[podiki]

But isn't that exactly it, that these (and healthcare) are very much part of the "market?" The goal to make money and to provide healthcare are at fundamental odds if you ask me. (Or they don't have to be, but the natural "experiment" of for profit healthcare in places like the US tells us much.)

[IG_Semmelweiss]

I think no one is against paying doctors to make a good living. Perhaps even extravangant living. If the product is great, why not? Apple, Tesla, Etc made owners very rich.

The problem is your share of health dollars going to administrators, which is bundled with the barriers to entry into healthcare and into insurance.

Its very hard to be a doctor that doesnt take insurance, so administrators come to rule the roost. If there was truly a free market, yiud see a material share of doctors working outside the insurance system. Yet no such niche really exists.

[xp84]

> doctors working outside the insurance system

I do see this to a huge extent in the area of mental health in the wealthy area that I live in.

Many of the best doctors have no need for insurance- rich people will gladly pay $300 an hour or more for a good therapist so why bother with the insulting $60 reimbursement that a doctor will get after doing a lot of paperwork with an insurance company.

I am not sure that this means anything whatsoever about a free market or not - and not all kinds of doctors are doing this, but it’s happening. And it really sucks to be paying the huge insurance premiums I’m paying, and still have the best doctors all out of reach unless I’m willing to shell out MORE money out of pocket.

[SoftTalker]

There are a few cash-only medical practices. I know of one personally. They have been operating this way for nearly 20 years so it must be working for them.

I would guess that most of their patients are quite well off, given that they have the cash available to pay out of pocket. That probably eliminates quite a lot of issues for the practice, as that would tend to select for reasonably educated and high-functioning patients. They also don't have to deal with insurance companies or collections.

[thefaux]

The problem with a doctor making an extravagant living is that it calls into question their motivation for working as a healer. How can I feel good about my patients if I know that they can barely afford to pay for my cafe? Or conversely, what does that say about me if I only work with wealthy patients?

[SoftTalker]

It's not a normal market because the customers (the patients) are generally not the people paying for the services.