Long Run wrote:Sue U wrote: The fact is that, for a host of reasons, healthcare is a segment of the economy that is just not particularly suited to market capitalism.
Actually, it works just fine in a capitalist market system, but unfortunately most of healthcare is a far cry from a true market. Look at the segments of healthcare that are true markets, where the customer pays for their medical needs directly. LASIK, dental braces and cosmetic surgery, are paid for by the consumer and stand alone as medical procedures that have gotten cheaper in real dollar terms while also steadily becoming higher quality at every price point. The rest of healthcare is a mishmash of heavy government regulation of both providers and insurers, government single-payer plans dominating a market with Medicare, Medicaid and the VA (and when we talk single payer in the U.S., those are the plans we're going to get -- not the Canadian, UK or Australia plans which are always described with rose-colored glasses). And the systemic problem is that there's always someone else paying the bill and insulating the consumer from the vast majority of the costs.
As a rule, LASIK, orthodontia and cosmetic surgery are not medically necessary procedures and do not affect physical wellness. If you have disposable income and want to spend it on these things, that's fine, but they do not truly constitute "healthcare" -- as evidenced by their lack of coverage under virtually every health plan, public or private. But emergency treatment and unpredictable major illnesses simply do not lend themselves to consumer "choice" in either obtaining treatment, selection of facility, or selection of physician. And I have no idea what you mean by "a mishmash of heavy government regulation of both providers and insurers," could you be more specific? Because as a rule, providers and insurers are governed by state law, and generally do not have much in the way of interstate business.
As for what we might get with a single-payer national health system, I don't know any senior who has serious complaints about Medicare, and I know from personal experience that coverage under my state's Medicaid program is actually better than most of the ACA or "traditional" plans available from health insurers.
Finally, as for "someone else paying the bill and insulating the consumer from the vast majority of the costs," the whole point of accessible and affordable healthcare is to encourage early use of low-cost primary-care services so as to avoid the need for much more costly and intensive care later. Insulating the consumer from the (highly inflated) costs of care for major illness is highly preferable to the much greater costs of personal bankruptcies resulting from medical expense debt. No consumer truly chooses how much s/he will spend on treatment for a serious illness or injury, especially because those costs are an unknowable mystery.
ETA:
What Big RR said above, also too.
