Another small observation - the properties you described (asymmetric information, obfuscation, and a necessary purchase) apply to many parts of the healthcare market. I wonder whether it means that this market is dominated by lemons.
"Lemons" is not so much of the problem in healthcare because of the (over)prevalence of litigation as a remedy for failures.
I can't sue anybody for a year's salary if I don't like my mattress (I don't).
Instead the market is dominated with inflated prices and mostly harmless procedures and tests. Sometimes the information isn't asymmetric, it's just difficult or sometimes just not a habit to try to find the best prices.
Here's an example that blew my mind a while back:
I was helping a friend with limited income afford medication. Generic Prozac, an extremely common drug.
Here are the current prices at Costco (you'll find the same trend many other places).
FLUOXETINE HCL 20 MG CAPSULE x100 $17.03
FLUOXETINE HCL 20 MG TABLET x90 $141.09 ($156.77 for 100, the price is listed for different values)
Look at that, nearly a factor of 10! For the same drug in a gel cap instead of pressed into a tablet. This isn't cherry picking, you can find the same scale of differences anywhere. Sometimes a drug will be cheaper in a tablet, other times a cap.
We had to call the doctor to get a prescription for the capsules, but for someone on a not-so-far-above-minimum wage job, that was a huge difference.
I only figured this out because I was curious about the difference and wanted to find out the best price, then I was blown away when I saw the vast differences in price. Anyone _could_ do the same thing for all of their prescriptions, but insurance and apathy mean that nobody cares so the market is extremely inefficient.
Not only are half medications useless to harmful, most of the time side effects aren't ever disclosed. I'm still bitter about this due to being prescribed medication I would have never had taken if the potential side effects we're disclosed.
Is this a serious comment? Of course it's not good enough.
I'm supposed to wait until after I leave the doctor's office and fill the prescription to know the side effects of a medication I just spent money on? So if I don't like the side effects I have to make another doctor's appointment and wait until the doctor has availability?
So I go to my doctor and say "I have X problem." Doctor says "take these pills." I go to the pharmacy and read about the medication. I say "well these side effects don't look good, I don't want to take the medication." I go back to my doctor, the doctor says "here's some different pills" and I have to fill that second prescription and compare the two side effects.
No, that's not good enough.
There's also the problem that that information is given in a vacuum, there's no information given about what the alternative treatments are for your condition and what the side effects are for those alternative treatments. That discussion rarely occurs to my satisfaction at the doctor's office because oftentimes the doctor seemly doesn't know about the side effects or is misinformed.
This has just been my experience...
For me, the medication in question was given to me in an acute setting. I asked directly about side effects and I was brushed off as "oh most people don't have any side effects" or something of that nature. Especially when the medication is administered by a nurse and I was just given pills, I had to firstly ask what the medication even was.
Honestly, you seem like a somewhat difficult patient. If you want to be more involved in medical decisions, it takes time and effort.
"big issue I have with doctors, I don't know if they are going to prescribe me some bullshit"
You want a somewhat different relationship with a doctor, it probably is not going to be very easy if your attitude is like that and you are not particularly willing to spend time and make effort. Finding the right doctor for what you want can be difficult, especially when you yourself are difficult.
I read all of my prescription documentation, and if there is an issue I raise it with my pharmacist or my doctor. Sometimes I go out and find journal articles too.
Sounds like you are using the VA, I'd believe you if you said it was time consuming and the doctors didn't have enough time for you.
Prior to Obamacare introducing some sanity to insurance spending/denial of claims due to pre-existing conditions, the health -insurance- market was dominated by lemons.
You would end up paying for a plan that would not not actually cover you when you had a catastrophic health event (Or would cover a lot less then you'd expect.)
I don't think the health care market is quite the same, because in the health care market, in most cases the people who are paying for the services are not the same as the people who are receiving them. The people who are paying for the services (health insurance companies) do not have the same issues with asymmetric information and necessary purchase: they can obtain much more detailed information than individual patients about the relative performance of health care providers, and they have the ability to switch which providers are allowed to participate in their plans.
The main problem I see with the health care market is just what I said above: the people who are paying for the services are not the same as the people who are receiving them. This means that the price signals the market is sending are not well matched with the actual value of the services to the people receiving them. Standard microeconomics says that such a market will be highly inefficient, which I think the health care market generally is. But "inefficient" is not quite the same as "dominated by lemons".