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Alphabet is spending billions to become a force in health care

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Re: Alphabet is spending billions to become a force in health care

#211
post #73

Earlier quoted context omitted.

I'm not convinced, even with the best of intentions. In fact, I am convinced of the opposite: A) Universal Health program would result in terrible quality health care B) It would lead to longer wait times, and less choices C) It would be insanely costly to fund. We've been busy printing a lot of $. Increased the Federal deficit from $21T to $30 since COVID and there isn't a good way to fund a bloated system in USA, c…

Regarding (A) and (C), this is the obligatory reminder that: * The US spends more public money on health care, per capita, than other wealthy nations, while also spending much much more private money than other wealthy nations * By many measures, the US gets worse outcomes (e.g. life expectancy) The conclusion that many draw from this is that perhaps a single-payer health care system in the US could dramatically lowe…

> * US doctors seemed really eager to waste money, like really eager, like it was creepy

I'd much rather a doctor "waste money" on a test than come up with an incorrect diagnoses based on symptoms only.

Re: Alphabet is spending billions to become a force in health care

#212
post #7

Earlier quoted context omitted.

Assuming by free you mean universal coverage that is (almost) free at the point of usage then this is a solved problem. What the United States lacks in order to realize a solution is political willpower and an electorate that is savvy enough to know that wanting such a system does not make one a communist. (And that being a communist does not make one an evil person.)

Being a communist absolutely makes you an evil person. About 5 times more evil than the group of people they fought against in a war. As for socialized medicine it makes doctors another arm of the government. In the UK last week (or the week before) one arm of the government ordered another arm of the government to kill a 9 year old. We are also just outside a 2 year stretch of tyranny of governments all over the wor…

> Being a communist absolutely makes you an evil person.

Tell me you don't know what communism is without telling me you don't know what communism is.

Yes, every known communist country has been rife with fascism, authoritarianism, and corruption. But those are orthogonal with communism as an economic model. It's like saying socialism is evil because the Nazis were socialist (they really weren't) just because "Socialist" is part of "Nationalist Socialist Party" .

> In the UK last week (or the week before) one arm of the government ordered another arm of the government to kill a 9 year old.

[citation needed], because this sounds like an extremely gross misinterpretation of a situation, likely done deliberately in bad faith.

Re: Alphabet is spending billions to become a force in health care

#213
post #209
post #61

Earlier quoted context omitted.

How do you avoid the obvious adverse selection problem? California can't prevent the most expensive people in the country from moving there, and the system we're talking about would be a powerful incentive for those people to do so.

I think you're overstating just how "obvious" this adverse selection problem is, because we haven't seen this play out historically. It sounds like a purely theoretical problem. Canada established its single payer system provincially, one-by-one, and they didn't have this adverse selection problem. Saskatchewan was the first Province to offer single payer in 1947, followed by Alberta in 1951, etc. By 1961, all Provin…

Maybe! These are all good points (well, the Canada example, at least). I guess it's down to "running a single-payer system for California would be very expensive, and you might need to make it mandatory in order to deal with the more pressing adverse selection problem" --- I don't know how much of a canard adverse selection is within the context of mandatory single payer, but it comes up.

Re: Alphabet is spending billions to become a force in health care

#215

I'm in the UK so that somewhat limits relevance but there are efforts to make available my data to companies, I opted out of data sharing from my GP. Link is here if you want https://www.nhs.uk/using-the-nhs/about-the-nhs/sharing-your-... A few points: I'm not against data mining at all, just handing it out to agencies without my say so. I'd be happy for it to be used for this purpose entirely within the NHS but that…

In Australia we have a similar mechanism, I opted out of sharing my health data. However down under when you opt out, this applies not only to private companies but also to State and Federal health providers. Source https://www.digitalhealth.gov.au/initiatives-and-programs/my...

Re: Alphabet is spending billions to become a force in health care

#216

Earlier quoted context omitted.

FHIR makes a lot of this better, but EHR vendors hate it for that reason. Also, it's complex to implement. Fortunately, we have HAPI [1] and it's very good, but has deployment complexity only a java developer could love. There's been a couple false starts on a nodejs based FHIR server, but nothing open source and production ready that I've found. [1] https://hapifhir.io/

FHIR provides a structure for communicating these data, but does not solve the hard problem in the parent comment about the massive heterogeneity of health care data across institutions (and even within institutions). The same messiness of the original raw data in the proprietary EHR data format can be replicated in FHIR. But at least the mess is available then in an open data format and a bit more regimented on cano…

We'll, I tend to silo phi per client to provide for auditable data segregation, so I don't try to scale HAPI up vertically.

FHIR is nice in that you can do uri pointers to external FHIR systems for resources, so it's possible to build up a pretty complex care team and access relationships that way.

I was going down this path and had a lot of it built out, but we ended up changing direction so I never saw it all the way through.

Shame.

Re: Alphabet is spending billions to become a force in health care

#217
post #84

Just imagine a world where they revolutionized healthcare as they did with advertising!

So, pushing treatments you didn't want or need? Yeah we're already there and they've certainly got the government connections to make it very lucrative.

I was thinking more like ad-supported hearing aids with built-in analytics so marketers can ask "Have you heard of this brand before?" for precise ad recall.

Re: Alphabet is spending billions to become a force in health care

#218
post #145

Earlier quoted context omitted.

Do you life with something chronic? Something were not a lot of people are doing research and we're there was no real discovery in the last 20 years? Because I do and you know how scattered the field of medicine is? There is one realistic way of getting more people with chronic issues new threatments and it's data. Lots and lots of it. IF someone can pull that of while protecting the individuals I believe it's alphab…

That's the possible upside. The possible downside is "if you ever search for a disease in Chrome, or on your Android device, or at google.com, we will notify your insurance company who will raise your rates".

not even if you search; if you searchED in the past!

Re: Alphabet is spending billions to become a force in health care

#219
As somebody who's been blacklisted by Google for no particular reason I can even discover, this terrifies me. I'm not saying they'd hire a hit man and kill me, but tweaking some doses of medicines? This isn't impossible if they get their claws into health care. It's free and easy. And Google is terrible for privacy and has major security problems which are endemic.

Re: Alphabet is spending billions to become a force in health care

#220
post #60
post #42

Earlier quoted context omitted.

Yes, because what we need is more gerontocracy. People should instead just make peace with the fact that their purpose in life is to reproduce, die within a reasonable time, and hand the world over to the next generation.

I mean, I guess, tell that to every important artist, author, architect, craftsperson, and humanitarian. Paul Farmer and Norman Borlaug both had children, but it's hard to argue that their real purpose in life was to reproduce. Could you get more Paul Farmer time? Seems like a worthy goal.

In a nutshell, your comment illustrates well the issue facing many western nations. The uniqueness of an individual is somehow extended to being applicable to the average person, and then folks hand-wring about why things seem to be trending in a bad direction.

Sure, Paul Farmer was special, but most people are not. To make any policy, or social conditioning, that is fine for an individual but bad for a collective, can result in some pretty terrible consequences, most critically this recent drive to discourage folks from having children due to whatever made-up reason, or cling onto power until others have to pry it from one's cold dead hands.

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