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If it's free, then you are the product

If it's free, then you are the product

Posted Sep 8, 2026 12:18 UTC (Tue) by marcH (subscriber, #57642)
In reply to: If it's free, then you are the product by linuxrocks123
Parent article: A note on subscription prices from LWN

A free market works only when there is actual competition. The only thing worse than a public monopoly is a private monopoly - because it's more efficient at extracting profit.

The problem with health insurance is really simple and every country except the USA understood it: competition just does not work in certain "markets". That's it. Free markets are fantastic for selling computers and smart phones but they utterly fail in other areas. One size does not fits all.

Health is insanely complicated and extremely emotional and "customers" are completely ignorant and such an easy prey. Moreover, the corrupt health insurance industry in the US has been very successful in making it even more complicated - because they know obfuscation destroys competition. This is very well documented and they are not even trying to hide it. They know that crying "socialists!" on social media is usually enough because no one reads Excel spreadsheets. Some journalists do read Excel spreadsheets but no one reads those journalists anymore and they are dying (unlike LWN).

I was employed in the US for years and it was so ironic hearing everyone complain about how they were getting zero choice of insurance and extremely little choice of provider and limited access to treatment. Much less choice than with most single payer systems. And those were the people lucky enough to have some of the best, employer-paid insurance.

> Waving a magic wand and having the government provide services doesn't make those services free, man.

Of course not free. It only makes it twice cheaper for better average outputs[*] - as measured in all developed countries. Because in this area, only governments are big enough to have enough knowledge and negotiating power. Single payer also avoids funding a very large, parasitic "health care finance" industry, not needed any more. Is single-payer perfect? Absolutely not. It's the "worst system, except for all the private insurance ones."

By the way "single payer" is the obvious option (except in the corrupt US) but it's only a very small part of how you design health care and there are massive differences between systems across countries. Some have a very large private sector. Public health insurance does not imply public health care at all. But they are all conveniently regrouped under the same "socialist" banner when (not) seen from the US. Wait, people outside the US have doctors? Wow, I had no idea! ;-)

[*] the super rich do not care about "averages" and the US system _is_ better for them.


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If it's free, then you are the product

Posted Sep 8, 2026 12:34 UTC (Tue) by marcH (subscriber, #57642) [Link]

> By the way "single payer" is the obvious option (except in the corrupt US) but it's only a very small part of how you design health care and there are massive differences between systems across countries. Some have a very large private sector. Public health insurance does not imply public health care at all.

Forgot to say: multiple countries provide basic, tax-funded health insurance that people or employers can "top-up" with private insurance. Both insurance types can co-exist and they do!

There is a very large variety of systems, every country is different and it's hard to compare. But there is only one rich country that stands out by spending twice more per capita while still letting people go bankrupt when they get sick. Truly extraordinary.


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