So, saw this video..... Healthcare cost in the US

[ImAnOgre]

I did not fact check this guy, but at the end everything he said made some sense.

http://www.upworthy.com/his-first-4-...tle-sick-2?g=2

Should we let the government hand out contracts to the lowest bidder?

[Khendraja'aro]

I don't really like to watch videos. I'm reading and understanding stuff way faster than some guy talking does.

Not to mention that rereading a passage is easier than rewinding a video.

As to your question: No. That's the problem with governmental contracts over here - choosing the lowest bidder very often results in doubled or even tripled prices in the long run.

My own home town experienced that twice. The demolition of an old sugar factor bankrupted three demolition companies (lowest bidders each) which resulted in the demolition taking two years and costing thrice the original estimate. Building our local museum bankrupted two building companies which doubled the original estimate.

[Aimless]

Haven't seen the video yet but will respond directly to it later. The Swedish experience with letting the govt--at various levels--hand out contracts to the lowest bidder, well, it's been pretty fucking awful.

[Loki]

I did not fact check this guy, but at the end everything he said made some sense.

http://www.upworthy.com/his-first-4-...tle-sick-2?g=2

Should we let the government hand out contracts to the lowest bidder?

Depends if you want healthcare that meets the minimum thresholds and nothing more.

[sheadunne]

"You know we're sitting on four million pounds of fuel, one nuclear weapon and a thing that has 270,000 moving parts built by the lowest bidder. Makes you feel good, doesn't it?"

[Dreadnaught]

Meh, he's right that the issue is highly complex. But then he makes a case for government-directed centralized price negotiation which definitely isn't a broadly usable solution unless we decide to embrace socialism.

[GGT]

I didn't watch the video, since it can't possibly address the complexities and nuances in US healthcare costs. But a pat reply of SSSocialism is just as myopic.

[Dreadnaught]

It does a good job listing all the complexities, though the solution hinted is that only by consolidating all the health care purchasing under one group (IE the government) will we get bulk discounts.

In fact, I think this hurts buyer pricing power in the long run because the presence of a single buyer limits the number of market participants. And also diminishes the number of pricing signals out there available for the buyer. We can see this in occasional scandal we see about how the government pays absurd prices for common things.

[GGT]

It does a good job listing all the complexities, though the solution hinted is that only by consolidating all the health care purchasing under one group (IE the government) will we get bulk discounts.

Compared to what we have now, where all the purchasing AND pricing power is under one sector (ie the Insurance Industry) with "bulk discounts" only available to large employers?

In fact, I think this hurts buyer pricing power in the long run because the presence of a single buyer limits the number of market participants. And also diminishes the number of pricing signals out there available for the buyer. We can see this in occasional scandal we see about how the government pays absurd prices for common things.

You make it sound like buying healthcare is the same as buying a personal automobile, vs riding a bike/walking. As if that's comparable to driving a company car, or equivalent to a fleet of government vehicles (which would include public transportation)...and the price of gas.

[Dreadnaught]

You make it sound like healthcare is so unique that no economic principles could ever apply to it.

[GGT]

You make it sound like healthcare is so unique that no economic principles could ever apply to it.

Yes, healthcare is unique. It's inextricably linked to other economic "outliers", like expensive R & D done by Universities, or NASA, or CDC. All relied on government funding to a great extent.

Advancements in Science, Technology, and Medicine have improved quality of life, and increased longevity. We're faced with a "unique" paradox of the modern world -- that no known 'economic principle' addresses comprehensively, judicially, or morally.

When more people can live longer, with greater expectations, than current generations can "afford" to fund --- who or what is seen as the weakest link? Should the young adult who's a victim of violence, injury, accident, or illness/disease (with no health insurance, or a flimsy plan) get less or inferior care and treatment than his Trust Fund peer? Should any parent or grandparent have to spend their retirement funds, almost like posting bail for criminal proceedings, to guarantee best care?

[GGT]

You make it sound like healthcare is so unique that no economic principles could ever apply to it.

Another way of saying the same thing: "Do whatever it takes. Don't give up. Keep them alive. Doesn't matter if the bill is more than a million dollars, or if it bankrupts the family. Doesn't matter where you providers get your compensation, just Do It."

[GGT]

Okay, so I finally watched the video. First impression -- that guy needs to cut down on caffeine consumption! But he does a fairly good job of covering all the bases, from spending to outcomes, and including variables like inelastic demand, and a broken negotiation process.

But I didn't come to the same conclusion as Ogre ("Should we let the government hand out contracts to the lowest bidder?") or Dread ("he makes a case for government-directed centralized price negotiation which definitely isn't a broadly usable solution unless we decide to embrace socialism").

I think you both focused too much on the "government" parts of his hip-replacement comparisons, and overlooked the consumer/provider "negotiation" part. He didn't do much to explain the symbiotic relationship between insurance companies and provider reimbursements, that basically treats patients as pesky variables. That's the nuttiest part of the US system.