will help make sure that the treatments that do improve lives are affordable for all of the people who would benefit from them.
I also think you could have a bigger role for the government without eliminating alternatives.
In Canada or in England if you want more than what the government provides, sucks to be you, go to another country.
But in Germany, or France, or Switzerland the government provides a minimum amount of care and you can buy more, or faster, or more luxurious, if you think that's a good use of your money.

So let me get this straight.  The same government monopoly that was given tens of thousands of dollars and 13 years for my education failed to make me competent enough to understand my own healthcare.  So your solution is to put the same government monopoly in charge of said healthcare decisions?  In what world is this logical?  Self interested people with the ability to hold providers accountable do better making their own decisions than unaccountable bureaucrats.  The answer is more transparency and consumer education, not an even bigger curtain of the state that isn't governed by any real standard of honesty (Barrack Obama would have been jailed if her were a CEO of a private healthcare company.)  

I also find it interesting that, more often than not, interventionists never actually take the time to evaluate the results of intervention.  Every wart or freckle in a market result can be analyzed dissected and stated as a call to action.  Then when the government intervenes, MAKES THINGS WORSE, we blame the market?  Accreditation, Licensure, and the AMA have very little to do with a true free market economy and they account for hundreds of thousands of dollars blocking the entry of intellectual capital into medicine.   

Economics is the rationing of scarce resources.  On a fundamental level, the biggest driver in the cost of someone to cut into your chest and fix a heart valve is that there are only  few people who know how to do it.  There's only so much any "system" is going to mitigate that economic reality.  

When you look at healthcare, like any good or service, the price is also a reflection of the amounts of resources that go into bringing that product to market.  In this case we have: The actual cost of care, the cost of the Insurance bureaucracy, and the cost of the government bureaucracy.  The basic fallacy with interventionists is that somehow dramatically increasing the size of the government bureaucracy is somehow going to reduce the cost of the underlying good or service which basically defies economics.  At current, just so the administrators between the care provider, the state and the insurance companies can talk to each other people get full college degrees in billing and coding.  It takes a decade in some cases to bring certain drugs to the market.  Those are massive massive costs that are absorbed by the consumer that don't actually go into the pocket of care providers.  If you really want to reduce costs then we have to mitigate those extra expenses.  

What's the best way to do that?  Let providers develop their own risk pools. There are lots of consierge practices and cooperatives that are set up where instead of paying a premium to a third party insurance company for the majority of your healthcare, you pay a monthly membership fee to the doctor and go when needed.  This saves tons of money in cost of compliance alone.  And we couple that with CATASTROPHIC INSURANCE for the cancer diagnosis or major illness that the average person can't pay for.

I think your comment about education is garbage.  You don't seriously want primary and secondary schools to be tasked with bringing an average person's knowledge of medicine up to where they could compete with an expert, so why bring it up?
Yes, I think average people could rely on one expert to be their advocate against other experts.  That's how class action lawsuits and many other things in law work.
I agree with you about the AMA and how needlessly difficult they make it to practice medicine.  I agree that drives a lot of cost increase.  But flsportgod hated that idea when I brought it up, said I wanted a "C student" to operate on me next time I had a problem.
I agree with you that steering more people towards catastrophic plans can help lower expenditures while minimally changing outcomes.
I don't agree that concierge care is going to improve anything for anyone besides an elite few.
I think your brain is contaminated with the "government as a bogeyman" meme and you need to work on that.  The public school teacher is not the same type of person as the police officer, and neither of them are the same type of person as a judge or a city manager.  Yet they all work for the government.  Governments are really bad at certain tasks, but they are really good at other tasks.  Experience around the world shows that governments help keep costs down and quality in health care.  Just because the Fed's interventions in housing and education have been convoluted busts doesn't mean that health care would be.
All I want the government to do is
-make it so Americans pay prices for prescription drugs that are similar to what Canadians and Europeans pay
-make it so people only pay a certain % of their income in health care premiums and deductibles, and insurance can't turn anyone down
-make it so you can keep whatever health plan you're on when you change employers - the plan is tied just to you, not the employer
in that order.

Most of your objections are not really relevant to any of these three goals, and there are various ways the government could achieve them, whether by directly taking stuff over, starting new publicly owned operations to compete with what exists in the private sector today, offering vouchers, etc.

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