A core aspect about the YIMBY is that housing isn’t that complex. Building more housing is straightforwardly good. Nearly everyone who would benefit from having more housing. Those people who would not benefit from having more housing have an easy way to choose to rent smaller spaces.
Healthcare is not like that. Getting more healthcare services doesn’t always help people. When buying a used car most people understand that they can’t just trust the car salesman with the assessment of the value of the car. While the relationship between car buyer and car salesman is economically similar to that between patient and surgery salesman surgeon, people do want to have relationships of trust with their doctors.
The doctor-patient relationship has been disintermediated by not one but two parties: insurers and employers.
That seems naive. There are a lot more parties than those two that disintermediate that relationship in the US healthcare system.
Between insurers and the employers there are insurance salesman that take their cut. In addition to the official fee that the insurance salesman get paid insurance companies find additional ways to financially reward them as well. Martin A. Makary (the new head of the FDA) book The Price We Pay: What Broke American Health Care—and How to Fix is good at explaining the insurance salesman issue and a few other issues as well.
Hospital used to get reimbursed more for an individual procedure than an independent practice (the Trump administration wants to change that). As a result, there pressure for doctors to be formally employed by hospitals. Those doctors often don’t know what’s actually chraged.
Insurance companies often pay a multiple of medicare reinbursement rates. Those are not set by the government but by the American Medical Association which is essentially a lobby organizations for doctors. If lobbyists for a given procedure win their fights within the American Medical Association, the reinbursement for that procedure becomes higher.
(there are probably other parties that disintermediate the relationship as well that don’t come to my mind right now)
A core aspect about the YIMBY is that housing isn’t that complex. Building more housing is straightforwardly good. Nearly everyone who would benefit from having more housing. Those people who would not benefit from having more housing have an easy way to choose to rent smaller spaces.
Healthcare is not like that. Getting more healthcare services doesn’t always help people. When buying a used car most people understand that they can’t just trust the car salesman with the assessment of the value of the car. While the relationship between car buyer and car salesman is economically similar to that between patient and surgery salesman surgeon, people do want to have relationships of trust with their doctors.
That seems naive. There are a lot more parties than those two that disintermediate that relationship in the US healthcare system.
Between insurers and the employers there are insurance salesman that take their cut. In addition to the official fee that the insurance salesman get paid insurance companies find additional ways to financially reward them as well. Martin A. Makary (the new head of the FDA) book The Price We Pay: What Broke American Health Care—and How to Fix is good at explaining the insurance salesman issue and a few other issues as well.
Hospital used to get reimbursed more for an individual procedure than an independent practice (the Trump administration wants to change that). As a result, there pressure for doctors to be formally employed by hospitals. Those doctors often don’t know what’s actually chraged.
Insurance companies often pay a multiple of medicare reinbursement rates. Those are not set by the government but by the American Medical Association which is essentially a lobby organizations for doctors. If lobbyists for a given procedure win their fights within the American Medical Association, the reinbursement for that procedure becomes higher.
(there are probably other parties that disintermediate the relationship as well that don’t come to my mind right now)