Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

YC Research: Universal Healthcare

blog.ycombinator.com

Post reply on HN
Print view View original

251–260 of 359 posts

Re: YC Research: Universal Healthcare

#251

Post by SilasX »

Sanddancer wrote: post #244
SilasX wrote: post #89

Earlier quoted context omitted.

If you think that policy is pure benefit for consumers and the only costs are to greedy mustache-twirling men, then there may be another bubble going on. It would mean that the US uses its leverage to push drug prices down to marginal costs, which would almost be the last domino in payers willing to pay for something like the value of new drugs. But drug development doesn't make sense if you can only charge marginal…

Or we could start funding medical research through our system of universities and the like. We have immense public and non-profit institutions that can take over. Maybe we'll even be able to see more benefit in treatment of rare and neglected diseases that way. It also means that a large number of people could actually afford medication, doctors, etc. I have friends who can't afford going to the doctor, can't afford…

Yes, it is definitely a possibility, that we could refactor the whole system and eliminate patents and set up a completely new model for drug development to work. That would affect a lot of stakeholders and be complicated politically, but yes, it's one route to take.

I was only trying to establish that it's not a matter of "here's a single, obviously bad policy that can be clipped out and which only has downsides for greedy capitalists".

Re: YC Research: Universal Healthcare

#252

Post by pessimizer »

SilasX wrote: post #89
warcher wrote: post #33

Earlier quoted context omitted.

In the united states we can't successfully implement negotiation on drug prices for MediCare . They literally can't negotiate with their suppliers. By law. Anybody thinking software is going to solve that is way in a bubble. http://healthaffairs.org/blog/2016/09/19/the-politics-of-med...

If you think that policy is pure benefit for consumers and the only costs are to greedy mustache-twirling men, then there may be another bubble going on. It would mean that the US uses its leverage to push drug prices down to marginal costs, which would almost be the last domino in payers willing to pay for something like the value of new drugs. But drug development doesn't make sense if you can only charge marginal…

If the government wants to fund drug development, it can fund it directly by buying research studies and proposals for studies rather than drugs from the drug companies. Something needs to be done to remove the incentives to falsify or exaggerate results and endlessly pursue me-too drugs.

Re: YC Research: Universal Healthcare

#253

Post by surfmike »

Sanddancer wrote: post #244
SilasX wrote: post #89

Earlier quoted context omitted.

If you think that policy is pure benefit for consumers and the only costs are to greedy mustache-twirling men, then there may be another bubble going on. It would mean that the US uses its leverage to push drug prices down to marginal costs, which would almost be the last domino in payers willing to pay for something like the value of new drugs. But drug development doesn't make sense if you can only charge marginal…

Or we could start funding medical research through our system of universities and the like. We have immense public and non-profit institutions that can take over. Maybe we'll even be able to see more benefit in treatment of rare and neglected diseases that way. It also means that a large number of people could actually afford medication, doctors, etc. I have friends who can't afford going to the doctor, can't afford…

Indeed, there are not enough incentives for pharma companies to target third world or not-so-common disease, but instead to push things like Viagra. That's one of the things Gates Foundation is helping address but ideally we do it at the government level. Research through grants to universities and labs already fuels a lot of great R&D in the US and I feel like we need to have even more of it for medicine.

Re: YC Research: Universal Healthcare

#254

Post by NeutronBoy »

TheSmiddy wrote: post #211
ameister14 wrote: post #189

Earlier quoted context omitted.

>Universal healthcare is already much more cost effective than fully or semi-privitised health care. That's not true. Most developed countries have some form of privatized system, falling into your 'semi-privatized' definition. It's more cost-effective.

In Australia we have a universal healthcare system for everybody and a private system that runs alongside that essentially gets you a more comfortable bed and the ability to jump the queue for non-critical surgery.

An importing part of the Australian system, is that for people and families earning over a certain threshold ($80k for singles, $160k I believe for families) you have the option to either

* pay for private health insurance, or

* pay an additional 2% surcharge/tax on your income

This is to encourage people who can afford it to purchase private health insurance, to lessen the load on the publicly funded system where possible.

Re: YC Research: Universal Healthcare

#255

Post by [deleted] »

TuringNYC wrote: post #18

(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…

[deleted]

Re: YC Research: Universal Healthcare

#256

Post by nishs »

TuringNYC wrote: post #18

(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…

> much like the Dining Philosopher's problem we're familiar with in Computer Science.

Worst attempt at an analogy I've seen.

Re: YC Research: Universal Healthcare

#257

Post by spangry »

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?

England has a single-payer (the NHS) and a population of 53m people. So I guess the answer is England?

Re: YC Research: Universal Healthcare

#258

Post by yummyfajitas »

anigbrowl wrote: post #246
yummyfajitas wrote: post #230

Earlier quoted context omitted.

The vast majority of emergency medicine is not emergency medicine, but emergencies are among the most likely things to have a catastrophic impact at the individual level. And this is handled by the high copay, high cap model proposed by RAND, Singapore and myself. You still have not identified any "fundamental economic problems" or misrepresentations of the behavior of the healthcare market. Unless you're poor or chr…

I just can't be bothered to go around this today since we're not going to agree anyway. On altruism, I was thinking of a specific comment you made a while back about being rationally focused on your interests, reproductive ability and descendants ( qua biology rather than social attitude, but I think it's consistent with your expressed libertarian viewpoint. I don't remember enough to successfully look it up right no…

I'm pretty sure I know the comment you are referring to: https://news.ycombinator.com/item?id=10180416

Altruism in that comment actually referred to the willingness of an individual to sacrifice personal reward for the cause of white power. I said that I'm not altruistic and am happy to make choices that harm white power in return for personal gain.

Also I'm not a libertarian, I'm closer to neoreactionary than to any other identifiable ideology.

Re: YC Research: Universal Healthcare

#259

Post by st3v3r »

yummyfajitas wrote: post #90

Interestingly, 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…

No, all that plan does is make people not go to the doctor when sick. They put stuff off until it is far too late, and they end up needing more expensive care that's much riskier.

Re: YC Research: Universal Healthcare

#260

Post by djrogers »

vondur wrote: post #111
TuringNYC wrote: post #18

(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…

Seems like in the US the easiest way for universal healthcare would be to extend Medicare to all. Most people seem to like Medicare. I'm sure their would be some tax increases, but I'm sure overall it would lower health care costs for everyone.

> Most people seem to like Medicare.

Except for the doctors that can't afford to treat Medicare patients due to the criminally low/skewed reimbursement rates for some services. There's a reason so many private practices don't take Medicare patients...

Post reply on HN