| ▲ | myrmidon 2 days ago |
| I don't think that is a good comparison at all. Unlike grocery stores, hospital ERs don't get frequent repeat customer interaction, so that makes the competition aspect basically completely inapplicable. As typical ER visitor, - You wont know what "quality" of care you are going to get beforehand - You will have very limited capability of selecting the hospital - You will be unable to compare prices beforehand So why would any of those 5 hypothetical hospitals decrease prices? More competitors won't do shit if the market is uncompetitive by design. |
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| ▲ | shawn_w 2 days ago | parent | next [-] |
| >Unlike grocery stores, hospital ERs don't get frequent repeat customer interaction... Oh yes they do. I can think of any number of patients I'm familiar with who end up in the ER multiple times a week. Practically daily for some people. And a few who are known for getting discharged from one hospital and immediately heading to another nearby one. |
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| ▲ | myrmidon 2 days ago | parent [-] | | What is a reason to end up multiple times a week in ER? I have a bunch of people with serious conditions in my "bubble" (spontaneus penumothorax, diabetes, ...) and none of those needed the ER more than ~1/lifeyear. If weekly hospital visits were typical, competitive free market hospitals would be more feasible IMO but I don't think we're close to that (and I don't want to be, either). | | |
| ▲ | shawn_w 2 days ago | parent | next [-] | | Addicts (usually but not always homeless) with all sorts of drug/alcohol caused health problems that they don't manage. Not to mention overdoses/too drunk to move. Medically fragile elderly people trying to live on their own when they shouldn't be. Frequent falls with injuries, etc. A friend of my mothers was in and out of the ER and med/surg floors for months with mysterious cardiac symptoms that ended up being a new reaction to a medication she'd been taking for years. People who are just psychologically, hmm, needy and looking for attention. When I worked on an ambulance there was a lady who'd call weekly because she said her blood pressure was high (it never was) and we couldn't refuse to transport her. And more... | |
| ▲ | philipkglass 2 days ago | parent | prev [-] | | What is a reason to end up multiple times a week in ER? This happened with a friend's mother during her last year of life. She had dementia, cardiac problems, infections, breathing problems, a whole litany of symptoms of slow death. But she didn't have any one clearly terminal condition (like late stage cancer) that would justify a switch to hospice, so she lived in an assisted nursing facility and also had to go to the ER more than 70 times in that last year. It was horrifying for everyone and the costs were astronomical. The state is now trying to seize her daughter's house to partially offset the accumulated expenses. |
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| ▲ | cogman10 2 days ago | parent | prev | next [-] |
| How could you even compare prices? If you go in because of a killer stomach ache you could end up needing a CT and emergency surgery. Or you could end up getting some pepto-bismol. And if you are taken there by an ambulance (which you also have no ability to compare any price to). You'll be sent to the hospital the paramedics decides to drop you off at. There is an inherent complete lack of information when going in for a medical situation that can't be fixed by the free market. You need (or believe you need) treatment now. There's no way for you to know what that treatment will be. Even going in for an annual physical can be the exact same. Some dicey numbers on your blood work and you might be looking at some huge unplanned bills that are completely unavoidable. |
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| ▲ | myrmidon 2 days ago | parent [-] | | That's exactly my point. Number of competitors is only one of the inputs for how competitive a market is, and price intransparency + lack of information on treatment quality make it moot for the healthcare sector in my view. I don't think higher hospital density would hurt, but we would have to pay for this and I don't see it help drive down prices. |
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| ▲ | esafak 2 days ago | parent | prev | next [-] |
| That's what reviews and word of mouth are for. Don't you do research before picking a hospital and doctor? We do need price transparency though. |
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| ▲ | myrmidon 2 days ago | parent [-] | | > Don't you do research before picking a hospital and doctor? No. Preventing rapid unplanned end of life is the main purpose of hospitals in my view. Enough time to make a choice of hospitals (or even to collect information on specific hospitals) is a luxury that I would not expect patients to have. | | |
| ▲ | esafak 2 days ago | parent [-] | | For every emergency I plan a visit to the hospital at least 10-20 times. Emergencies are the exception, by definition. I think everyone with health insurance, which the Census Bureau says is 92% of Americans, since they will not go directly to the ER. | | |
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| ▲ | wat10000 2 days ago | parent | prev [-] |
| An ER is only a small part of what a typical hospital provides. And life-threatening, must-get-treatment-immediately-or-die emergencies are only a small part of what a typical ER provides. Yes, there are some kinds of care that aren't very amenable to competitive market forces, but the vast majority is. |
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