2 ms·

Is that a serious comment? I'm typing this on a quad core with 2 21" monitors. My cell phone has more capabilities than my computer did a decade ago. Way mor

by jbooth 17y ago

Is that a serious comment? I'm typing this on a quad core with 2 21" monitors. My cell phone has more capabilities than my computer did a decade ago. Way more people have computers, smartphones, etc than 10 years ago. Bodies haven't double transistor counts. More to the point, there are actually fewer people insured as a % of the population than there were a decade ago, and the population has certainly not been growing at 15% a year. You're probably big on curbing gov't spending.. go walk down to your local town/city hall, get a copy of the budget now and 10 years ago, take a look at the difference in healthcare spending.

yummyfajitas 17y ago
Today, medicine has more capabilities than 10 years ago. There are all sorts of medical technologies today which were available to few/no people 10 years ago. Roughly 10/17 of all non-generic drugs were invented in the past 10 years. It's more or less the same situation: new technology creates more features, and people are willing to spend more on those features. So yes, it was a serious comment. You stated a criteria which should trigger reform, namely 15% growth/year. Are you willing to apply this criteria uniformly, or is it really just a made up post-hoc rationalization for your already existing beliefs?
- jbooth 17y ago
  Yes, if you can find a single example in the economy where something's a basic necessity (or even a commonly owned luxury) and we're dealing with a 15% increase in unit costs per year, then that's something badly broken. I wouldn't argue for gov't involvement in reform unless it were a basic necessity, luxuries tend to work themselves out through the market, charge too much and people won't buy. What we're seeing with these price increases isn't people loving health insurance so much they want to buy more of it. It's people being forced to pay more and more for a necessity because if they don't have insurance, a broken arm means bankruptcy or close to it. There's no functioning market.
  - yummyfajitas 17y ago
    Why do you believe that increases in health care costs are due to increases in the cost of basic necessities? How do you know the increase is not due to spending on unnecessary medicine? In fact, there is compelling evidence that this is the case. Most studies show that a considerable fraction of medical spending is on medicine which provides no health benefit whatsoever. See this comment for a link to some review articles: http://news.ycombinator.com/item?id=1140658 http://news.ycombinator.com/item?id=1140658 So indeed, people love medicine so much that they want to buy more of it. They buy all sorts of medicine which doesn't even make them healthier. Also, trauma care (broken arms, car crashes) is not a major driver of medical costs.
    - jbooth 17y ago
      That's all true. So how come, without insurance, it costs me $500 for a bottle of antibiotics? Insurance is a necessity, and I'm chained to all the profiteering and idiocity going on in the industry. I can't opt out, because even though a broken arm isn't a "major driver of medical costs", it would clean me out pretty good. 3 visits with xrays, the cast, some meds.. you're talking about 10k getting billed there. Maybe not quite bankruptcy but a lifestyle change for sure. Especially when you consider that the hospital charges me twice as much as they would charge my insurer, due to a byzantine, broken billing system. (interlude -- none of those things have a good reason to go up by 15% a year. X rays, antibiotics and opiates have been around for a century.) So basically, I'm roped into paying a monthly total into this ridiculously broken system because if I don't, the cost of routine, cheapo medical care would bankrupt me. Maybe not this year, but eventually the dice would come up snake eyes for me. I have no option to take my business elsewhere -- that's market failure. Here's another good article on busted incentives that I linked below: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_... One town in texas has double the national average in healthcare spending. Really interesting article on why, compared to the cheapest towns for healthcare -- it has nothing to do with health.
      - yummyfajitas 17y ago
CWuestefeld 17y ago
I'm typing this on a quad core with 2 21" monitors. My cell phone has more capabilities than my computer did a decade ago. Way more people have computers, Ummm. That's precisely the point. Your phone and PC are more complex, with more capability, and more other people are using such devices. The exact same thing is driving increased spending in healthcare. The previous comment stands. More to the point, there are actually fewer people insured as a % of the population And yet virtually all of those uninsured people already get medical care. If they have an acute need and go to the emergency room, they will be served. I don't mean to say that the system is perfect -- indeed, it's badly broken. But misrepresenting the problem doesn't get it fixed. At best, it fixes a problem that doesn't exist because it's targeted at the wrong thing!
- jbooth 17y ago
  Well, I'm glad that we agree the system is broken. I really think you're underestimating how big 15% a year is over a decade. Regarding the statement about people without insurance already getting medical care -- you're ignoring the fact they're going to be saddled with a $20k medical bill afterwards. Sure, they can declare bankruptcy, but who wins then? Me, paying my share of the hospital visit that could have been avoided had the person been getting regular checkups? The system's ridiculously broken. Seriously, go find your local government budgets and look at how much money is being spent on medical care compared to 10 years ago. That's money that could be in your pocket or in your community via more school spending, better road upkeep or whatever. Then apply the same savings to every private US-based product or service you buy, if they're giving their employees health insurance, you're paying for it. Healthcare investments in technology should be reducing costs. Like in electronics. They're increasing them instead. That's badly broken.
  - CWuestefeld 17y ago
    Healthcare investments in technology should be reducing costs. And they are. As far as I can see, this is just another example of class warfare and envy. The fact is that even the poorest are better off medically than any point in the past. Because we've now got antibiotics, advanced imaging tech, minimally-invasive surgery -- all things available even to the poorest through Medicare or bad-debt writeoffs in the hospital -- more people can get better care than ever before. But those things came about because at the beginning, the developers were able to make a killing (excuse the pun) when they sold it. It was the willingness of the more affluent to spend so much that brought about the economies of scale that now let us produce so many of the standard treatments for so little (how much does something like basic antibiotics cost now, even for the uninsured?). Trying to control the costs of those early treatments that are still in the "pay off the investment" phase of their lifecycle is killing the goose that lays the golden eggs. I wish I could afford the same treatments that the zillionaires get today. But I know that in a not-too-long time those same treatments will become available to my economic means.

by jbooth 17y ago

yummyfajitas 17y ago

Today, medicine has more capabilities than 10 years ago. There are all sorts of medical technologies today which were available to few/no people 10 years ago. Roughly 10/17 of all non-generic drugs were invented in the past 10 years. It's more or less the same situation: new technology creates more features, and people are willing to spend more on those features. So yes, it was a serious comment. You stated a criteria which should trigger reform, namely 15% growth/year. Are you willing to apply this criteria uniformly, or is it really just a made up post-hoc rationalization for your already existing beliefs?

jbooth 17y ago
Yes, if you can find a single example in the economy where something's a basic necessity (or even a commonly owned luxury) and we're dealing with a 15% increase in unit costs per year, then that's something badly broken. I wouldn't argue for gov't involvement in reform unless it were a basic necessity, luxuries tend to work themselves out through the market, charge too much and people won't buy. What we're seeing with these price increases isn't people loving health insurance so much they want to buy more of it. It's people being forced to pay more and more for a necessity because if they don't have insurance, a broken arm means bankruptcy or close to it. There's no functioning market.
- yummyfajitas 17y ago
  Why do you believe that increases in health care costs are due to increases in the cost of basic necessities? How do you know the increase is not due to spending on unnecessary medicine? In fact, there is compelling evidence that this is the case. Most studies show that a considerable fraction of medical spending is on medicine which provides no health benefit whatsoever. See this comment for a link to some review articles: http://news.ycombinator.com/item?id=1140658 http://news.ycombinator.com/item?id=1140658 So indeed, people love medicine so much that they want to buy more of it. They buy all sorts of medicine which doesn't even make them healthier. Also, trauma care (broken arms, car crashes) is not a major driver of medical costs.
  - jbooth 17y ago
    That's all true. So how come, without insurance, it costs me $500 for a bottle of antibiotics? Insurance is a necessity, and I'm chained to all the profiteering and idiocity going on in the industry. I can't opt out, because even though a broken arm isn't a "major driver of medical costs", it would clean me out pretty good. 3 visits with xrays, the cast, some meds.. you're talking about 10k getting billed there. Maybe not quite bankruptcy but a lifestyle change for sure. Especially when you consider that the hospital charges me twice as much as they would charge my insurer, due to a byzantine, broken billing system. (interlude -- none of those things have a good reason to go up by 15% a year. X rays, antibiotics and opiates have been around for a century.) So basically, I'm roped into paying a monthly total into this ridiculously broken system because if I don't, the cost of routine, cheapo medical care would bankrupt me. Maybe not this year, but eventually the dice would come up snake eyes for me. I have no option to take my business elsewhere -- that's market failure. Here's another good article on busted incentives that I linked below: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_... One town in texas has double the national average in healthcare spending. Really interesting article on why, compared to the cheapest towns for healthcare -- it has nothing to do with health.
    - yummyfajitas 17y ago

CWuestefeld 17y ago

I'm typing this on a quad core with 2 21" monitors. My cell phone has more capabilities than my computer did a decade ago. Way more people have computers, Ummm. That's precisely the point. Your phone and PC are more complex, with more capability, and more other people are using such devices. The exact same thing is driving increased spending in healthcare. The previous comment stands. More to the point, there are actually fewer people insured as a % of the population And yet virtually all of those uninsured people already get medical care. If they have an acute need and go to the emergency room, they will be served. I don't mean to say that the system is perfect -- indeed, it's badly broken. But misrepresenting the problem doesn't get it fixed. At best, it fixes a problem that doesn't exist because it's targeted at the wrong thing!

jbooth 17y ago
Well, I'm glad that we agree the system is broken. I really think you're underestimating how big 15% a year is over a decade. Regarding the statement about people without insurance already getting medical care -- you're ignoring the fact they're going to be saddled with a $20k medical bill afterwards. Sure, they can declare bankruptcy, but who wins then? Me, paying my share of the hospital visit that could have been avoided had the person been getting regular checkups? The system's ridiculously broken. Seriously, go find your local government budgets and look at how much money is being spent on medical care compared to 10 years ago. That's money that could be in your pocket or in your community via more school spending, better road upkeep or whatever. Then apply the same savings to every private US-based product or service you buy, if they're giving their employees health insurance, you're paying for it. Healthcare investments in technology should be reducing costs. Like in electronics. They're increasing them instead. That's badly broken.
- CWuestefeld 17y ago
  Healthcare investments in technology should be reducing costs. And they are. As far as I can see, this is just another example of class warfare and envy. The fact is that even the poorest are better off medically than any point in the past. Because we've now got antibiotics, advanced imaging tech, minimally-invasive surgery -- all things available even to the poorest through Medicare or bad-debt writeoffs in the hospital -- more people can get better care than ever before. But those things came about because at the beginning, the developers were able to make a killing (excuse the pun) when they sold it. It was the willingness of the more affluent to spend so much that brought about the economies of scale that now let us produce so many of the standard treatments for so little (how much does something like basic antibiotics cost now, even for the uninsured?). Trying to control the costs of those early treatments that are still in the "pay off the investment" phase of their lifecycle is killing the goose that lays the golden eggs. I wish I could afford the same treatments that the zillionaires get today. But I know that in a not-too-long time those same treatments will become available to my economic means.