thegreekdog wrote: PLAYER57832 wrote:For Capitalism to work, you have to have truly free access, consumers have to have the knowledge and ability to choose. That is not the case in health care.. ever.
Wait... you have to explain this a bit more. First, talk about the phrease "free access." What does that mean?
If I want a TV, or washing machine, I can look around, see what's available. Not everyone has the same availability, but we all have choice, even if some people might have to go further.
When your child or you are suffering an appendicitis attack, swallow poison or stop breathing, you go to the NEAREST facility that can take you.
Even for less pressing issues, things like cancer treatment, etc, the "choice" has to do with location, access and not really variation in care. When there is variation, it is as I note below, that their doctor sees one facilty or another as meeting the patient's needs more closely.
thegreekdog wrote:Second, why don't consumers have knowledge and ability to choose in healthcare?
We don't have medical degrees. We really don't have the ability to gain the knowledge we need, despite the hype about self-found cures on the internet. In fact, the misinformation on the internet is never more a problem than on the internet.
I am not saying we have to be utterly ignorant, but the real truth is (and study after study shows this), people do tend to follow their doctor's reccomendations on decisions, and for good reason.
In fact, as several studies, including a Texas study cited not too long ago (I think in another thread), this is why having more doctors actually doesn't result in lower costs. Because the doctors feel pressured to treat more and more patients and convince themselves that those on the border would benefit. (note, I am NOT talking about any intentional practice. Most ofthese doctors will swear up and down that they are not altering their decisions. This is something subtle that happens). It is actually the exact opposite of a free market.
thegreekdog wrote: Third, why does the Affordable Care Act fix any of those perceived problems you have.
That comment is not about the Affordable Care Act, its about constitutional mandates and Nightstrike's insistance that a free market for healthcare is a good idea.
If I had to pick a US system, I would look at something like Geisenger. Its not perfect and I am still finding out more about it (may be our area care, for one thing), but it has done some good things, like holding themselves responsible for mistakes and limiting the treatment options available in some cases, based on evidence of effectiveness.
Also, here is the thing. When it comes to a refridgerator, you may want a side-by-side freezer, I may want one on the bottom, maybe you want bigger meat drawers, etc, etc. When it comes to medicine, its about what works best to cure the disease. That does vary with the individual, but its not really a matter of taste or opinion, its a matter of evidence and data.