If the difference between affording a car and not being able to afford a car would kill me, then maybe I would like the government to step in to negotiate on behalf of all of its citizens.
Not being able to afford food can also kill you (you would starve to death). Is that a sufficient justification for the government to step in to negotiate food prices on behalf of its citizens?
There are merits to government price controls and there are certainly countries that have employed them successfully. That said, it isn’t the only solution to bending the cost curve, and there are also downsides to price controls. It’s complicated.
I agree on the wider point but in case you or some other reader were unaware...
Government does that in the US (and the EU and Canada and basically every first world nation that's not a city state). The department of agriculture and others spend somewhere between 10s and 100s of billions every year to make sure that food (and other crop) prices stay within carefully set, tightly defined limits.
It may not directly negotiate the prices of food, and that's fine: If there's another form of intervention that would provide healthcare to people without directly negotiating the price, I'd be fine with that too. However, the government has not subsidized the healthcare industry to the point where healthcare is as accessible as food.
Healthcare is not just a demand-side issue. There is also constrained supply. I'd be happy to see the government subsidize supply production (building new medical schools etc) in a similar way that it subsidizes food production.
I'm by no means advocating government negotiation or single-payer or medicare-for-all as the thing the government must do on this issue. I'm fine with a form of intervention that allows the market forces to go the last mile in this.
> Is that a sufficient justification for the government to step in to negotiate food prices on behalf of its citizens?
Yes? We already do this? For many years directly in the postwar period and now indirectly through agriculture subsidies and programs like SNAP. Making sure everyone has enough to eat is step one of having any kind of functioning society and why it’s always been a source of massive government intervention in the economy.
Yes, that's the whole point. SNAP and directed subsidies are decidedly NOT the same as government prices-setting. The analog in healthcare is targeted subsidies for poor people that cannot afford care, not government negotiation and price setting.
Making sure everyone has access to healthcare is, for the most part, a universally held goal. The disagreement is whether the only way to achieve that is through government price controls.
> The analog in healthcare is targeted subsidies for poor people that cannot afford care
Food subsidies aren't targeted at the poor. The US government spends many billions of dollars subsidizing corn and soybeans and other crops that lower food prices for huge portions of America.
While at the same time, imposing huge tariffs on other products (notably sugar), drastically increasing the prices of those products domestically. So if you're one of the people concerned about the usage of HFCS in pretty much everything, the blame lies squarely at the feet of the government for artificially raising the price of sugar.
Yup, and a strong analogous policy in healthcare would be for US government to spend billions of dollars subsidizing medical education and hospital construction.
“Access” in this context is just a weasel-word cooked up by hospitals and insurance companies to protect their bottom lines. Almost every other wealthy, developed country guarantees healthcare itself, not the right to get surprise billed or screwed by your insurance company. And even those countries that are closer to the American model (e.g Germany and the Netherlands) don’t let these industries get away with egregious abuse of people at their most vulnerable, as happens in the US. I don’t agree that I want people with critical illnesses or disabilities (or anyone else) to get “access” to healthcare. I want them to receive healthcare itself and pay for it with my taxes.
SNAP and ag subsidies are also just price controls with extra steps. We can argue about their efficacy, but they’re far closer to price controls than anything like free markets, especially given the increasing monopolistic control of industrial agriculture in the US.
> Almost every other wealthy, developed country guarantees healthcare itself, not the right to get surprise billed or screwed by your insurance company.
I'm not sure who argued that "the right to not get surprise billed or screwed by your insurance company" is the optimum solution. The argument is that guaranteeing access to healthcare itself is attainable without price controls.
> SNAP and ag subsidies are also just price controls with extra steps
They're really not. The closest analog would be to institute a basic income that's earmarked for health insurance premiums. We don't have that today, at least in a uniform way (ACA subsidies come close).
Guaranteeing “access” is functionally meaningless. You already have “access” to healthcare in the U.S., it just comes with all the fleecing and abuse unto death that we have under the status quo. When you argue for “access,” that’s precisely what you’re endorsing. This is why again, other countries guarantee actual healthcare and not these kind of doublespeak vagaries.
You might be putting words in my mouth. What I am advocating for is not merely “access”, I’m literally advocating for giving money to people that are unable to afford healthcare. That’s effectively what SNAP is.
I do not think this is the best smell test for government involvement.
Not being able to afford health care in no way condemns one to being killed. It's obviously not advisable, but plenty of people do just fine without regular doctor checkups because they keep healthy and live balanced lives. And, interestingly, given how many each year die in traffic accidents, it's not such a stretch that being _able_ to afford a car would kill you.
We all have really different reasons for wanting health insurance and owning a car. We have different components, considerations, and properties, which we value about these decisions. Given this, it seems ludicrously complex, inefficient, and cruel to subject all citizens of a nation to the same exact process of obtaining and using health care.
We all know how bad of an idea it is to centralize services, but because some linguistic jokesters have gotten the phrase "healthcare is a human right" to be passed around the globe enough times, people seem to drop context when it comes to this discussion.
As soon as youtube-dl got hit with its recent DMCA takedown request, GitHub obliged and the whole dang HN community lost their collective minds. "Decentralize your git repos" we all saw people writing - and they weren't wrong. But for reasons that continue to escape me during these awful lockdowns we're all facing, people don't seem to think that their government-provided healthcare workers and price negotiators will do anything of the sort.
You can guarantee universal healthcare (and medication) without top-down control of pricing, or at least not total control. Most drugs aren't making headlines, so you can control the x% that matter while still getting cheaper prices for most consumers by letting the outlets compete.
Your website suggests you are American, so I recommend taking a look at the various healthcare systems on display in Europe, they're not all made equally (i.e. Some do more on behalf of their citizens than most). In my experience of watching American discussing healthcare in the EU, the subtleties are often lost, sadly.
The free market has a tendency to optimize for profit, and fairly often short-term profit. Yes, that necessarily means companies must have customers willing to pay them, and so a certain amount of quality of product & service must be present, but it does not optimize for everyone to own specific product even if everyone wants that product.
Saying the market can solve the problem of healthcare for everyone is a bit like saying it should be able to solve the problem of providing flagship-quality phones for everyone. But in fact, given the "law" of supply & demand, a product like healthcare which is in demand by literally every single person, yet constrained by supply, the solution the market converges on is going to extract the most amount of money it can from however many customers can be served by the available supply.
Supply constraints are also one of the problems I would, given complete faith in market forces, expect the market to solve but it has not done that either. Market forces did not prevent or resolve the dumping of cancer-causing chemicals, or known cancer-causing product like cigarettes to be removed, or any number of other undesirable things whose costs end up being paid by society as a whole rather than a given individual(s) responsible for the problem. When the market fails to solve a problem, some other force needs to intervene.
Maybe a free market purist would say we didn't give it long enough to solve these problems. I don't believe that, but let's say it's true: Saying the market will eventually solve a problem, when human lives or suffering are at risk, is a bit like saying evolution will eventually solve a problem. It may be true, but the timescales involved are sufficiently long to render their eventual solution irrelevant to the people who die or suffer before it materializes.
I don't claim to know the best way to do this, and perhaps my analysis above is incomplete or over-simplified, but the point stands that the market has not solved this problem, and does not show signs of doing so.
Most US healthcare is neither free nor particularly a market. Most healthcare in the EU has a significant market element to it, and it works just fine (and usually costs less per capita)
Yes, the government has a stronger negotiating position than me, for obvious reasons.
The concept of "markets" is not useful in a discussion about healthcare, because unlike other markets, a participant will often die unless they immediately purchase a good from the seller physically closest to them, regardless of price.
Would you prefer the government to negotiate the price of your car for you? Markets are a powerful tool