Earlier quoted context omitted.
> Americans intuit that it’s not Any evidence for this?
GP’s comment? It’s predicated on separating “high chronic disease burden” from “poor healthcare system performance.” I don’t think this is a broadly held belief, I think it’s the “eeehhrm actually…” contrarian belief that’s trying to discredit the consensus view that our healthcare system gets very poor results for the money. So it shows up in places like this exact HN thread.
Brave Care Has Closed
121–130 of 160 posts
Re: Brave Care Has Closed
#122Earlier quoted context omitted.
Most people outside of healthcare will have a hard time disrupting anything until they realize the goverment has tilted the rules in favor of status-quo. Healthcare insurance in the US is heavily subsidized, and no number of revolutionary care delivery models will put you on level terms with the behemoth of US govt insurance subsidies. Your only hope as a non-provider is to come in with your own a-la-carte insurance…
You will still lose on the insurance front. If you’re on the exchange, you’ll get absolutely hammered by risk-adjustment. If you’re not, you’ll never be able to sell to anyone. You’ll have to lock up huge amounts of capital, which will grow as you grow, that you can’t invest or use. It will just sit in an account in case you can’t pay claims. You’ll have to accept horrible contracts with provider systems in order to…
The same applies to insurance. You can't take crap contracts that don't work for you, so maybe create a contract of your own based on 1st principles and going back to the definition of insurance.
Re: Brave Care Has Closed
#123I have heard conflicting accounts of inefficiencies in the US healthcare system. One account is that the US has too many medical facilities in urban areas. In other words, there might be five hospitals each with its own radiology equipment. That equipment is idle some of the time, so you could close some of the imaging departments and leave just one or two for the metro area. That would obviously inconvenience some p…
I work for a hospital chain that has done similar things. A lot of the failing hospitals in little towns across the US is because of this, and the consolidation that's happening is to remove similar inefficiencies. People that live in these little towns with failing hospitals see any move towards correcting these inefficiencies as evidence that our medical system is failing and use it to vote for right wing politicians who make empty promises.
Re: Brave Care Has Closed
#124I have heard conflicting accounts of inefficiencies in the US healthcare system. One account is that the US has too many medical facilities in urban areas. In other words, there might be five hospitals each with its own radiology equipment. That equipment is idle some of the time, so you could close some of the imaging departments and leave just one or two for the metro area. That would obviously inconvenience some p…
Re: Brave Care Has Closed
#125I have heard conflicting accounts of inefficiencies in the US healthcare system. One account is that the US has too many medical facilities in urban areas. In other words, there might be five hospitals each with its own radiology equipment. That equipment is idle some of the time, so you could close some of the imaging departments and leave just one or two for the metro area. That would obviously inconvenience some p…
>That would obviously inconvenience some people, but the gist of the criticism is that the US duplicates medical capacity for the sake of convenience. I work for a hospital chain that has done similar things. A lot of the failing hospitals in little towns across the US is because of this, and the consolidation that's happening is to remove similar inefficiencies. People that live in these little towns with failing ho…
If you have 2 hospitals and one takes your insurance and the other doesn't you still get service. If you consolidate to one and they don't take your insurance you may have to drive hours to get medical service.
A huge failure of the system is how health insurance works.
Re: Brave Care Has Closed
#126Earlier quoted context omitted.
As a Brit, that sounds like a positive not a negative, though I appreciate that in the US it might be a political negative.
I don't know, the experience with my mother in law over the last few weeks has left me wondering about that. I certainly don't want a free for all system like the US has (and I suspect the Tories want) but it isn't great at the moment.
Re: Brave Care Has Closed
#127Earlier quoted context omitted.
So my four pigs analogy, where insurance companies, drug/device companies, doctors/hospitals, and lawyers all feed at the trough, increase costs and point to someone else (although I will admit lawyers are probably the smallest cost component and the most blamed by the other three). There is a fifth one that imposes costs: our comprehensively unhealthy food, health, and lifestyle in America that capitalism feeds upon…
> reform the FDA to make bringing drugs to market cheaper. We recently tried this with some vaccines and now a large segment of the population is now vaccine-hesitant. https://pmc.ncbi.nlm.nih.gov/articles/PMC10257562/ > Lawyers: caps caps caps so there isn’t costly malpractice insurance. Caps don’t always result in improved health outcomes. https://scholarship.law.georgetown.edu/cgi/viewcontent.cgi?p... > Maybe woul…
Forced vaccination was the problem here.
Re: Brave Care Has Closed
#128Earlier quoted context omitted.
As a Brit, that sounds like a positive not a negative, though I appreciate that in the US it might be a political negative.
I don't know, the experience with my mother in law over the last few weeks has left me wondering about that. I certainly don't want a free for all system like the US has (and I suspect the Tories want) but it isn't great at the moment.
Politicians - mostly the tories but Blair's government take a lot of blame too - have defined "not privatising the NHS" as only meaning keeping it free at point of use. But in the background, NHS trusts have been forced to sell land and buildings that they used to own and rent it back from the new private owners, and many areas have seen both staff and equipment privatised, from agency staff (where instead of hiring cleaners or nurses or whatever, they instead hire agency staff, where the hourly cost to the NHS is double or more what an employee would cost with most of that increase going to the agency companies not to the workers) to private hospitals (where instead of investing in a new operating theatre, or whatever, they pay to have NHS patients operated on in private hospitals), etc.
The NHS is far from perfect, but the lesson we learn from those imperfections shouldn't be that nationalised healthcare is bad, but that underfunding it and then using that underfunding to justify privatising lots of stuff in the background is not a good way to run a nationalised health service.
The root problem is that many politicians would like to see the NHS fall to pieces so that an American healthcare system can create lots of opportunities for companies to make money, but because the NHS is hugely popular it would be political suicide to make that an official policy, so instead they've taken this approach which not only creates these short term opportunities for companies to come in and profit as mentioned above, but also gradually erodes the it's popularity with the long term goal being that eventually it won't be political suicide to say "Look the NHS is a failed experiment, we need to replace it with American style private companies and healthcare insurance".
Re: Brave Care Has Closed
#129Real way to fix healthcare: facilities based on repurposed container ships offshore near cities with lots of flights into them, to be outside of US regulations, staffed by physicians shuffled from Eastern Europe. Will offer more than an order of magnitude price advantage and will quickly squeeze the existing systems making it irrelevant until what's left of it is forced to change.
My mom refuses to leave the US healthcare system despite the costs because
1. She pays for insurance, not surgery (in her mind)
2. regardless of the keening US healthcare system is the best in the world
Re: Brave Care Has Closed
#130Don't get the wrong idea about this announcement. The problem is not that pediatric urgent care is not a viable business. The problem is that it's not a great VC-funded business. VC investors are hoping for huge growth and eventually earning back multiples of their investment. That's going to be really hard to do in this segment of the health-care market. We've got a wonderful pediatric urgent-care place in our area,…
Geriatric care will be the gold rush of the 2040s. If I knew a solid way to invest in that, I would.