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Goldman Sachs questions whether curing patients is a sustainable business model

arstechnica.com

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Re: Goldman Sachs questions whether curing patients is a sustainable business model

#131

Post by buserror »

The health industry has no reason to cure patients. On the contrary, they have reasons to create new patients.

And it's across the board. I tell myself exactly that when I look at my toothbrush.

A toothbrush lasts about ~3 weeks before needing replacing. I'm sure someone in the industry will tell me that it's because it's made of unobtainium unicorn hair specially designed to make my teeth whiter and all that.

I also have a another plastic brush to clean my shotguns of all things (I do a lot of clay pigeon shooting) -- the construction is identical to a toothbrush, just perhaps a tad bigger. Doesn't have the fancy colored handle.

Now the brush I'm currently using I've been using for 3 years and the brush is still pretty much pristine, after being used to generously scrub bits of sharp, grim metal once or twice a week.

Hmmm... How does that work? Better unicorns? Well, think about it, everyone is changing toothbrush on a monthly basis, that is a huge revenue. Even reducing the lifetime of a toothbrush by 5% would increase the number of brushes sold by a huge amount.

All the while, it creates fantastic amount of plastic waste. Fancy packaging and 100% plastic, possibly not even all recyclable.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#132

Post by rectang »

ramblerman wrote: post #78
brann0 wrote: post #54

Earlier quoted context omitted.

So we agree medicine cannot be managed as a business, right? It's ok if healthcare losses money, in fact it should be ok for all public sevices to operate and not being profitable.

You are jumping from one extreme to the other. Creating a public institution with no pressure to make profit is a disaster waiting to happen. You can certainly keep a 'competitive' environment which is regulated with incentives. And I do agree healthcare needs this, and shouldn't live purely by the free market.

It's refreshing to see skepticism of both market-based and government-based solutions. Too often I feel like I am being presented with arguments which require either blind faith in the "invisible hand" or denial that inefficiency increases in the absence of competition.

> You can certainly keep a 'competitive' environment which is regulated with incentives.

This is my preferred approach as well. It's worst weakness is the potential for regulatory capture. I tend to believe that should be addressed by not giving corporations as much power as they currently enjoy in the US: enforcing constraints on participation in politics and requiring transparency, disconnecting health insurance from employment status, enabling clawback of executive bonuses, etc.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#133

Post by ekianjo »

fsloth wrote: post #126
ramblerman wrote: post #78

Earlier quoted context omitted.

You are jumping from one extreme to the other. Creating a public institution with no pressure to make profit is a disaster waiting to happen. You can certainly keep a 'competitive' environment which is regulated with incentives. And I do agree healthcare needs this, and shouldn't live purely by the free market.

"Creating a public institution with no pressure to make profit is a disaster waiting to happen." Why? Schools are not for-profit institutions (well, not everywhere). Police don't make a profit. Nor does the fire brigade. Or the military, for that matter. Are all of these disasters waiting to happen?

You have never heard of private military companies? They are extensively used byvthe US mostly for non combat situations. They are very effective, for profit, and much less costly than the regular army.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#134

Post by megaman22 »

dominotw wrote: post #59
masklinn wrote: post #43

Earlier quoted context omitted.

> There is another one. Vaccines. Vaccines are absolute shit from a business perspective. They're expensive to develop, generally cheap to produce, and their administration is a single or limited event point. Sure you've got breadth but you've got no depth, once an individual is vaccinated they're done, or maybe they'll need an other round years from now. Big pharma companies absolutely hate vaccines, having people p…

> administration is a single or limited event point. What about flu vaccines? Even govt runs ads urging people to get their flu shots, even though they have been shown to be useless.

I almost wonder, in my more cynical moments, if "flu shots" are people just paying to get poked with a couple of cc's of saline, for all the effectiveness it seems to provide.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#136

Post by whatisunseen »

PeterStuer wrote: post #24

The 'ideal' drug from a business point of view not only not cures the patient long term, it offer a short term mitigation while increasing the risk on relapse and thus future recurring consumption of the treatment. At the same time it can be IP protected to block alternatives and has an insured third party collective payment coverage to guard against the treated running out of funds to afford the perpetual dependency…

This only works if there are no better treatments or cures. If a competing treatment works better, or might be a better cure, it must be kept out of the market. Sums up the massive web of red tape that we call healthcare.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#137

Post by dghf »

buserror wrote: post #131

The health industry has no reason to cure patients. On the contrary, they have reasons to create new patients. And it's across the board. I tell myself exactly that when I look at my toothbrush. A toothbrush lasts about ~3 weeks before needing replacing. I'm sure someone in the industry will tell me that it's because it's made of unobtainium unicorn hair specially designed to make my teeth whiter and all that. I also…

> I also have a another plastic brush to clean my shotguns of all things (I do a lot of clay pigeon shooting) -- the construction is identical to a toothbrush, just perhaps a tad bigger.

Is it, though? Are the bristles made of the same material, for example? I'm guessing that bristles tough enough to scrub metal would not be the best things to use on your teeth and gums.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#138

Post by no_u_idiot »

buserror wrote: post #131

The health industry has no reason to cure patients. On the contrary, they have reasons to create new patients. And it's across the board. I tell myself exactly that when I look at my toothbrush. A toothbrush lasts about ~3 weeks before needing replacing. I'm sure someone in the industry will tell me that it's because it's made of unobtainium unicorn hair specially designed to make my teeth whiter and all that. I also…

This is only true for a single company in isolation. Any company making their products worse (whether it's healthcare or something else) will soon be replaced by someone doing it better. As such, any company not producing or selling viable cures for diseases will quickly lose a lot of money to a new company that sells those cures.

In practice, this works more or less well depending on which country on earth you are in. But your statement that the health industry has no reason to cure patients is wrong basically everywhere and idiotic at best.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#139

Post by sametmax »

buserror wrote: post #131

The health industry has no reason to cure patients. On the contrary, they have reasons to create new patients. And it's across the board. I tell myself exactly that when I look at my toothbrush. A toothbrush lasts about ~3 weeks before needing replacing. I'm sure someone in the industry will tell me that it's because it's made of unobtainium unicorn hair specially designed to make my teeth whiter and all that. I also…

This is where traditional Chinese medicine got it right : they have a culture of trying to keep people healthy. You are supposed to go to the doctor to not become sick.

It's maintenance. Not that I think it's better, but economically, you suddenly have the same goal as your clients. And that more sane.

Re: Goldman Sachs questions whether curing patients is a sustainable business model

#140

Post by dynofuz »

The industry is being defined too narrow. The full industry includes insurers. Insurers have every reason to cure patients. Cured patients live longer. The longer you live the more years you pay premiums. The more premiums the higher your profits. So insurance is incenivized to put the money in the hands of those who cure rather than those who require insurance to fork up a fixed amount on an ongoing basis.
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