Health care cannot be free market by one simple fact - you have total inflexibility of demand/constant production of goods/information asymmetry. No sane person will buy brain surgery if he has no problems even if it 1$ and he has no choice but to buy one at whatever cost if he has.
We should work towards making healthcare cheap in absolute sense - if we could make healthcare cost on average 1000$ per person per year than the question who should foot the bill is moot - it will be such a small sum it won't matter.
False. The RAND experiment shows that people's consumption of medicine is dependent on it's marginal cost to them. Higher levels of cost sharing induce people to reduce consumption of medicine by 30% (with no adverse health effects).
The Oregon health study got similar results, although it demonstrated one adverse health effect of consuming less medicine, namely increased rates of depression.
Which fails to translate into a meaningful result beyond what every other socialized healthcare system already knows and has addressed: you bill for stuff at the low end to keep people from going to the doctor for every tiny complaint, but it's utterly nonsensical to say that charging people for setting bones, or performing needed surgery is somehow going to encourage them to consume less.
I would love to see how someone gets 70% kidney or joint transplant. Like they put the stuff but don't sew you? Or you forfeit the anesthesia? Or if you have infection they give you antibiotics only 7 of the 10 days needed? They remove the bone cask a week before it is fully healed? Remove only 70% of tumor during surgery?
The major medical problems that you "don't have a choice" but to get are not 100% of all medical problems that can exist. There are only so many organs available for transplant every year (thousands yes, but no millions) but seeing the doctor for the sniffles is bounded only by the number of people in the US, 300 million. There's a difference between something that will kill you in short order (like a horrible car accident where you're bleeding out) where you take whatever medical care you can get at any price, and the more mundane, routine stuff like ACL surgery where you can afford the time to shop around or perhaps even forego it entirely.
No but it makes case about the fact that we are currently overtreating people in some cases. With defensive medicine and the fact that there is growing body of evidence that aggressive screening for cancer in a lot of cases does little good there is good chunk we could eliminate.
By my friend that is on dialysis cannot use it 30% less in the long term without endangering her life or degrading her quality of life to the point of not worth living.
Fracture a bone - you can go without professional help - risking all kinds of nasty stuff that will get you into ER or limping for the rest of your life.
You can ignore the dermatitis but if a mole starts bleeding you MUST go to the dermatologist to check yourself for skin cancer. 30 percent less of the later checkups and you have a few corpses on your hand.
> No sane person will buy brain surgery if he has no problems even if it 1$ and he has no choice but to buy one at whatever cost if he has.
So what? Also, if there are multiple methods to treat his conditions, he may choose more expensive(or more cheap) method. Also, he may choose not to have brain surgery -- and sadly suffer or die. Socialism is hardly a solution here, if state will fail to provide necessary amount of surgeons to fulfill demand for them, then people will die too(not mentioning that there always be better methods and better qualified surgeons, so you won't be able to achieve the same level of healthcare anyway).
First - if I cannot afford a treatment not getting it is not a choice.
A choice is when I have insurance and refuse chemo because the side effects outweigh the benefits.
I am not talking about socialism. I am talking that we should treat the healthcare system the same way that we treat power plants and energy distribution utilities. A system of grants and loans that ensures long term supply of goods. So you pay your bills each month but the government takes care of you not being price gouged (except in California)
In the US (disclaimer - most I know for the healthcare is from the media, non US citizen) a good starting point will be forfeiting and subsidizing medical education so the graduates will be loan free. Also the government should not leave R&D to the private sector but create human health Manhattan project - this will have the benefits of everything that comes out of it entering public domain so no royalties patents and other shit to take care of.
A good healthcare system should be like interstate etc. It is there it is low margin but enables the society to move faster towards the future.
> First - if I cannot afford a treatment not getting it is not a choice.
The same is true in your system, substituting "afford" for whatever verb is better suited for your proposed system.
> Also the government should not leave R&D
Government leaving R&D to private sector(which is major source of funding even now, at least in the USA) would be the great decision. It will stop crowding out resources from private R&D, thus making R&D more effective and more beneficial to economy.
Patents are the separate issue. There is the flaw in your logic. Patents are government granted. You view them as undesirable, but your solution is even more government. However, the logical solution would be abolishing patents.
> Government leaving R&D to private sector(which is major source of funding even now, at least in the USA) would be the great decision.
The only people who claim this are those who have no idea what constitutes anything near blue skies research. Anything worth looking into for the mid to long term is going to have questionable profit potential and therefore not conducive to profit seeking.
There's a reason why most research uni's are public and the results are dumped out for industry to exploit, and it's not because it steals the talent by paying so well.
> You view them as undesirable, but your solution is even more government. However, the logical solution would be abolishing patents.
So your plan is to incentivize private R&D by abolishing IP. Hahahahahaha.
Mid to long term research probably doesn't pay off inside the patent window so what does it matter? If I discovered a technology that's 30 years from adoption who cares if I can get a patent? It will be expired by the time I have any ability to make money from it.
Drugs usually have about 7 years on their patents before generics can hit the market. Since it costs sometimes hundreds of millions of dollars in R&D for one drug to hit the market, the patent period is extremely important.
Particularly since the drug must clear the FDA and there is potential for recall.
(I'm from Europe) Does the word "socialism" actually mean something different in the US, or is it just an abuse of notation? I see this all the time. I don't see what worker-owned means of production has to do with the efficacy of healthcare.
Even though every other OECD country save Mexico provides more socialized medicine with essentially universal coverage, produces equal or better overall health outcomes than the US, and spends far less per capita and per GDP on health care than the US. But, yeah, sure, "socialism is no help here", because if it was, that would require people to reconsider their laissez-faire religion.
I suspect that's impossible unless you first reach a full post-scarcity economy of nanotech and robotic servants. For rare conditions, it's not overall cost-effective to spend the necessary money to make them cheap, and for everything else there is too much labor involved to ever be cheap.
We should work towards making healthcare cheap in absolute sense - if we could make healthcare cost on average 1000$ per person per year than the question who should foot the bill is moot - it will be such a small sum it won't matter.