And I agree with those two sentences - never was arguing that we pay less (compared to other models) in our public markets. But you are not strengthening a counter-point to the conclusion I presented from the book regarding zero price control in conjunction with for-profit insurances which jacks up overall costs through coverage disputes, excess admin work etc, lack of price transparency pre-treatment etc. What is your personal hypothesis for why US healthcare is such a poor value for the price?
If you look at the vision correction and plastic surgery markets, you'll see they function quite well! Providers compete on a combination of quality and cost. So I don't think there is anything intrinsic to the free market that suggestion it's to blame for ever increasing prices.
My personal hypothesis is that Americans get a lot more healthcare than most countries provide, combined with higher prices. Not all of it is all that beneficial.
If you want to read something really eye-opening, check out this McKinsey report, bottom of page 14[1] It basically compares US healthcare spending across categories, adjusting for GDP (expecting the US' higher GDP means we spend more).
For inpatient care (hospital care), the US actually spends inline with what other countries spend. For long term and home care, the US spends less than other countries. Same thing with durable medical equipment.
Almost all the "excess spend" is in the outpatient setting. American's get a shit ton of procedures done that other countries just wouldn't do. Have a hernia? Providers in the US fix that, where other countries might say "we'll do something if it becomes a problem" (for example).
Yes, they reduce costs by saying “this is what we’ll pay”, but it’s still much more costly than other countries’ systems.