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tptacek07/31/20252 repliesview on HN

For this argument to work you have to believe that decreasing the price of service delivery wouldn't decrease the price of health insurance. Provider costs dominate US national health expenditure, like it's not even close; it's not a full order of magnitude difference but it's close to one.


Replies

hangonhn07/31/2025

But part of the provider cost is driven by the availability of money to pay, which is part of the reason why drug costs are so much higher than in the US. For example, the doctor has no strong incentive to prescribe less costly drugs since they don't pay. The patient don't know any better and aren't the payers either. The insurance has some control over what they will pay for and how much but except for some cutting edge treatments, it is very hard for them to say no. This is part of the reason why insulin in the US is so expensive and why drug companies advertise to doctors and patients, etc.

I think in countries where the health care costs aren't as astronomically high as the US there is some form of government intervention to distort the market. And the original post is more or less arguing for a market distortion that doesn't rely on simple price signals to bring costs under control. But that is very different than what has happened in Denver's housing market.

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pcai08/05/2025

> For this argument to work you have to believe that decreasing the price of service delivery wouldn't decrease the price of health insurance.

I think we are talking past each other. My argument is not that lower prices for medical services wouldn’t lead to lower insurance costs. My argument is specifically that increasing supply doesn’t necessarily lead to lower prices for medical services. It would be quite a finding if US cities with more doctors per capita have cheaper medical services but if anything the opposite is true