Doctors, Revolt

Presumably the underlying data for the linked chart is already adjusted for inflation. And the index used doesn't matter all that much, it will be applied to both data series and various inflation measures aren't that different anyway.

The higher administrative costs at US hospitals account for something like 3% or 4% of total US healthcare spending. A huge win if you take it all back and not any sort of solution to the cost problem.

This article and the comments here combine to illustrate for me the difficulty of making healthcare work in all the different ways it has to. I read the article, and I think, "Yeah! That's the kind of healthcare I want!" I read the comments with contrary opinions, and I think, "Those are great points — these counter-intuitive practices make sense when you need healthcare to scale." I talk to my wife, a physician, and I hear about what results in the rare cases when these protocols and consultations don't happen, and I think it's a wonder that hospitals function at all.

I think it's not a matter of finding the solution to the problem, but a maximization problem, where we have:

- patients who need to be cared for as human beings and allowed to make their own informed decisions, but who are generally not experts in medicine

- physicians who have more patients than they can keep in their minds at once, and who are reliant on nurses and computerized systems to keep patients breathing and not get sued, but who are also skilled, highly-educated professionals whose human judgment is frequently superior to any algorithm

- nurses who are both underpaid and responsible for more than their training considered

- hospitals that need to pay the bills, pay salaries, attract new physicians, etc.

There are so many conflicting aspects of this problem that any simple solution is probably unrealistic.

> Your ignorance is not as valid as my knowledge and to assume that in your version of this myth that insurance companies (but in the more common version of this myth, Doctors, Pharmaceutical Companies etc) are primarially interested in keeping the population teetering on the edge to milk them dry is disingenuous. You really know how to talk to people haha. It seems like you were triggered by something I said even though it did not apply to you.Take a breath. It is okay for other people to have different viewpoints on the medical industry in the United States.

>This is an absurd and oft-repeated claim that taps into variations of the conspiracy thinking around 'doctors keeping the cure for cancer (or insert other condition here) secret' because powerful lobby groups insist that there is more money to be made in 'treating' than 'curing'. It is patently untrue.

Where are your sources? I never stated that they are hiding the cure for cancer? It is a fact that treating vs curing is a business model in the United States. The U.S outspends everyone yet gets them same results >https://www.npr.org/sections/goatsandsoda/2017/04/20/5247741...

It is also true that privacy data laws and business models are impeding the impact of disruption in healthcare where technology is disrupting every other field. (https://www.bloomberg.com/news/articles/2017-11-28/alphabet-...)

I never mentioned anything about Australia, I was talking about the United States. I cannot speak for Australia.

>Please inform yourself and don't just trumpet that which you hear on the internet.

The fact that medical records are not electronic being a standard is laughable. I cannot speak for anyone else but the United States. HIPA laws are one of the reasons which makes it harder for researchers and doctors to actually get data they need to develop cures because of the need an individual signature for everyone.

Regarding Supply of Doctors >In the United States, the supply of doctors is tightly controlled by the number of medical school slots, and more importantly, the number of medical residencies. Those are both set by the Accreditation Council for Graduate Medical Education, a body dominated by physicians’ organizations. The United States, unlike other countries, requires physicians to complete a U.S. residency program to practice. (Since 2011, graduates of Canadian programs have also been allowed to practice in the U.S., although there are still substantial obstacles.) This means that U.S. doctors get to legally limit their competition. As a result, U.S. doctors receive higher pay, and like anyone in a position to exploit a cartel, they also get patients to buy services (i.e., from specialists) that they don’t really need. (https://www.politico.com/agenda/story/2017/10/25/doctors-sal...)

Limits on the supply of doctors a conspiracy? >https://mises.org/library/how-government-helped-create-comin... >https://skeptics.stackexchange.com/questions/4561/does-the-a... >https://www.quora.com/Who-or-what-controls-the-number-of-med...

It is also a fact that insurance companies are the most powerful lobby in the United States. >https://www.cbsnews.com/news/ex-dea-agent-opioid-crisis-fuel...

Business Model Point >Imagine a portable, low-intensity X-ray machine that can be wheeled between offices on a small cart. It creates images of such clarity that pediatricians, internists, and nurses can detect cracks in bones or lumps in tissue in their offices, not in a hospital. It works through a patented “nanocrystal” process, which uses night-vision technology borrowed from the military. At 10% of the cost of a conventional X-ray machine, it could save patients, their employers, and insurance companies hundreds of thousands of dollars every year. Great innovation, right? Guess again. When the entrepreneur who developed the machine tried to license the technology to established health care companies, he couldn’t even get his foot in the door. Large-scale X-ray equipment suppliers wanted no part of it. Why? Because it threatened their business models. (https://hbr.org/2000/09/will-disruptive-innovations-cure-hea...)

Say you're a gastroenterologist and in the video, your patient was interviewed by a pathologist. The pathologist would ask pathologist questions, but you need to know gastroenterologist answers. How do you get them from the video of a pathologist asking pathologist questions?

The NHS does worse in treating cancer than other countries, but many of those countries (Germany, France, etc) have public health care also. It's not clear that the difference in performance is because of public, vs privately, funded medicine.