The complaint seems to be that things like raspberry pies are cheap while nutritious food is expensive. The market optimizes for that consumers want without accounting for invisible costs like poor health outcomes from routinely eating calorie-dense nutrient-sparse food. Likewise affordability of healthcare is not optimized for in the US; the incentives in that market drive it towards high but subsidized prices. Someone who is well-employed benefits from health insurance that make prices reasonable-ish, but anyone not subsidized by their employer or government is effectively left out of the market.
This is not a state of affairs where a free market will sort things out. In the food case, the prerequisite of rational agents in the marketplace is not met; people are bad at making good long-term health decisions and will vote with their dollars against their best interests.
In the healthcare case the real transaction is not happening between the consumer and healthcare provider, but between the provider and employers or governments and no party has incentives to change this (except maybe the government following the will of the people). This relationship provides employers a way to attract and retain talent and makes a lot of money for providers.
I find a lot of the criticism of healthcare today to be misguided.
Why would healthcare be inexpensive? Go into a clinic today and there’s a legion of professionals who attend to each patient. Each of them has years of training, even the clerk at the desk.
They use a whole battery of expensive equipment. Multi-million dollar machines to literally see inside your body.
Every piece of tubing, bandage, needle, plastic fitting, etc is sterile, and used only once. They are made in a facility to exacting standards which is in turn monitored and supervised by another network of professionals with reams of policy dictating how the equipment is made, accounted for, and an army of lawyers behind the scenes as well.
The facility itself has exacting standards for cleanliness, emergency power, disaster-resistance.
The medical records are held in computer systems which abide by HIPAA requirements, again with a team of engineers and cybersecurity professionals ensuring that standards are met.
Healthcare is expensive because it’s expensive. The alternative is suffering with untreatable injuries or just dying, which we take for granted because we don’t see it that much anymore. We don’t have country doctors working out of their house charging a few bucks for a visit.
Are there inefficiencies? Is there waste, fraud and abuse? Are there greedy pharmaceutical execs making billions of dollars on the backs of unsuspecting pill poppers? Could we do things better or cheaper? I’m sure we could, but I don’t think there’s some kind of grand conspiracy to make us slaves to our employers vía medicine.
I'm not just talking about the cost, I'm also talking about the experience.
The alternative isn't a lack of healthcare, it's a compassionate experience that understands that we are people, not bags of money. Individual medical centers may live up to that standard, but the industry does not.
> I don’t think there’s some kind of grand conspiracy to make us slaves to our employers vía medicine.
There doesn't need to be a grand conspiracy, just aligned incentives. The result is the same.
It's also true that modern cutting-edge healthcare is expensive any way you slice it. In free market capitalism it is up to each person to bear that cost. This means that some people will not be able to afford treatment or will be plunged into crippling debt. I'm of the belief that if we can treat someone with a health problem then that treatment should be available to them either for some marginal cost or for free. Basic human needs can not be subject to market pricing as consumers are essentially under duress when making purchasing decisions; they cannot choose to forgo lifesaving medicine should the price be unreasonable.
