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YC Research: Universal Healthcare

blog.ycombinator.com

51–60 of 359 posts

Re: YC Research: Universal Healthcare

#51
Founder of healthcare startup here too:

This sounds like a great project. I love the idea of building technology for healthcare in a small, controlled, active care environment, and then scaling those tools to a larger audience.

The bigger issue in healthcare IMHO is that the American healthcare model, while hugely inefficient, seems to be the system that best incentivizes innovation. We pay 10x what Sweden pays for medical devices, but the US market is the only reason those device companies can be profitable. If we move to a single-payer system in the US, the economic incentives for innovation go way down.

If someone can figure out how to lower costs, while still providing a profitable market in which drug and device companies can innovate, we'll all benefit.

Re: YC Research: Universal Healthcare

#53

(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.

More like, there's too much sugar that people are using. It's doesn't matter if it's corn syrup or not.

Re: YC Research: Universal Healthcare

#54
post #12
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.

Somebody better tell all those non-humans in Western Europe about this.

Except for Switzerland, Western (not to speak about Eastern) Europe's universal healthcare means universal high taxes, universal low quality of treatment and universal access to waiting queues.

Re: YC Research: Universal Healthcare

#55

(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.

It's so difficult to eat healthy in the US because we're still in this false mindset of "reduce fat intake" when in reality is we should be reducing starches/sugars (carbs except for fibre and limited sugar alcohols).

Most of the "light" and "healthy" foods in stores are LOADED with sugars or starch. The FDA really needs to revisit the weight given to carbohydrates when creating the total calorie count.

https://www.youtube.com/watch?v=dBnniua6-oM

Re: YC Research: Universal Healthcare

#56
post #49

Why can't we import more doctors like UK and other countries in EU. Isn't that a low hanging fruit?

Because scarcity raises doctor salaries, and healthcare professionals are very good at organizing and negotiating. HN always gets riled about how H1B visas may lower wages, but doctors actively prevent foreigners from being allowed to practice medicine in their jurisdiction.

> healthcare professionals are very good at organizing and negotiating

Hardly - if that were the case, we wouldn't see so many private practices (and even hospitals) going straight out of business.

> but doctors actively prevent foreigners from being allowed to practice medicine in their jurisdiction.

This isn't really true either - it's true that there are restrictions around practicing (e.g.) in the US without completing a residency here. But contrary to popular belief, that restriction isn't within the control of physicians or any representative body of physicians. And physicians are generally rather apathetic about the topic - they don't like the idea any more than HN likes the idea of foreign developers working in the US, but physicians themselves aren't inclined to take much action on the topic.

Re: YC Research: Universal Healthcare

#57
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.

"Universal" means goverment-paid. It means that we have officially accepted that healthcare is so unfathomably impossible for a normal person to afford that the government has to inflate the cost out of existence.

This is obviously not a sustainable or mature solution to the problem, but it's a band-aid that appears to relieve much of the burden involved for patients.

I broke it out once and my net salary would be about $1k less than what I receive now if I lived in Canada instead of the U.S. I know that those extra taxes aren't all directly attributable to the health care apparatus, but the unverified impression is that a lot of it goes to that.

There have been periods when I've had to pay more than $1000/mo on medical bills on an ongoing basis, and there's pretty much always at least $500/mo going out to medical payments of some type or another in our family of 7. Our credit has also been routinely hounded by the medical industry's inability to figure out its own billing. Is avoiding all of that worth a net loss of $500/mo? Probably.

The polarization in America is really sad. We need to acknowledge that these are legitimate issues. Republicans need to take their heads out of the sand and quit just shrieking that "we have the best health care in the world!!!! We're America, bitch!", and Democrats need to respect that Republicans don't think "Just have the government pay for it and increase taxation commensurately" is an acceptable solution. Let's get away from each others' throats and try to figure this out constructively.

IMO the best option is to outlaw non-catastrophic medical insurance, set up new, temporary medical device and pharmaceutical suppliers who sell brand-name products at a loss, make serious revisions to the terms of drug patents, remove any applicable governmental subsidies that encourage reckless, unsustainable expansion of medical facilities, and make a law that says medical bills cannot be included in any credit worthiness determination.

This converts everyone to self-pay, which means medical providers will have to charge prices that real people can actually pay, it will end the absurd pricing showdowns and billing shenanigans between providers and insurers that often leave patients as collateral damage, it will undercut the supply chain that ratchets up the costs for everyone on the way down to the patient, it will discourage hospitals from building extravagant campuses that rival universities and instead focus on affordable, utilitarian designs, and so on.

I can hardly think of a worse solution than "just make everyone get an insurance policy and leave everything else essentially the same", aka Obamacare/Romneycare.

That should take us a long way to a sustainable, market-based solution. But it's clear at this point that some governmental action is needed to grease the wheels here.

Re: YC Research: Universal Healthcare

#58
Pardon my cynicism, but I don't like the idea of choosing a patient you're going to "spend your money on" as a replacement for a basic universal healthcare. Healthcare shouldn't be a popularity contest. As an addition to a normal "basic" healthcare it's fine, but please don't replace existing systems with this stuff.

Re: YC Research: Universal Healthcare

#59
hospitals are BIG business. They will never let their inefficiencies be addressed by an external force. They do not even share their price lists. Can you imagine going going into best buy and not knowing what anything costs? But having to get the price by researching it on the net?

Re: YC Research: Universal Healthcare

#60
post #51

Founder of healthcare startup here too: This sounds like a great project. I love the idea of building technology for healthcare in a small, controlled, active care environment, and then scaling those tools to a larger audience. The bigger issue in healthcare IMHO is that the American healthcare model, while hugely inefficient, seems to be the system that best incentivizes innovation. We pay 10x what Sweden pays for m…

There are 9.5 million people in Sweden and 320 million in the US - the huge market size in the US would still be a big incentive, whatever else you did.
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