Google Co-Founders on Healthcare: “Thanks, But No Thanks” • Hacker News Board

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#111

Post by michaelt » Thu, Jul 10, 2014, 1:52 PM UTC

rwallace wrote: post #102

michaelt wrote: post #94

Earlier quoted context omitted.

I wish I believed we could make a database shared between my GP and my spine specialist without my records also being shared with all insurers, employers, marketing companies, security services, medical researchers, credit rating agencies, and anyone who slips any hospital employee a hundred bucks.

So do I, but given the world as it is, wouldn't you much prefer some idiot marketing guy spamming you on the basis of your medical records, than a screwup in the chain of communication between your GP and spine specialist leaving you crippled or dead?

I don't have anything requiring regular medical treatment, but my medical records identify me as someone who has suffered mental health problems, who regularly drinks to excess, who habitually uses cocaine, and who caught an STD in a nazi-themed prostitution orgy while I was a sex tourist in a deprived country.

I'd prefer to retain my privacy and take my chances on the medical miscommunication front, thanks.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#112

Post by TheCondor » Thu, Jul 10, 2014, 1:57 PM UTC

justinph wrote: post #8

When you fuck up in health, people can die. Regulation exists for a reason.

For profit medicine just seems rife with moral hazards.

Dengue kills poor people but we've got dick pills when you can't get it up. The regulations are just part of it...

What did an MRI cost 20 years ago, what does it cost today? No competition, no Moore's law, and that's on the technology side...

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#113

Post by unethical_ban » Thu, Jul 10, 2014, 2:00 PM UTC

rwallace wrote: post #102

michaelt wrote: post #94

Earlier quoted context omitted.

I wish I believed we could make a database shared between my GP and my spine specialist without my records also being shared with all insurers, employers, marketing companies, security services, medical researchers, credit rating agencies, and anyone who slips any hospital employee a hundred bucks.

So do I, but given the world as it is, wouldn't you much prefer some idiot marketing guy spamming you on the basis of your medical records, than a screwup in the chain of communication between your GP and spine specialist leaving you crippled or dead?

This is a false dichotomy. Can't we have secure, somewhat non-portable EHRs with super strong "Won't release without auth" procedures, or perhaps, as someone else implied, the data should be transfered via sneakernet on USB or similar?

And how common, as a ratio, are crippling medical screwups related to multi-practice miscommunication? I'm sure the absolute number is non-zero, but risks must be weighed. If one person having a crippling issue saves 100,000 people from having their personal data released against their will...

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#114

Post by drcode » Thu, Jul 10, 2014, 2:17 PM UTC

gph wrote: post #6

Healthcare is heavily regulated, and I understand why some companies would be reluctant to branch out into it. But that doesn't mean the privacy and legal concerns surrounding HIPAA regulations are unwarranted. Yea, it would be nice if we lived in an ethical utopia where we wouldn't have to feel worried about people looking through our health records. But we don't. I would not feel comfortable with my health records…

The problem with HIPAA is that it's supposed to look after my interests as a patient, but if I feel that it isn't, there's no way for me to opt out of it.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#115

Post by jeffbr13 » Thu, Jul 10, 2014, 2:18 PM UTC

tn13 wrote: post #40

zmmmmm wrote: post #35

It's worth noting that highly regulated industries are not necessarily bad for startups to enter, exactly because they throw up particularly high barriers to large companies. Google can't enter health without accepting the full baggage that comes with that - people worried about their privacy, every random nutter looking to sue them and get a payday, FDA breathing down their neck every step of the way, etc. A small s…

It sounds very contradictory. In most of the heavily regulated industries such as healthcare or insurance, one of the economic efficiencies are a better understanding of the complex law, startups can not solve this inefficiency in their favor.

Legal frameworks are definitely tractable, and investing the time to navigate them more effectively can give you the same sort of competitive advantage as mastering a technology.

Same principle, different domain.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#116

Post by mcculley » Thu, Jul 10, 2014, 2:22 PM UTC

BrokenEnso wrote: post #99

mcculley wrote: post #90

Earlier quoted context omitted.

I'm not. The illiquidity is why different healthcare specialists can't share data about me without resorting to a ten finger interface that leads to transcription errors. I want my general practitioner and my spine specialist to be using the same database for records, test, and scans. I'm okay with being embarrassed if it means living longer and better.

I'd like for that database to be something that I control. This is, something that I carry with with me, like a usb stick; and that I have the software/tools to view it. Then I could actually take read though any notes and maybe take a more active role in my health.

I would like that as well, but do you seriously think that would work for most people? Would you want your less technical loved ones to be responsible for the physical security of their data and carry it with them at all times?

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#117

Post by yebyen » Thu, Jul 10, 2014, 2:27 PM UTC

moe wrote: post #109

mcculley wrote: post #90

Earlier quoted context omitted.

I'm not. The illiquidity is why different healthcare specialists can't share data about me without resorting to a ten finger interface that leads to transcription errors. I want my general practitioner and my spine specialist to be using the same database for records, test, and scans. I'm okay with being embarrassed if it means living longer and better.

If only we had a technology to physically carry around data in our pocket, and selectively share it without uploading it to remote servers...

Great... now your doctor can read the news in your patient file only once/after and while you're in the room. I'm sure that won't affect his or her bill rate.

As it is, I only get to see my doctor for three and a half minutes when I need help, after 5 minutes with a PA, and I don't know if the PA has even had a chance to communicate any of what I told her to the physician, so I have to write everything down lest I forget to repeat something important. Now it sounds like you want to remove the chance they might have actually reviewed my history before I get there, by having me carry it around in my pocket with me?

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#118

Post by [deleted] » Thu, Jul 10, 2014, 2:28 PM UTC

TheCondor wrote: post #112

justinph wrote: post #8

When you fuck up in health, people can die. Regulation exists for a reason.

For profit medicine just seems rife with moral hazards. Dengue kills poor people but we've got dick pills when you can't get it up. The regulations are just part of it... What did an MRI cost 20 years ago, what does it cost today? No competition, no Moore's law, and that's on the technology side...

[deleted]

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#119

Post by fixermark » Thu, Jul 10, 2014, 2:33 PM UTC

michaelt wrote: post #111

rwallace wrote: post #102

Earlier quoted context omitted.

So do I, but given the world as it is, wouldn't you much prefer some idiot marketing guy spamming you on the basis of your medical records, than a screwup in the chain of communication between your GP and spine specialist leaving you crippled or dead?

I don't have anything requiring regular medical treatment, but my medical records identify me as someone who has suffered mental health problems, who regularly drinks to excess, who habitually uses cocaine, and who caught an STD in a nazi-themed prostitution orgy while I was a sex tourist in a deprived country. I'd prefer to retain my privacy and take my chances on the medical miscommunication front, thanks.

I can't help but think that the nazi-themed prostitution orgy part doesn't need to be in the medical records. You should probably talk to your practitioner about logging discretion. ;)

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#120

Post by fixermark » Thu, Jul 10, 2014, 2:35 PM UTC

jerf wrote: post #106

rwallace wrote: post #102

Earlier quoted context omitted.

So do I, but given the world as it is, wouldn't you much prefer some idiot marketing guy spamming you on the basis of your medical records, than a screwup in the chain of communication between your GP and spine specialist leaving you crippled or dead?

Yes, of course. But "idiot marketing guy" isn't the worst case scenario, nor is it even the worst plausible scenario. Job loss and inability to get health insurance aren't hypothetical concerns... laws have been written about this because they happen, at scale. While I'm inclined to think the regulations as they stand today are heavy-handed and more expensive than they need to be to get the job done, that doesn't neg…

It seems almost like the real issue is the insurance schema that makes medical care inaccessible without third-party money.

This notion suggests that the right place to start the kind of big-data medical disruption that could work would be a nation with a weaker or nonexistent medical insurance framework.