[detbuch]

Originally Posted by spence

We let Pharma companies charge what ever they want for patentable drugs without any negotiation.

Not my idea of market forces at work...

Free market does allow big pharma to charge whatever they want--usually what it thinks the market will bare. Charging more diminishes sales. The negotiation in a free market is between seller and buyer, usually expressed as sale or no sale. The reason big pharma can charge "whatever they want" is because of the controlled market regulated by the "negotiation" between it and the Government (FDA), which precludes competition from smaller companies and entrepeneurs due to the high price and length of time required by the regulations, and due as well to the cozy collusion between the FDA and pharma.

Over simplification. I could see medicare raising some costs as it put more people into the health care system. And unlike many industries, health care is still pretty manual and doesn't scale well.

Usually, volume permits price to drop. Unlike many industries, health care payment has been put in the hands of third party payers, medicare being one, and the third parties have deeper pockets than most individuals, medicare's being the deepest, which allows higher prices by the sellers (doctors, hospitals, etc.)

But there are a lot of other reasons costs have increased. A big one is the proliferation of advanced (i.e. expensive) technologies that are now standard and expected. I'd also think that we treat so much more than we did 50 years ago...ailments and diseases that simply weren't diagnosed previously.

Again, because of wealthier third party payers, the health industry can pay more for technologies (similar to how government is ripped off as it pays for its technology when buying for "the people"--especially the military). In those industries that have to sell directly to individual buyers their costs, including technology, is lower.

Joke. Although I do like the perspective of the Economist. Usually pretty smart.

OK. Smart, unfortunately, doesn't always equate with right.

Being able to pay doesn't mean it's painless. I remember when my first son was born in 2003 my out of pocket was maybe a few hundred bucks. Fast forward to 2010 and my second son cost easily 10X that out of pocket. Same company and relatively the same plan. While I'm fortunately "able to pay" that few thousand bucks would put a damper on a lot of families budgets.

Please don't tell me that you believe it's the governments responsibility to make our life painless. And if your paying an insurance company to do likewise, then it better come across or you should drop it. At least in a free market you are allowed to drop it. But when government mandates, you have no choice. Suffer the pain and rejoice.

I'll let the SCOTUS decide on legality...

So you have no opinions on Constitutionality? You just blindly accept SCOTUS opinion as infallible? You don't see the obvious mis"interpretation" of the Commerce Clause that presumably gives Congress the power to tell you that you cannot grow your own vegetable garden because if everyone did, in the aggregate it would affect the price of food and destroy or distort the commercial market? You cannot see the obvious fallacy of using the General Welfare clause to give Congress the power to give succor to a select few to be paid for by others when "general" refers to all, equally, and in the construction and syntax of the Constitution the clause refers to general welfare (welfare of ALL in the same manner) as given through its enumerated powers not in any way it chooses, else it would have greater, if not exclusive, power to attend to your welfare than you would have yourself? You do not plainly see that the Necessary and Proper Clause refers to the "foregoing powers" (the enumerated powers) not any power Congress chooses to impose? The Constitution is not that long and difficult, and was meant to be understood by all, not just a select few lawyers and judges. The SCOTUS was meant to interpret whether Congress acted within its powers, not to interpret what the Constitution meant, and to apply the Constitution as written, not to apply it as the judges think would be more "responsible." The individual is supreme in our system, and as such is as much responsible to be involved with governing as are all the "servants." When the citizens "let" judges or politicians act according to their view of "responsible," and don't voice objection when they see bad judgement, they give their Constitutional power of self governing over to those servants and deserve the tyranny they allow.

Like I mentioned above, there are a lot of problems.

Another big one is simply how the system works, where people never really see the cost as it's passed to an insurance company and then you see only your part weeks after. People don't even question the costs they're being charged.

That is the nature of third party pay, whether it's private or government. And we should question both. Just as we should absolutely question our judges bad decisions. It's our money and our freedom that's at stake.

I switched to an HSA this year and it's making me much more aware of what's actually being billed. If the tax exemption will really save any money remains to be seen, the shyte is so complicated I can barely figure out what's going on.

Yes, and as regulations need to be reformed, new regulations pile on old ones and the complexity and lack of transparence becomes greater. That is the nature of law. The more detailed your regulation, the more parties, points of view and opinion are involved, the more it requires finer and more complex points of law. The Ten Commandments just wont do.

I think market solutions are more desirable but are also easily corrupted and can be self consuming when not monitored.

Government is also easily corrupted. And the corruption of Central government reaches farther than most other corruptions.
And who or what is the monitor? And who monitors the monitor? In a free market, there is a, granted loose, self regulation. This can be enhanced by limited governance that is a result of consent of the people on local levels. But Central power over a large diverse market tends to create static, unevolving markets--not only stagnant, often imploding, but, in our case, UNCONSTITUTIONAL.

Health care is somewhat unique in that most everybody needs it, we have a very complex system to deliver it, the massive size of the industry attracts a lot of R&D, hospitals are obligated to dispense some of it and most of the system is for profit.

The consumer is in essence quite detached from the market in many ways. If a market solution is the answer, perhaps that's really the root of the problem.

-spence

Most everybody needs food, and shelter, and energy. And we have a very complex system to deliver them. When the cost of delivery is paid for by the individual buyer, it seems the price is generally lower than when a richer third party, especially the government, pays for it.