tz writes:

I’ve been reading your series on ER problems and would note deep irony.

First, did any of those reporting problems call up their own physician (much less make an earlier arrangement) whereby they would pay some sum in cash for 24/7 or similar service assuming it was not something that would be triaged to the head of the line in the ER? Assuming you post this, will anyone reading this make such arrangements, or wait until next time they have a problem will they just go to the nearest ER?Second, did they shop for a location – maybe a 24 hour urgentcare clinic that had a much shorter wait? If they spent 15 minutes calling (even from the ER) they might have not spent 2 hours waiting. Or drive to the next county which didn’t serve a big city? Why is it rational to just go to the first place you think of? I probably do more rent-seeking on trivial items via google than people do for their medical care.

Third, they end up intentionally going into a regulated, price controlled (and do I have to remind the econ 101 “artificially low prices equals shortages”) place and expect something different. They do not give any specific reason for going to the ER – either the day and hour meant it would be difficult to find a doctor (a 2 hour wait means it can’t have been immediately life threatening), or because they knew their insurance would be more likely to pay for it, or that they were just lazy?

I really don’t understand and want to understand.

And shortages implying the prices are artificially low, do they expect not to pay higher fees for better service? The market is wonderful but it is not magic in the sense that even it does not provide something for nothing. I doubt any physician would refuse $5000 in cash at the time of treatment so you simply need one who is willing to do so 24/7. (Anyone from the American Association for Physicians and Surgeons out there?) But if you want employer paid or the regulated insurance to handle it, they will place limits just as I pay various premiums on my car insurance depending on the deductible and kind of car. Where are the medical savings accounts?

If people will not pay for good service over abysmal service, how can the market possibly work? Or they are simply getting what they are willing to actually pay for?

There are, I think, some valid questions here in regard to how much we’re willing to put our money where our mouths are rather than just settle for the nearest state-controlled health care provider. Responses to tz and/or me are welcome.