You're discussing natural monopolies when your earlier point stated, "This also generally requires that the handoff of public to private control creates a competitive market."

This is not possible with a natural monopoly. The ineffectiveness of a competitive market is the definition of a natural monopoly.

What I want to know is when have you ever heard anyone without a direct financial interest (or a very small mustache) advocate privatization without the creation of a competitive and accessible marketplace?

Honestly, I don't think that point is ever really discussed or given proper consideration, which is why I included that in my post. Privatization where that transition isn't possible is a bad idea.

this all boils down to the main question which is who will build the roads?

People would just drive other roads if the roads was no good

Now lets have some real fun and talk about Healthcare in the US and why Public vs Private is too simple of an argument.

So Healthcare fits the requirements I was talking about earlier in that its viewed as a necessity and has pretty inelastic demand. This is because at some point in our society we came to the wise conclusion that when people become sick or injured, its a good thing that they should have access to healthcare. And as it is in one's self interest to not die, people very rarely pass up medical treatment for a serious illness or injury.

The current marketplace we have in healthcare is very inefficient for a number of reasons, far too many to list. But the key point is that as a patient you're left in a position where you have very little control over the cost of your own care. Marketplaces are dominated by big medical providers who have near monopoly powers to force high rates on to insurance companies who individually have little power to push down these rates for risk of having that medical provider no longer accept their coverage. Inevitably these rates get passed on to the consumer either through higher health insurance cost structures or through direct payments to the medical providers. Where the medical provider can refuse to accept a certain insurance with little repercussion, the insurance company will lose their customer base in the area of that provider if they are dropped, and the individual consumer is powerless to fight this price increase.

To parallel this to a more natural marketplace, if the orange crop is bad and orange farmers raise prices to recover their costs, a grocery store can either pay these rates or not have any oranges. However, where it is easy for an individual consumer to decide not to purchase Oranges if they have to pay $5 per orange, thus decreasing the demand for that item, it isn't easy to say hey I'm not going to get that emergency surgery done unless the price is $1,000 because I can't afford $10,000.

So how is this inequity fixed in the marketplace? If we are to believe that the key to these sort of problems is always public vs private control then the simple answer would be to switch all healthcare over to government run healthcare. This of course would require a massive takeover and reformation of the healthcare system, but ultimately could work as public control of the healthcare system would be able to at least partially solve the market inequities by making healthcare more accessible and affordable for those of lower incomes. However, the private solution would be to switch to a single payer system where the government acts as the sole insurer to the private healthcare system, and as sole insurer is now able to exert greater pricing power than the current insurance system. In this situation the government is leaving healthcare in private hands while exerting its force through regulation and pricing control to ensure that the private companies act in the public interest. The inequity here is created at the level of the medical provider, but it is actually the role of regulating the pricing of these medical providers that needs to be turned over to public control to fix the inequity, not the actual role of medical provider itself.

Thats the somewhat short version of things. People much smarter than me have written far more on this topic if you're really interested, but congrats to anyone who read all of this.

That is ludicrously not true. Medical providers are not the main, or even close to the main, driver of health care costs. It's the FAQ, so going much deeper seems wrong, but **** man that is just absolutely completely and totally wrong. Cost increases have been driven by growth in medical device cost, pharm, living longer and other ****. Payment to doctors is barely going up at all or dropping depending on where you're working.

As to why health care costs are going up in a post I'm willing to write right now. People want the new and best treatment at every single point of their life, even if it only buys a few weeks when you're 92 or keeps an infant alive that is a few steps above a vegetable for the rest of their lives. That's expensive. There's other reasons, but at the end of the day the reason why health care is expensive is that the consumer demands it is expensive.

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Always thought of ikes as a baby killer

Imaging is a nice microcosm. Here, the latest and greatest must be used, and used incredibly inefficiently. Somewhere like Taiwan, the previous generation is used with hundreds of patients per day per machine for all but the <1% of cases.

So it's a $25 MRI or whatever.

I'm sure the numbers are off, on price and on how fast an MRI can be done, but you get the point.

Tufts puts out a paper every few years about how much it costs to develop a drug. It's kind of weird because it takes into account how much money is spent on drugs that never make it to market, factors that in, but to get a successful drug to market it's up to around $1B. **** is expensive, then you have to maximize what you have left on your 20 year patent. I mean you have to do high-throughput screening, actually find something, file an IND, very expensive clinical trials, file an NDA, market it, etc.

Man I know it's just trolling but people actually believe that kind of nonsense and it's horrifying.

Yeah, was just a joke. Only doctors kill babies

Meh, I honestly don't know exactly how progression of technology applies to MRI cost, but I do know a lot of places in the USA have something called 'certificate of need'. Basically that allows companies to outlaw other people from building machines if they think it will take away their business.

What we most definitely do in this country is way too much imaging. Typical case is something like we get a person who describes a perfectly classical presentation of appendicitis. We get an ultrasound proving their appendix is inflamed. For some reason we get a CT which definitely isn't needed if you factor in cost, but it does give us a great view of the abdomen before starting surgery. Cost control is not a high concern in most medical situations.

LOL STEVE JOBS

My completely uninformed understanding of that phenomenon is machines have to be used to justify subsidies and qualify for insurance. So they use it all the time.

Plus customers are blind to the cost and never provided the option to say no.

Just eat only apples bro, what ails you will go away.

An apple a day does indeed keep the doctor away, especially if you don't see one because you think eating them cures your ass cancer.

The skin of apples is toxic, you know. But if you accidentally eat some, you can smoke some cigarettes and suffocate the toxins.

Dude, I texted you 911

Cats can flatten themselves to go through walls. They don't abide by the laws of physics.

mandatory link

I kinda hate that clip cuz it's mostly wrong.