[mrtracy]

This would work very well for medicine/procedures which are known to work very well, to both doctors and consumers. This includes medicine which is already OTC (pain relievers), but also probably anything they can do at an urgent care: x-rays for broken bones or sprains, throat cultures, antibiotics (drug resistance is complex for this but people generally know they work).

Where costs will inevitably get complicated are:

1. emergency medicine, where the purchaser is in severe pain or possibly unconscious.

2. conditions without cures, or possibly even well-established treatments, and there is thus active experimentation and disagreement

Both of these are unpredictably expensive to an extraordinary degree, and the second category is sometimes rare enough that economies of scale don’t come into play for individual conditions.

I think government coverage of emergency medicine, aka ERs for severe injuries, is relatively uncontroversial due to its nature of treating unconscious patients.

However, that other category is very large in modern medicine. It includes all chronic conditions without cures, for which many options are available and improved techniques are constantly sought - and it includes complicated conditions where treatment has risks involved, which is basically a huge range of surgeries.

The problem in these areas is that the consumer does not have adequate understanding of the efficacy of what they’re buying, yet they’re driven to buy it strongly by pain and suffering. They are likely to want to do whatever a doctor or hospital tells them to do.

What is needed here is a consumer advocate with medical knowledge to keep prices consistent. In the US, this is provided by a mixture of regulation, medical malpractice lawsuits, and insurance companies.

Insurance companies are now failing in that role, but removing them entirely without any sort of replacement is going to leave the courts as the major vehicle to manage the costs - that isn’t a system renowned for efficiency.