It's Time to Break Up Big Medicine

squillion · 2024-12-13T16:33:14 1734107594

I was never convinced by the argument that patients and doctors can't be trusted to request the care they need, and would overconsume healthcare unless strictly constrained. I mean, it will definitely happen (I know some hypochondriaques), but to what extent? On one hand, "overcared" patients would likely avoid serious illness through prevention, so it's not obvious costs would explode. And on the other hand, there's a limit to how many useless treatments you can push onto patients. However, there seems to be no limit to consolidation and price gouging...

I'm glad this article provides real data and solid analysis to back my intuition.

s1artibartfast · 2024-12-13T17:13:32 1734110012

The two topics are intertwined. Most patients and doctors would not overconsume treatments, but they wouldn't not provide checks on spending and prices.

A patient and doctor don't care if a treatment costs $1 or $1million if they aren't footing the bill. You need someone in the system to say that treatment is too expensive, you cant have it.

squillion · 2024-12-13T18:27:27 1734114447

> You need someone in the system to say that treatment is too expensive, you cant have it.

That'd be triage, and I don't think it's the insurers' business – or even the doctors', unless they're in a field hospital in a war zone.

The article argues that prices are too high, because of monopoly power. Get prices down and triage won't be necessary anymore.

s1artibartfast · 2024-12-13T20:07:25 1734120445

Prices dont go down by themselves. You need someone to select cheaper options and reject more expensive ones.

If there is nobody to say no to $1 million dollar aspirin, that is how much you pay.

Money is finite, so that means people dont get care. Care is always rationed.