US cities pay too much for buses

Well, there is your answer. The one making the purchase isn't the one primarily paying for the purchase. This makes them less sensitive to pricing.

Kinda like how expensive healthcare is since it is paid for by insurance.

Or how you don't care how much you put on your plate or what you choose to eat at an all you can eat buffet.

The second you detach the consumer from the price of something, even through an intermediary such as health insurance, that is when they stop caring about how much something costs, and so the price jumps.

    > The second you detach the consumer from the
    > price of something, even through an
    > intermediary such as health insurance, that
    > is when they stop caring about how much
    > something costs, and so the price jumps.

You'll find that (even ignoring the outlier that is the US health care system) that in some countries where consumers bear at least some of the cost directly via mandatory insurance and deductibles, the spending per capita (and which survives a comparison with overall life expectancy etc.) is higher than in some countries where the consumer is even further detached from spending, via single-payer universal healthcare systems.

Or, the other way around, it's almost like it's a very complex issue that resists reducing the problem to an Econ 101 parable.

1. https://www.oecd.org/en/publications/2023/11/health-at-a-gla...

An easy way to examine this is to compare the price of over-the-counter versus pharmaceuticals. If a third party weren't paying for them, the price would have to either come down to something affordable to the average person, or else the market for it would shrink to only the wealthy.

If you look at e.g. the per-dose price of insulin it's as low or lower in countries with single-payer universal systems, where someone requiring insulin is never going to have any idea what it even costs, because it's just something that's provided for them should they need it.

In that case it's usually some centralized state purchaser that has an incentive to bring prices down, or a government that has an overall incentive to keep the inflation of its budgetary items down, which ultimately comes down to public elections etc.

In any case, a much more indirect mechanism than someone who'd be directly affected paying the costs associated with the product, which directly contradicts this particular argument.

OF COURSE single-payer means lower prices, the government has a shit ton of power in negotiating prices if they want to. They don't want to because they are corrupt, freaks like the above are only there to rationalize the theft. They need to be defeated politically.

It's very easy to find examples of abuse in this system. For example, in modern "factory towns" around corporate campuses, somehow, routine dental maintenance costs exactly the maximum amount provided for this purpose by the employee health plan.

> If consumers actually directly paid the whole cost for health services, the prices charged would become far more regular.

Which is arguing against the very idea of insurance which distributes risk, its an absurd argument not even libertarians make. The problem for literarians/neoliberals is that we already have exactly the system they think should work great, it just doesn't, but they completely refuse to ever recognize that the reason it doesn't work is systemic and it will never be fixed by more literarianism/neoliberalism, we need to shove it. Whats needed is a single-payer, universal, zero(!!!)-private, public health care system.