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YC Research: Universal Healthcare

blog.ycombinator.com

21–30 of 359 posts

Re: YC Research: Universal Healthcare

#21
post #10

Unless you remove people out of the equation, universal healthcare will never work. There's no incentive for anyone to be efficient, more frugal, work harder, provide a better service in universal healthcare. Humans arent wired for this.

I believe humans will work out of intellectual interest and goodness of their hearts. But, I have heard many argument similar to the one posted above, against basic income but this is the first I am hearing about this with respect to basic health care, and would like to hear different perspectives on why that would not be the case.

An argument from my side would be that basic income and health may give a person means to give a dignified life, but are not going to let him buy a Ferrari.

I have heard from friends that in Northern European countries, there are people who live their whole lives on welfare. But, we also have very productive people from these societies.

Re: YC Research: Universal Healthcare

#22
post #10

Unless you remove people out of the equation, universal healthcare will never work. There's no incentive for anyone to be efficient, more frugal, work harder, provide a better service in universal healthcare. Humans arent wired for this.

I stay late sometimes without expecting extra pay. My commitment to my clients and the products I have created is what drives me.

Maybe you only care about money so that clouds your understanding of human behavior.

Re: YC Research: Universal Healthcare

#23
post #10

Unless you remove people out of the equation, universal healthcare will never work. There's no incentive for anyone to be efficient, more frugal, work harder, provide a better service in universal healthcare. Humans arent wired for this.

Nice hypothesis! You should try to test it empirically sometime.

Or wait- other people already have!

Skim through this paper and let me know what you think.

https://www.oecd.org/els/health-systems/Universal-Health-Cov...

Re: YC Research: Universal Healthcare

#24
post #10

Unless you remove people out of the equation, universal healthcare will never work. There's no incentive for anyone to be efficient, more frugal, work harder, provide a better service in universal healthcare. Humans arent wired for this.

> Unless you remove people out of the equation, universal healthcare will never work.

Every OECD nation except the US has universal healthcare; many have generally comparable outcomes and all have lower costs (both per capita and as a share of GDP) when compared to the US.

So, I'm not sure what your binary standard of "work/not work" is, but universal healthcare can and often does work better than what we have in the US.

Re: YC Research: Universal Healthcare

#25
post #10

Unless you remove people out of the equation, universal healthcare will never work. There's no incentive for anyone to be efficient, more frugal, work harder, provide a better service in universal healthcare. Humans arent wired for this.

There could certainly be a base level of care, with private insurance for additional levels. That's how it works in Taiwan.

Calling all universal healthcare non-competitive is like calling building roads non-competitive. We have government roads and private toll roads. The same goes for many services we take for granted.

A more advanced basic level of healthcare is something we are able to achieve because of our wealth and success. We already have sanitary toilets, housing, heating, clean water. Every generation has built upon what we can join together as a society to provide in order to promote our health.

In my opinion, Buffet, Gates etc. are the heroes of our time for standing up as rich folks to advocate giving back more to society. They don't view government as the enemy; rather, it is the result of our working together.

Re: YC Research: Universal Healthcare

#26

(Full-time co-founder of a healthcare startup here): W/r/t the US specifically: it seems there is no shortage of inefficiencies and obvious solutions to the inefficiencies in the US healthcare system. To me, the real problem seems to be a system that has almost diabolically evolved to create competing interests that deadlock all sides into a sub-optimal solution. Specifically-- patients, payers, physicians, pharma, f…

I bet making structural changes so that cost of care is more visible to patients would help a lot in the US. Of course this means disincentivizing health care as a benefit rather than incentivizing it, so it will never happen. It is kind of happening with things like HSAs, but not really.

We should also work on removing arbitrary barriers to entering the supply side of the market. Not just for individuals that want to be a doctor or other sort of provider, but certificates of need and such too. Currently, lots of states dictate who can operate a CT scanner.

Re: YC Research: Universal Healthcare

#27

(Full-time co-founder of a healthcare startup here): W/r/t the US specifically: it seems there is no shortage of inefficiencies and obvious solutions to the inefficiencies in the US healthcare system. To me, the real problem seems to be a system that has almost diabolically evolved to create competing interests that deadlock all sides into a sub-optimal solution. Specifically-- patients, payers, physicians, pharma, f…

Don't forget farm subsidies dumping cheap corn syrup into the bellies of our entire populace. Health care in the USA must deal with the reality of our obese and overweight masses (no pun intended).

Mental health in this country is similarly crippled by rapid societal changes, but that would take longer to explain in detail.

Re: YC Research: Universal Healthcare

#28

I wonder what the long-term on this is going to look like. It would seem to me like an amazing irony if the receiving nation ended up with better and cheaper healthcare than the US considering that YC and Watsi call the US home.

I imagine they will discover that many efficiencies correlate with individuals as much as with processes and then run out of funding.

Re: YC Research: Universal Healthcare

#29
post #5

Cool and interesting. I'm not very familiar with Watsi, but is its innovation mainly in business processes for healthcare non-profits - mainly improving information and resources flows?

https://watsi.org/about They accept donations to fund healthcare for people in the third world, while being radically transparent (there is a Google Docs link out there with the details for every procedure they've funded). They're also exceedingly good at weeding out fraud, and are transparent about that as well (when fraud has occurred, the resolution, and how they fix the problem moving forward). They are, quite fr…

Thanks for the information! Your concluding sentence is really interesting.

Re: YC Research: Universal Healthcare

#30
We sell to governments, which is similar to healthcare.

I cannot stress this enough: technology is not the hard part.

Do they have outdated software? Yes.

Can you build better software? Yes.

None of that matters if you can't get it into their hands. Procurement is the hard part. Can you empathize with the needs, fears, desires, quirks, and crazy of ten different stakeholders? Pry proprietary API specs from the cold-dead hands of one-off contractors? Educate users who's technological proficiency peaked at SMS to manage a full-featured SaaS product in 2017?

Don't focus on the software. That isn't the hard part. People are the hard part. People are always the hard part.

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