Earlier quoted context omitted.
Wow. Incentivizing people who need money to sell their organs has "zero negative effects"? Really?
Really. Done all over the world.
Why stop at organs? Why not sell entire persons?
What Atul Gawande Got Wrong about U.S. Health Care Spending
31–40 of 77 posts
Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#32Earlier quoted context omitted.
When you are designing a service, you can optimize for median latency or tail latency. Sometimes when you optimize for tail latency, median latency gets worse. It is similar to the health care systems. The US system is awesome at doing really crazy life saving stuff. For example US is probably the best in keeping premature babies alive. In addition it has a ton of resources. If you want an MRI scan, you can get one i…
>This is why, if you look where all the really rich rulers decide to go for surgery or other complicated care, it is the US. If that were true, why would a US Senator go to Canada for surgery then? https://www.courier-journal.com/story/news/politics/2019/01/...
This was one case where the best hospital in the world for THAT particular procedure was in Canada - and is primarily a PRIVATE hospital.
(Though the hospital also gets some $ from the government, so I'm not quite sure what it means to be "private"...)
I think you can have both claims to be true: the vast majority of complicated procedures are best-in-class in the US, but there are some centers of excellence elsewhere as well.
Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#33Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#34Earlier quoted context omitted.
Medicare for All. Help try to get Bernie elected, as he’s the only candidate who actually backs the policy. Warren has back-pedaled now that she’s secured the top position as the moderate alternative. https://jacobinmag.com/2019/09/elizabeth-warren-campaign-med...
I believe Andrew Yang also supports this to some extent IIRC.
You can only bring down costs and combat things like hospital consolidations through a single payer system and dismantling private insurance (i.e. Bernie or Jayapal’s bills), so none of the “compromises” proposed by other candidates will do anything too meaningful. If you want a good breakdown on why, I recommend Tim Faust’s new book:
Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#35Earlier quoted context omitted.
allow doctors on H1B to come from india. That's what they do in UK.
Wouldn't that help the bottom lines of hospital conglomerates even more?
If two million trained software engineers magically arrived in the US overnight, it would certainly help the bottom lines of AMFGOOG in the short-term, but would probably drive down the long-term cost of 'I want some software built'.
Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#36Earlier quoted context omitted.
Really. Done all over the world.
It's also condemned by the World Health Organization unless totally altruistic because organ trafficking and human trafficking are intertwined with the politics of organ transplantation. Living donor programs already exist in many states and hospitals - If you want to help reduce medicare spending by donating your organs, go for it! But don't expect to get paid for it any time soon.
It has negative externalities as well. The poor cannot afford to donate kidneys - the time out of work, the lifetime extra health maintenance and checkups. So it becomes a rich person's prerogative.
And it remove a source of cash from an entire population, with all that entails.
Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#37Earlier quoted context omitted.
When you are designing a service, you can optimize for median latency or tail latency. Sometimes when you optimize for tail latency, median latency gets worse. It is similar to the health care systems. The US system is awesome at doing really crazy life saving stuff. For example US is probably the best in keeping premature babies alive. In addition it has a ton of resources. If you want an MRI scan, you can get one i…
I do not believe that this is accurate, in my opinion this assertion requires some documentation. I looked up the survival rate of premature babies and the neonatal mortality rate (28 days after birth) is higher in the US than in Canada.[0] I'm having trouble finding numbers on other procedures, in my opinion it may be because because the US is falling behind on them as well. [0]: https://www.healthsystemtracker.org/…
I am talking about premature infants.
The one study I could find from 2000 that compares them showed
>Relative risks for infant death from all causes among singletons born at 32 through 33 gestational weeks were 6.6 (95% confidence interval [CI], 6.1-7.0) in the United States in 1995 and 15.2 (95% CI, 13.2-17.5) in Canada in 1992-1994;
https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&as_vis...
Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#38I really wish we had transparent pricing, it's maddening, outrageous and needs to be required by law.
Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#39> When most people speak of health care “prices,” they often have in mind point-of-service prices one pays when picking up a prescription, being hospitalized, having a baby, or seeing a doctor.
This reminds me of the infuriating pattern in some health care conversations when discussing consumer discounts and rebates for prescription drugs. The pharma company will say, "we give pricing relief to our customers, and ensure that no patient will pay more than $20 for a monthly supply!" That's all well and good, but it elides over the fact that the insurance company is still paying $1000+/month for their share of the prescription, and that money eventually comes out of the patient or the employers pocket, which means it eventually comes out of our pockets as their consumers.
> However, when economists refer to “health care prices,” they mean the overall payments for a service—not just what the patient pays to the provider in the form of a copay or deductible, but what the insurer pays to the provider on behalf of the patient...But the distinction between these two ways of thinking about prices leads me to the second problem with the emerging price consensus: the failure to consider what is baked into the payments that payers (whether public or private) make to providers.
Fundamentally, if we were able to reduce our spend as a percentage of GDP to that of the average OECD country, it would remove $1 Trillion in annual revenue from our health care system. The existing health care industry is going to fight that tooth and nail. That doesn't mean we shouldn't do it.
Re: What Atul Gawande Got Wrong about U.S. Health Care Spending
#40Earlier quoted context omitted.
It's also condemned by the World Health Organization unless totally altruistic because organ trafficking and human trafficking are intertwined with the politics of organ transplantation. Living donor programs already exist in many states and hospitals - If you want to help reduce medicare spending by donating your organs, go for it! But don't expect to get paid for it any time soon.
It has negative externalities as well. The poor cannot afford to donate kidneys - the time out of work, the lifetime extra health maintenance and checkups. So it becomes a rich person's prerogative. And it remove a source of cash from an entire population, with all that entails.
I'm not surprised - you probably didn't even look into the living donor programs available in the US.
Many hospitals will cover most if not all of these costs, including your wages, health maintenance, checkups, etc. If the hospital near you won't cover these things, the National Living Donor Assistance Program will help.
> And it remove a source of cash from an entire population, with all that entails
There's something like 100,000 people on the kidney donor list right now (UNOS). Maybe 20,000 of these get a kidney donation per year. It's not really that much of lost productivity, and as we have already explained these costs are usually covered by programs for living donors.
You're acting like this isn't a solved problem, when it is except that people are attached to their own body parts. I for one don't really want to give my kidney away unless I'm already dead. Maybe we should argue for opt-out deceased organ donation programs nationally, instead of this asinine idea that we should allow poor people to sell their kidneys.