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

thehealthcareblog.com

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

#121

Post by fixermark »

mcculley wrote: post #116
BrokenEnso wrote: post #99

Earlier quoted context omitted.

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?

I think that's over-thinking it. Medical alert bracelets already exist; I can't imagine it'd be too much challenge to embed a ruggedized USB stick in one, and people generally don't worry about less technical people failing to remember to wear their bracelet.

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

#122

Post by uxp »

vacri wrote: post #51
zenbowman wrote: post #48

Earlier quoted context omitted.

A lot of the regulation has allowed people to die when there was a chance they would have lived without it. Regulations on advertising and OTC drugs are absolutely needed, but stopping a doctor from prescribing a risky drug to a terminally ill patient who will die without it anyway is counterproductive. The main reason people aren't healthy has nothing to do with the medical system or regulation. It has everything to…

stopping a doctor from prescribing a risky drug to a terminally ill patient who will die without it anyway is counterproductive. And if the patient survives, but has a debilitating condition that was a side-effect of that risky drug, then claims he was going to survive anyway and now his life has a shattered quality because the doctor prescribed an drug that hadn't been fully cleared yet? It's not as black and white…

> if you didn't have that regulation, you'd have medication with a much lower quality

Kind of like supplements? http://www.nytimes.com/2013/11/05/science/herbal-supplements...

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

#123

Post by fixermark »

k-mcgrady wrote: post #93
RoryH wrote: post #79

Brin's partner co-founded https://www.23andme.com/ and that got it's nose cut off by the FDA IIRC.

Rightly so. If I recall correctly, instead of just providing the results to you they also included recommendations to try to prevent things their tests had shown you were at risk of. Their tests have never been vetted/proven accurate by anyone other than themselves so providing health advice based on them is reckless. If they were allowed to continue anyone could start their own 'DNA testing service' create bogus rep…

... which is not nearly as big a risk these days as it was in the days of snake-oil salesmen; there isn't a "new town to set up shop in" for a bad DNA testing service in the days of the Internet.

I'm in favor of protecting people from bad medcine, but I think the current regulatory structure is an overly-restrictive tool for the job. Either that, or (given that it steps on the neck of 23andme but lets GNC and homeopathic practitioners continue to operate) it's mis-tuned for modern technologies and tools.

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

#124

Post by rayiner »

fixermark wrote: post #120
jerf wrote: post #106

Earlier quoted context omitted.

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.

It's not just insurance. Companies these days are using credit history as a reason to deny people employment. The credit card companies will hand out this information to almost anyone. Imagine what these folks will do with medical data.

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

#125

Post by kenjackson »

harryh wrote: post #103
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 don't think rayiner is worried about being embarrassed, he's worried about (for example) not getting a job one day because his private health information has made its way into the hands of a potential employer.

Can't we just make it illegal for an employer to use this information? While not perfect, ask any Black person, it seems preferable to the mess we have today.

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

#126

Post by samirmenon »

drcode wrote: post #114
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.

Are you sure? I've seen waivers and "individual consent" forms that can supposedly release your health records.

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

#127

Post by dragonwriter »

drcode wrote: post #114
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.

> 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.

To the extent that the first part is true [1], the second part is not true in any substantive way -- the privacy protections restrict what can be disclosed without your consent. So, yes, you can effectively "opt out" of any of the restrictions by consenting to disclosures.

[1] HIPAA -- the Health Insurance Portability and Accountability Act -- exists, in terms of direct goals, mainly to look after your interests as a potential purchaser of health insurance, the as-a-patient privacy protections are secondary to that, and were put in place in HIPAA, and subsequent revisions, to mitigate political opposition to the incentives for automation and related standardization of electronic transactions provisions designed to make the health insurance system -- both in terms of enrollment and claims processing -- more efficient.

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

#128

Post by TeMPOraL »

vacri wrote: post #51
zenbowman wrote: post #48

Earlier quoted context omitted.

A lot of the regulation has allowed people to die when there was a chance they would have lived without it. Regulations on advertising and OTC drugs are absolutely needed, but stopping a doctor from prescribing a risky drug to a terminally ill patient who will die without it anyway is counterproductive. The main reason people aren't healthy has nothing to do with the medical system or regulation. It has everything to…

stopping a doctor from prescribing a risky drug to a terminally ill patient who will die without it anyway is counterproductive. And if the patient survives, but has a debilitating condition that was a side-effect of that risky drug, then claims he was going to survive anyway and now his life has a shattered quality because the doctor prescribed an drug that hadn't been fully cleared yet? It's not as black and white…

> stopping a doctor from prescribing a risky drug to a terminally ill patient who will die without it anyway is counterproductive.

It's also about balancing incentives. If there were no such regulations whatsoever, you'd find yourself in a situation, where a patient with a mild cancer and a broken arm is potentially "terminally ill" and needs the New Risky Drug. It could degenerate to regular, systematic experimentation on humans in the guise of "doing everything we can".

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

#129

Post by aianus »

k-mcgrady wrote: post #93
RoryH wrote: post #79

Brin's partner co-founded https://www.23andme.com/ and that got it's nose cut off by the FDA IIRC.

Rightly so. If I recall correctly, instead of just providing the results to you they also included recommendations to try to prevent things their tests had shown you were at risk of. Their tests have never been vetted/proven accurate by anyone other than themselves so providing health advice based on them is reckless. If they were allowed to continue anyone could start their own 'DNA testing service' create bogus rep…

So what? I want to see my results. They make it clear it's not an exact science and they link to the relevant studies so you can make your own decisions. Why should the FDA prevent them from sharing that information with me? I'm not even American!
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