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The Amish health care system

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Re: The Amish health care system

#131

Post by virmundi »

amiga_500 wrote: post #122
anon09809809 wrote: post #103

Earlier quoted context omitted.

The 250k+/year US salary of the fully trained doctor setting bones could be a problem. Many doctors are paid significantly less in many of those other countries.

Go back a step further. Why do they need a big income? Because they took on lots of education debt. Why did they take on so much? Why is it so expensive? Because the usurers extend that much credit. The free market in shampoo is okay, sort of. For a lot of other stuff "free market" + fiat looks like a mess.

We don’t have a free market in healthcare. We have a highly regulated one. Free market healthcare is lasik and boob jobs. Both have come down in price because they are not part of the insurance system. They’ve also gone up in quality due to competition and demand.

Re: The Amish health care system

#132

Post by trentnix »

peter_d_sherman wrote: post #130

In general, the healthcare profession could do the same double-blind studies they do on drugs -- but on substances that are not patentable, such as vitamins, minerals, fruits, vegetables, natural herbs and plants, etc. They could even do double-blind studies on things that are not ingestable, like sunlight, doing enough exercise, getting enough rest, etc., etc. But will they, ever? No they will not. That's because th…

They could even do double-blind studies on things that are not ingestable, like sunlight, doing enough exercise, getting enough rest, etc., etc.

Is there any great mystery as to the health benefits of each of those items you mentioned that has gone unanswered?

Undoubtedly resources are commonly committed where there is opportunity for a return on that investment, but there are decades of research (and plenty of anecdotes too!) on each of the items you mentioned. I just don’t think they are packaged in a way you like.

I think of myself as a skeptic when it comes to healthcare and healthcare professionals - mostly because of the bravado and certainty healthcare professionals exude regarding the actual utility of what they think they know (which is, embarrassingly, not much much more than your average self-aware and discerning Joe or Jane Public). But even as skeptical as I am, I think you characterize healthcare, healthcare professionals, and the business of healthcare too cynically.

Re: The Amish health care system

#133

Post by Balgair »

da02 wrote: post #93
a2tech wrote: post #19

Yeah...just no. The Amish are not a group you should be modeling yourself after. I grew up surrounded by the Amish and the clean living salt of the earth myth is simply that—a myth.

Can you provide more details of what occurred? I'm curious and would like more info. since I never lived near any Amish people.

https://en.wikipedia.org/wiki/Rumspringa

https://www.npr.org/2020/01/19/797804404/investigation-into-...

The Amish are insular and unique, but they are humans just like the rest of us. Working hard and using electricity, or not, is independent of human nature and all it's failings.

Re: The Amish health care system

#134

Post by mixmastamyk »

peter_d_sherman wrote: post #130

In general, the healthcare profession could do the same double-blind studies they do on drugs -- but on substances that are not patentable, such as vitamins, minerals, fruits, vegetables, natural herbs and plants, etc. They could even do double-blind studies on things that are not ingestable, like sunlight, doing enough exercise, getting enough rest, etc., etc. But will they, ever? No they will not. That's because th…

That’s what universities and government are for.

Re: The Amish health care system

#135

Post by rayhendricks »

peter_d_sherman wrote: post #130

In general, the healthcare profession could do the same double-blind studies they do on drugs -- but on substances that are not patentable, such as vitamins, minerals, fruits, vegetables, natural herbs and plants, etc. They could even do double-blind studies on things that are not ingestable, like sunlight, doing enough exercise, getting enough rest, etc., etc. But will they, ever? No they will not. That's because th…

There are very extensive studies done on non-patentable lifestyle choices/activity/smoking which have had similar results over the last 70 odd years. These include the nurses study [0], the bus drivers/conductors study [1] and also the [2] Farmington heart study. The overarching findings here: maintain a healthy BMI (weight), maintain a healthy blood pressure, be active like 10k steps/day active, don’t eat too much processed foods. This will cut incidence of chronic disease a lot, although there will still be the outlier of a healthy 25/yo runner that does of pancreatic cancer due to genetics bc this is inevitable. This has been known forever, however no one wants to follow it because we have fat and sugar in everything.

Of course if we cared about preventive healthcare in the United States we could also greatly reduce the incidence of chronic disease and free up $$ for actually researching interesting aspects of disease and not just putting out fires.

[0] https://en.m.wikipedia.org/wiki/Nurses%27_Health_Study [1] https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC2027... [2] https://en.m.wikipedia.org/wiki/Framingham_Heart_Study

Re: The Amish health care system

#136

Post by grandmczeb »

peter_d_sherman wrote: post #130

In general, the healthcare profession could do the same double-blind studies they do on drugs -- but on substances that are not patentable, such as vitamins, minerals, fruits, vegetables, natural herbs and plants, etc. They could even do double-blind studies on things that are not ingestable, like sunlight, doing enough exercise, getting enough rest, etc., etc. But will they, ever? No they will not. That's because th…

> the healthcare profession could do the same double-blind studies they do on drugs -- but on substances that are not patentable

But... they do? Pretty much everything you mentioned is well studied, although a lot of times it’s hard to get conclusive evidence when the effect size is small.

Re: The Amish health care system

#137

Post by asveikau »

arkades wrote: post #111
motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

Everyone with absolutely no knowledge of our healthcare system "look(s) at the medical profession as the racket it is." They then proceed to point at things as the root cause that every health policy expert in the country can tell you is not the root cause, and that doesn't hold up to even slight scrutiny by comparison with other, similar, countries.

Could that just be a way of saying that health policy experts are attached to the status quo? Do they have a consensus on how to fix commonly cited problems, and agreement that we ought to?

Re: The Amish health care system

#138

Post by lukifer »

motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

"Do no harm" sounds suspiciously like "don't be evil": https://en.wikipedia.org/wiki/Iatrogenesis

Just as with politics, it's mostly well-intentioned, "good people in a bad system"; nonetheless, each individual is perversely-incentivized to normalize the moral hazard.

Re: The Amish health care system

#139

Post by mrtksn »

motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

So does the developers. Anyone can code and do %90 of what a developer can do with a very little training.

Yet, these are highly paid jobs because It’s not about being able to do it, it’s about understanding what they are doing. This way, they don’t just know how to do it but why to do it and what are the implications of doings it and how to debug it when the outcome is not the expected one.

Any junior can probably do %99 of what their seniors can do, yet when you look for a highly paid senior you don’t take a cheap junior as an option.

US health system might be a racket but not the health profession. No where else visiting a hospital is a financial decision(yet the med staff is still well paid), you only worry about the medical issue and it’s impact on your life and the lives of your loved ones, except maybe when you need some very novel treatment for your rare condition.

I have to add that this way of thinking, in general, is a very blue collar mental model on how world works. Nurses claim that they can do what doctors do, mechanics claim that they can do what engineers do all the time.

Re: The Amish health care system

#140

Post by HeadsUpHigh »

motohagiography wrote: post #97

Why does nobody look at the medical profession as the racket it is? You don't need to be an MD to handle %80 of hospital visits, and you can train trades people to handle most emergencies. Insurance companies are awful, but seriously, we can train field medics to do stitches and set bones, why should it cost $3000 to have an MD do it? Listening the hand wringing about it is infuriating when you realize that the reaso…

Because it's not. If you actually look at the numbers doctors only get about 1/3 of the money. Furthermore with the kind of money you have to loan it would make no financial sense to become a doctor. Noone is having a good time with this system. Doctors want the insane amounts of work and stress coming from the lack of personnel that justify the salaries just so they can pay the student loans.
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