Would prefer more organic items in the vaccine; or prefer a more natural method of having the kid catch the disease and natural immunization.

They need to do what the beauty products industry has done so well: Now with natural coconut extract!

Come on! It makes sense! Letting people die of polio eliminates the weak people who tend to die of polio. Never mind that nobody has to die of polio so that "weakness" is kind of a non-issue. We could expand this philosophy wider by setting land mines everywhere. Sure, it's a problem we don't actually have to live with, but it does keep us on our toes and it weeds out people who don't pay attention and people with bad clotting times.

A colleague of mine suggested that we screen resumes by randomly shredding 50% of them. Those are the unlucky people. Why would you want an unlucky person on your team? If only the lucky people are left behind, the team is much better off.

On average, we lose more of those who are less able.

But, as you note, who is to say whether that's a good thing or not?

"Marge, it takes two to lie. One to lie and one to listen."

-Homer J. Simpson

No, I'm genuinely curious about this. It may be more than you have, but is it a crazy unreasonable amount? Are we talking $10K? $100K? $1M? Because the plan you have should have a reasonable out-of-pocket maximum for a serious problem, and it should be far, far below the actual medical bill. For a Bronze Plan, your individual yearly out pocket maximum for a debilitating injury would be $6,350. That's bad news for anyone, but it's a lot better than being stuck with the bill for getting your hip or knee surgically reconstructed, as you problably know better than the rest of us.

The reason I'm pushing this is because every time somebody has become the "Joe the Plumber" face of getting screwed by the ACA in the national news, it has turned out that they actually had very good (often better than before the ACA!) options available to them. The only exception to that is people who fall below the income level for the normal ACA markets and who should have been covered by Medicaid but aren't because their states decided to screw them in order to score political points. It sounds like you're probably one of those people.

So the question is, did the ACA screw you, or did your state screw you by rejecting the Medicaid provisions of the ACA that were designed to cover people with low income? It's quite possible that you should be on Medicaid right now according to the way the law was originally written. Your anger may well be misdirected.

Those options are good, but they don't cover everybody. 1 and 3 are great for people like us who qualify for good jobs that provide health care coverage. For the people who don't (and there are lots of them), those options are right out. You're on the individual market or, if you're disabled and unable to work, Medicare. But not everybody with an expensive chronic illness is disabled either, and not every preexisting condition is a chronic illness--a lot of the time it's just something bad in your medical history that doesn't really affect you much any more.

You said that medical prices can not be pushed down because they are essential, thus don't respond to free-market pressures. That is my understanding of what you said.

That's simply not what I said. I said that the primary reason for the difference in pricing between "essential" and "non-essential" medical goods is the shape of the demand curve at and around the equilibrium quantity. I'm not sure how many different ways I can exlain it to help you understand, especially given the fact that I've said explicitly that both of them respond to market forces perfectly well. Continue with your lecture if you will, but it's pretty clear now that I'm not the one who is missing something.

The interesting question in economics is never, "Does X market respond to market forces?" because every market responds to market forces. The interesting question is, "What does the market look like and why is the outcome what it is?"

I'm really trying to tease out what's in your head here and if you have some sort of underlying point you're trying to make. I made a very narrow point about something way up the thread, and you turned it into a meandering half-assed Socratic lesson trying to teach me something I assumed we both understood perfectly well. I'm now apparently being taken to task for not mentioning price transparency when we just spent the past several posts going round and round on how supply affects price.

The problem with these discussions is that the person with the really shallow understanding thinks he's maneuvering the conversation somewhere clever and the person who actually knows what he's talking about assumed that the clever "end" they were driving at was just one of the axioms at starting point of the discussion that everybody sort of leaves unsaid. It's like trying to sit still and nod politely while somebody ploddingly explains to you the joke you just told.

I'm surprised you haven't read any of that, since you seem to have a degree in economics.

Look, price transparency is good. Markets are good. I understand that supply curves slope up and demand curves slope down. Now that we have that out of the way, do you have something substantive to contribute, or am I wasting keystrokes and inviting more of this facetious self-congratulatory horseshit?

Well, I have a degree in economics, so it's probably not that I'm missing the basics of supply and demand and need to be led there one sentence at a time. It's more likely just that I'm not claiming that increasing the supply of medical care won't reduce the price.

The post I originally responded to noted that non-essential care has dropped in price as if that's evidence that Evil Socialism is driving up the price of essential care. But it's not as though non-essential care is an unfettered free market and critical care is heavily regulated. They're both highly regulated markets with limited supply of specialized caregivers. The key difference is that non-essential care is (surprise!) non-essential, so the shape of the demand curves in the critical regions differ and the equilibrium prices at easily-reached supply levels differ.

If you want to talk specifically about how to increase the supply of critical medical care, that's an interesting topic. There are a whole lot of reasons why it's not the simplest thing in the world to do, but it's definitely interesting.

You're clearly trying to lead me to something really clever, but I'm just not getting there. This is all pretty basic economics, so what am I missing? Is there a way you could say it without the use of question marks?

No, it's reasonable to assume that the demand curve is more or less smooth and continuous. "Essential" goods act just like any other normal goods once you're out to a certain quantity. But below that, the demand curve shoots off into the stratosphere. That happens for water or food. It happens for critical medical care. It doesn't happen for Troll dolls or DVDs.

I have no idea how you could have gotten that from reading my post and the link I provided. Supply and demand work perfectly well in healthcare. But for lifesaving health care, the demand curve is basically vertical where supply and demand meet in the real world. The demand curve for essential goods approaches infinity as quantity approaches zero and drops off rapidly after your essential needs are met. That means that you're almost completely insensitive to price until the supply increases beyond that point.

If we ever get to the point where there are a bunch of heart surgeons milling around for every one person who needs heart surgery, we'll be way down at the same point on the demand curve as we are for rice and fresh water. But that's not where we are.

We consume food at a much lower marginal utility. We've progressed far enough in our provision of food and water that we produce enough that we now consume them way down on the marginal utility curve. If we were starving hunter gatherers, we'd gladly trade our last beads and monkey skulls for a little bit of food for the same reason. For a variety of reasons, we haven't yet progressed to the point where medical care is provided that far out on the curve (although some of it is--lifesaving antibiotics that would have been worth kingdoms can now be bought like Skittles). Once machines that automatically perform heart surgery are available right next to the vending machines that clog our arteries, we'll wonder why we ever had this conversation.

It looks like at least 27 states are going forward with it in 2014 with a number of states sill debating.

"Having problems?" "Going to prison?" Are we still talking about Medicaid?

So you're going to do the super smart thing and not have any health insurance at all, right? That'll show 'em.