Freakonomics

[King]

Healthcare is NOT like any part of the economy. People do not shop around for healthcare and have no means to do it. When you have a heart attack, you don't go on Yelp and compare nearby hospitals.  You take the nearest available medical assistance at whatever cost. As a consumer, you don't know the difference between a good MRI machine and a bad one.  To compare it to free cars is bull.

I hate when economists talk out of their ass. Freaking stupid economics is more like it.

[King]

Healthcare is NOT like any part of the economy. People do not shop around for healthcare and have no means to do it. When you have a heart attack, you don't go on Yelp and compare nearby hospitals.  You take the nearest available medical assistance at whatever cost. As a consumer, you don't know the difference between a good MRI machine and a bad one.  To compare it to free cars is bull.

I hate when economists talk out of their ass. Freaking stupid economics is more like it.

Emergency heath care may not be like much of the economy, but there are many other parts of health care to consider. Over the years as a family we have shopped for a primary care physician, a dentist, an optometrist, a pharmacy, and a facility for my wife to give birth. We also review insurance coverage periodically in case we wish to shift insurers, which has happened a couple of times over the last 25 years. Those parts of health care are quite similar to other economic decisions we make as a family.

But at the same time, your decisions are not based on any sort of cost value like most other shopping experiences. You're simply looking at doctors who accept your insurance, rating them on personality, and if the waiting room looks clean.  There's no way to the quality of their work, accuracy of their diagnosis, and if their equipment is the top of the line or a few years old.

It's equivalent of buying a car because you liked the salesman, not researching the car.

[King]

Healthcare is NOT like any part of the economy. People do not shop around for healthcare and have no means to do it. When you have a heart attack, you don't go on Yelp and compare nearby hospitals.  You take the nearest available medical assistance at whatever cost. As a consumer, you don't know the difference between a good MRI machine and a bad one.  To compare it to free cars is bull.

I hate when economists talk out of their ass. Freaking stupid economics is more like it.

Emergency heath care may not be like much of the economy, but there are many other parts of health care to consider. Over the years as a family we have shopped for a primary care physician, a dentist, an optometrist, a pharmacy, and a facility for my wife to give birth. We also review insurance coverage periodically in case we wish to shift insurers, which has happened a couple of times over the last 25 years. Those parts of health care are quite similar to other economic decisions we make as a family.

But at the same time, your decisions are not based on any sort of cost value like most other shopping experiences. You're simply looking at doctors who accept your insurance, rating them on personality, and if the waiting room looks clean.  There's no way to the quality of their work, accuracy of their diagnosis, and if their equipment is the top of the line or a few years old.

It's equivalent of buying a car because you liked the salesman, not researching the car.

Actually in some of the cases I cited cost value was a factor. That was particularly true for the birth of our first, since my wife did not care for her referred obstetrician so we chose to go out-of-pocket for the childbirth. Trust me, as we interviewed over a dozen options from specialists at hospitals to family physicians to nurse midwives at clinics, cost was very much a factor.

Though my situation was unusual in that regard, some of the other items on my list like my optometrist and pharmacy were decided in part on the range of products available. Having a wide range of eyeglass frames with an optometrist is important since insurance typically covers only a fraction of the cost of all but the cheapest frames.

Yes, it is an unusual situation.  Not common enough in the healthcare sector for an all-private system to work in that kind of way efficiently. Optometry and pharmacy indeed are parts of healthcare where the consumer can shop around and know a good product when they see it, but they aren't the vast majority of the healthcare market.

I'm not a fan of single payer because I do believe the American health care system has a lot of advantage to single payer nations that cannot be overlooked. I'm not however a Freaknomic all private guy either. I think our current system of private insurers, private hospitals, and massive government regulation that we've had for decades is a winning system provided the government is allowed to reform the rules every decade or so without there being cries of tyranny.