[EDIT: Immediate downvote? New personal record! HN is becoming more and more liberal I guess. Never mind.]
Once again, there are many opportunities for improvement. Business opportunities.
Healthcare is plagued by inefficiencies, over regulation, and "just think of these people who suffer" mentality- basically, we undertreat, overtreat and in both case overspend because of inefficiencies caused by overregulation, just because we don't have the guts to say "no". (the fear of prosecution might also help.) To those who are so worried about people being left to die in pain as the result of a "no", just think about how cheap morphine is. There is no need for pain and suffering.
It might take a long time to solve all these issues, if it can be done at all, but there are many good ideas thrown around.
Price transparency - ie knowing in advance how much a procedure will cost depending on the most possible outcomes would help. It should be mandatory - for the most typical stays, give a detailed pricing in advance then let the market solve the problem.
Ending the price discrimination would also be a great thing. Same service = same price. Insurance are getting low costs not because of their "volume purchase" but because they use their market power, as oligopsonies, to get the low price they receive, subsidized by the non-insured.
The current incentives make sure that the minimum is being done (if only to code and bill for that - like the chest X ray in the example. If it was not billed, how certain would you be that it was performed 100% of the time?) and it is a good thing, because I am more worried by undertreatment than by overtreatment. The latter may only cost more, but the former may cost more due to delayed proper treatment and may cost lives.
As shocking to my libertarian values as it can be, I recently came to the conclusion that subsidized first line triage should be offered, not even at costs, but for free.
Healthcare has an information problem - it's hard for patients, especially if they are uneducated, to determine how grave their symptoms are. Even if they are intellectual and successful - so don't think it can easily be solved by education. Read about Don Rosa eye problem, how he delayed treatment for a grave retinal disease.
In economy, self rationing is usually good - but when that decision is based on a lack of proper information of the consequences and their future costs, it's not.
I'm not suggesting to provide free treatment here - just at least free information. A right diagnosis, upon which the patient can decide what to do.
Markets work best when some basic conditions are met. There is no real market in healthcare at the moment because prices are not published, and the information asymetry, while less important than before thanks to the internet, remains strong.
Once we have a medical tricoder and an ebay-like place for medical procedures, I guess the situation will improve.
[medical tourism is a step in the right direction, but even discarding the information problems, until prices are properly aggregated and compared, it won't be enough]
> Ending the price discrimination would also be a great thing. Same service = same price.
This is actually an anti-libertarian idea.
But is a very good idea. This is a service industry, not a manufacturing industry, so there is very little "economy of scale" coming into play, and the consumers with the least ability to pay have the highest prices.
Heck, you could even say "prices must be within a factor of 4" and it would still be an improvement over today's system.
If it was a working market, with published MSRP and true competition, price discrimination could theoretically be used to increase surplus. But it's not currently a market!
At the moment, it's not. I'm not concerned with dogma so much - I care about efficiency. Ideally, all regulations would be removed.
But we are not starting from scratch - we have the current status of healthcare. We want to go to a working market - the question is how can we do that?
Enforcing uniform prices is a step in the right direction - because the uninsured will stop subsidizing the abnormal low rates insurance companies can strongharm the hospital.
Welcome to being a liberal-tarian. We can support solving externalities (like your free triage does) without saying that the government should run it, etc. Public funding of open / competitive systems can be the optimal solution to problems like this - just how roads and utilities are built (both of which are pretty reasonable the older the industry).
I.e. Internet has way higher margins than natural gas service because we haven't gotten internet monopolies regulated as well as natural gas b/c the latter has been around for longer and has been refined pretty well for the end-user's needs.
Once again, there are many opportunities for improvement. Business opportunities.
Healthcare is plagued by inefficiencies, over regulation, and "just think of these people who suffer" mentality- basically, we undertreat, overtreat and in both case overspend because of inefficiencies caused by overregulation, just because we don't have the guts to say "no". (the fear of prosecution might also help.) To those who are so worried about people being left to die in pain as the result of a "no", just think about how cheap morphine is. There is no need for pain and suffering.
It might take a long time to solve all these issues, if it can be done at all, but there are many good ideas thrown around.
Price transparency - ie knowing in advance how much a procedure will cost depending on the most possible outcomes would help. It should be mandatory - for the most typical stays, give a detailed pricing in advance then let the market solve the problem.
Ending the price discrimination would also be a great thing. Same service = same price. Insurance are getting low costs not because of their "volume purchase" but because they use their market power, as oligopsonies, to get the low price they receive, subsidized by the non-insured.
The current incentives make sure that the minimum is being done (if only to code and bill for that - like the chest X ray in the example. If it was not billed, how certain would you be that it was performed 100% of the time?) and it is a good thing, because I am more worried by undertreatment than by overtreatment. The latter may only cost more, but the former may cost more due to delayed proper treatment and may cost lives.
As shocking to my libertarian values as it can be, I recently came to the conclusion that subsidized first line triage should be offered, not even at costs, but for free.
Healthcare has an information problem - it's hard for patients, especially if they are uneducated, to determine how grave their symptoms are. Even if they are intellectual and successful - so don't think it can easily be solved by education. Read about Don Rosa eye problem, how he delayed treatment for a grave retinal disease.
In economy, self rationing is usually good - but when that decision is based on a lack of proper information of the consequences and their future costs, it's not.
I'm not suggesting to provide free treatment here - just at least free information. A right diagnosis, upon which the patient can decide what to do.
Markets work best when some basic conditions are met. There is no real market in healthcare at the moment because prices are not published, and the information asymetry, while less important than before thanks to the internet, remains strong.
Once we have a medical tricoder and an ebay-like place for medical procedures, I guess the situation will improve.
[medical tourism is a step in the right direction, but even discarding the information problems, until prices are properly aggregated and compared, it won't be enough]