Växẍ Säbbäth on Nostr: the problem with "private healthcare" and "insurance" is that they wind up in a ...

the problem with "private healthcare" and "insurance" is that they wind up in a terminal death-spiral: third-party payment creates a situation where providers are incentivized to raise their prices as much as they can, because the consumer of the service is not the payer for that service and there is a fairly large amount of "float" that can be absorbed systemically without obvious specific pain felt by any particular party, therefore price discrimination is not a thing that happens

this is a VERY tough problem to solve; it isn't just how do you tell Dr. Noseberg the Shekel-Grifter "no", it's how do you tell Dr. White von Highskill that he might be exactly the best surgeon on five continents that he thinks he is and yet the market ***still*** can't bear the downstream consequences of him charging 100% of what he thinks appropriate, that he must accept some limitations there in at least some circumstances?

the cure for this winds up looking a lot like monarchy; the Royal College of Physicians is a prestigious thing, and titles are handed out for those who embody particular excellence, but it is ***royal*** and therefore mediated by some sovereign who takes an interest in its application to the welfare of his people