I really wish Congressmen didn't have federal healthcare, and they had to use the same insurance us plebeians use. That would help them fix up the system real fast.
YC Research: Universal Healthcare
101–110 of 359 posts
Re: YC Research: Universal Healthcare
#102Founder 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…
With a single payer system, the insurer can choose prices that will still leave incentive for innovation and not bankrupt all the medical device companies. It is just a matter of choosing the correct pricing, which I am sure is not trivial, but is possible. That said, our health outcomes are not great in US, so maybe we need to balance things out a bit and spend less on new medical devices that help a small number of people and spend more on low tech preventative care measures that help everyone.
Re: YC Research: Universal Healthcare
#103Healthcare definitely seems like the land of process inefficiency, even in developed countries like here in Canada, so there's plenty of opportunity for major improvement. There's still plenty of paperwork done on... paper, information that constantly has to be repeated when you go from one provider to another, and plenty of mistakes made. Some time ago Ontario spent a massive amount of money on computerizing healthc…
What are you basing the yielded nothing on?
Canada is well on it's way to Electronic Health Records.
Re: YC Research: Universal Healthcare
#104Earlier quoted context omitted.
> Doctors without borders disagrees with your assessment in the USA. Not really - I didn't say that the barriers don't exist. I said that doctors aren't the ones responsible for them. Requiring one year of residency in the US is not an unreasonable requirement, for a number of reasons. But the bottleneck in the number of residency slots is the funding for them (which is subsidized by Medicare), and doctors aren't eve…
Saying that doctors are not responsible for restrictions on physician training and certification is like saying that banks are not responsible for credit card and payment processing restrictions and regulations. The government is enacting and enforcing the restrictions, but the doctors are campaigning for them (under many different justifications and tactics). The AMA is like many other trade organizations, in that i…
> but the doctors are campaigning for them (under many different justifications and tactics).
My point is that they're not campaigning for them. Either directly or indirectly.
> The AMA is like many other trade organizations, in that it often acts as one of many lobbyists for industry interests.
The AMA is not really a trade organization, because (a) only a small minority of doctors actually belong to it[0], and (b) they don't really consistently advocate for physicians' interests.
Even the very article you link doesn't really implicate the AMA at the source (or even the enabler) of these restrictions:
> Even if the AMA were to magically produce a few thousand more residency slots, it would barely make a dent in 91,500 projected doctor shortage.
[0] and most that are members of the AMA aren't members because they want to receive any representation from them, but because AMA membership is required to gain access to the paperwork required for certain types of billing (AMA holds the copyright on the paperwork).
Re: YC Research: Universal Healthcare
#105Unless 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.
Yeah, there's definitely some things to consider here. Despite all the plusses of universal health care which others have already gone into - many people in Canada go to the US to get tests done faster because they can just pay for them, sometimes you're stuck waiting months.
The US is also pretty much the world capital for a number of drug development and medical research areas simply because it's much more profitable to do there - taking away that profitability may have a negative impact on Healthcare advancement - not just in the US but world wide.
Some kind of balance needs to be reached here. I thought Obamacare went a lot in the right direction, but it seems that's a big mess of its own.
Re: YC Research: Universal Healthcare
#106I really wish Congressmen didn't have federal healthcare, and they had to use the same insurance us plebeians use. That would help them fix up the system real fast.
> I really wish Congressmen didn't have federal healthcare, and they had to use the same insurance us plebeians use.
They do; through 2014, like other federal employees (and most employees of large businesses) they had a choice of the private plans contracted by their employer. Since 2015, they've been limited to ACA exchange plans.
http://www.factcheck.org/2009/08/health-care-for-members-of-...
Re: YC Research: Universal Healthcare
#107Unless 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.
Interestingly enough, as a non American poster I find it amusing with the US posters having predominantly this type of selfish response.
Every time healthcare is discussed on reddit, slashdot, etc, most of the people commenting on us healthcare debate it in the form of : "not with my hard earned money, you lazy commies, why don't you start working".
What's interesting is that it isn't their fault.
From the outside, the system looks a bit rigged against the common person, and the dog eat dog mentality is propagandized heavily.
I sometimes wish that our fellow Americans experience better, see that it actually works, and engage more against the corrupt system that milks them, instead of the rest of the fellow human beings.
What amazes me though, is that HN seems a decent place today for a discussion like this one.
Re: YC Research: Universal Healthcare
#108Earlier quoted context omitted.
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 t…
cost of care is more visible to patients In the US you get to see the cost of care every time you have reason to see the physician - there's the copay for the physician visit and medications, and then there's the explanation of benefits, where you, as a patient, get to reconcile accounts. In NIH Britain OTOH, you get to see nothing of that sort (except a small copay for medication), and healthcare costs are better co…
> In the US you get to see the cost of care every time you have reason to see the physician
I feel it's important to point out that you see the cost in the bill. There's no reliable way to see the cost beforehand.
Re: YC Research: Universal Healthcare
#109What does this have to do with universal healthcare?
We know how to make healthcare more efficient. We know how to remove the administrative overhead. Other countries already have these systems in place. Look at Taiwan for one example. They have digital medical records and an extremely low administrative overhead because of universal care.
Healthcare will continue to be broken no matter how many YC research programs there are - because the US population lacks the desire and political will for universal healthcare.
Re: YC Research: Universal Healthcare
#110Interestingly, we already discovered a mechanism for drastically reducing the cost of healthcare back in 1986. It's a way of crowdsourcing the problem called high copays . Basically, you have to pay out of pocket for 90% of your health care up to a (high) cap. It turns out that patients are very good at figuring out which health care will improve health and which won't - the high copay group had no statistically sign…
A one-sided presentation of the conclusions. From the RAND study:
Cost sharing in general had no adverse effects on participant health, but there were exceptions: free care led to improvements in hypertension, dental health, vision, and selected serious symptoms. These improvements were concentrated among the sickest and poorest patients.
Personally speaking, I'm very much in favor of concentrating benefits among the sickest and poorest patients so as to minimize avoidable suffering. The pursuit of economic equilibrium on healthcare is a chimera because the conditions for perfect competition do not apply; patients cannot choose when to be sick, and thus lack the discretion on when they enter or exit the market; nor are competing therapies or competing providers of the same therapy offering a commodity product that can be freely selected between, just as if you suffer a catastrophic injury you won't get a timeout to make choices about which emergency room offers the best bang for the buck.
Like any sane person I want to minimize the overall cost of healthcare, but I also want to minimize avoidable suffering. I would much rather pay a bit more in tax and have a system that was somewhat less fiscally efficient but more accessible to those in the greatest need. This isn't just a matter of altruism or anxiety about high healthcare costs; if you have a maximally efficient healthcare delivery system then it's likely to fail in the event of a black swan public health crisis because all the gains from efficiency have already been booked for profit.