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YC Research: Universal Healthcare

blog.ycombinator.com

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Re: YC Research: Universal Healthcare

#141

Post by Eliezer »

It boots nothing to subsidize that which is in restricted supply. So long as there are only 350 othodontists allowed to graduate per year, there's a corresponding limit on how many patients are allowed to have straight teeth regardless of who pays for what or what software is used. Improve the software, and the price of orthodontia must still equalize demand to the limited supply.

Offer free dollar bills, and a line will form until the cost of staying in line burns more than $1. Medicine isn't costly because it's inefficient, rather it can end up inefficient because the limited supply means it must somehow end up costly.

It is not possible to solve the healthcare crisis without somewhat deregulating the supply of healthcare and allowing it to increase. Until then, every subsidy just raises the price, and every efficiency improvement just creates room for more inefficiency elsewhere.

You can't solve the housing problem in San Francisco by building more efficient software for selling houses. Only interventions that somehow increase the total supply of living space can cause more total people to be able to live there.

Re: YC Research: Universal Healthcare

#142

Post by thereisnospork »

Arnt wrote: post #134
sbierwagen wrote: post #125

Earlier quoted context omitted.

Medicare Part D plans are run by private insurers and they certainly do negotiate on price. Why is a third party negotiating for Medicare, rather than Medicare negotiating directly? Because they're smaller, and have less leverage. physician administered drugs are paid for at a rate that is the average of what private payers pay. Why is a third party negotiating for Medicare, rather than Medicare negotiating directly?…

Switzerland, England, Canada, the Netherlands... which negotiator in any of those countries is not smaller than Medicare?

well none of them, since Medicare isn't a negotiator?

Re: YC Research: Universal Healthcare

#143

Post by dagss »

nightski wrote: post #91
ones_and_zeros wrote: post #34

Earlier quoted context omitted.

I think the point of this project is to replace the people, not necessarily to make software for people to use. Software is just means to an end.

If that is true, how is a pilot project in the developing world going to help at all in that sense? It doesn't seem like it is particularly relevant to the goal of reducing bureaucracy in the United States. Or do they really believe making a software platform is the missing piece here?

Nothing in the OP mentions US at all. It explicitly says "governments" in plural.

Re: YC Research: Universal Healthcare

#144

Post by rocky1138 »

dragonwriter wrote: post #24
whb07 wrote: 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…

Even non-OECD nations have excellent, universal health care. For example, see Taiwan: http://www.npr.org/templates/story/story.php?storyId=8965191....

The USA stands out horribly. I can't even imagine why anyone would choose to live in a country that did not offer universal health care.

Re: YC Research: Universal Healthcare

#145

Post by DanBC »

HarryHirsch wrote: post #130
CaptSpify wrote: post #108

Earlier quoted context omitted.

> 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.

What's seeing the expenses going to do, what mechanism is supposed to lower cost? When you need healthcare you need healthcare. No one goes to the physician for fun, elective procedures like breast enlargement or Lasik excepted.

The free market argument goes that informed consumers will chose healthcare services, and thus will either drive up quality, or drive down prices.

The problem is that the customers cannot see the prices, and thus can't negotiate before hand. This isn't just for emergency care, but for stuff that shouldn't be too hard to get pricing for. There's a nice Vice(?) video about a couple having a baby. They find it impossible to get even an indication of cost before hand.

This patient choice stuff made its way to England, and frankly it's dumb. People don't change their utility suppliers even though they'd save large amounts of cash. They don't change their GP unless they've moved house; they don't have enough information to make an informed choice of hospital if they need to go for surgery. It's a lot of bureaucracy that has very little benefit.

Re: YC Research: Universal Healthcare

#146

Post by 20years »

I would love to see more transparency in where the costs for dr visits is going. A recent 1/2 hour visit to my daughters doctor for a basic checkup and a couple of shots resulted in a $1500 bill to the insurance company. We paid a fraction of that but it still blows my mind that the bill was so high. I am assuming most of that was for the shots. If watsi can develop software that makes these costs more transparent maybe then we can address ways to lower them.

Re: YC Research: Universal Healthcare

#147

Post by dsjoerg »

nightski wrote: post #91
ones_and_zeros wrote: post #34

Earlier quoted context omitted.

I think the point of this project is to replace the people, not necessarily to make software for people to use. Software is just means to an end.

If that is true, how is a pilot project in the developing world going to help at all in that sense? It doesn't seem like it is particularly relevant to the goal of reducing bureaucracy in the United States. Or do they really believe making a software platform is the missing piece here?

I didn't see anything in OP about the goal being to reduce bureaucracy in the United States. Everything in OP seems explicitly global.

Re: YC Research: Universal Healthcare

#148

Post by whyileft »

grzm wrote: post #139
whyileft wrote: post #135

Earlier quoted context omitted.

Almost smells like the ACA, doesn't it? Edit: My apologies for sounding a bit antagonistic. The ACA is currently making use of high copays for that reason and more. It also hopes to force more transparency as well as most people want more than a icd-10 code when they have to write a check for $4k.

Healthcare discussions can quickly devolve into flame wars. Please take extra care to comment civilly and substantially.

That's a valid point. I've updated it to be less flippant. Appreciate you bringing that to my attention as there is a lot of great discussion going on in this thread.

Re: YC Research: Universal Healthcare

#149

Post by wvenable »

alienjr wrote: post #54
CPLX wrote: post #12

Earlier quoted context omitted.

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.

You don't have to look further than Canada to know that isn't true. My taxes are not significantly different from yours and I don't have to pay for insanely high medical insurance on top of that. Quality of treatment is fine and wait times aren't significantly different (but vary according to need).

I don't know how anyone can with a straight face argue that the US healthcare system is efficient with regards to money, time, or outcome compared to most single payer systems.

Re: YC Research: Universal Healthcare

#150

Post by rocky1138 »

alexmingoia wrote: post #109

What 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…

> because the US population lacks the desire and political will for universal healthcare.

Nailed it.

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