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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

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.
  - jbooth 17y ago
    Well, now you're at least circling the real issue. To start with, why are we bankrolling the world's R&D? Here's a great illustration of what I think is the real issue, borked incentives: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_... This one town in Texas, average demographics, not particularly less healthy than anywhere else, has double the average healthcare costs. Why? It's a racket -- the doctors are in league with the equipment manufacturers and just recommend that their own stuff is purchased, over prescribing a ton of artificially expensive and btw, unnecessary procedures. That's market failure. BTW -- "class warfare" isn't in my lexicon. I'm doing plenty ok. Put down the flash cards :)
_delirium 17y ago
It's not clear to me that medicine actually has "more capability" than a decade ago in the same way that computers are today objectively faster. Studies attempting to show improvement in outcomes due to improvements in medicine tend to be inconclusive or negative for most areas, though there've been improvements in a few narrow ones (like HIV prognosis). For most diseases, though, your probabilities basically haven't budged in the past 20 years. In any case, I see the analogy as pushing the opposite viewpoint: in computers I get more capability for less money than a decade ago. I used to have to spend $2000 for a decent laptop, but now I spend $700. Why can't I get better medicine than a decade ago for >50% discount? Does the medical field not make technological advances in the same way as computing, that make existing technology get cheaper over time?

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.
- jbooth 17y ago
  Well, now you're at least circling the real issue. To start with, why are we bankrolling the world's R&D? Here's a great illustration of what I think is the real issue, borked incentives: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_... This one town in Texas, average demographics, not particularly less healthy than anywhere else, has double the average healthcare costs. Why? It's a racket -- the doctors are in league with the equipment manufacturers and just recommend that their own stuff is purchased, over prescribing a ton of artificially expensive and btw, unnecessary procedures. That's market failure. BTW -- "class warfare" isn't in my lexicon. I'm doing plenty ok. Put down the flash cards :)

_delirium 17y ago

It's not clear to me that medicine actually has "more capability" than a decade ago in the same way that computers are today objectively faster. Studies attempting to show improvement in outcomes due to improvements in medicine tend to be inconclusive or negative for most areas, though there've been improvements in a few narrow ones (like HIV prognosis). For most diseases, though, your probabilities basically haven't budged in the past 20 years. In any case, I see the analogy as pushing the opposite viewpoint: in computers I get more capability for less money than a decade ago. I used to have to spend $2000 for a decent laptop, but now I spend $700. Why can't I get better medicine than a decade ago for >50% discount? Does the medical field not make technological advances in the same way as computing, that make existing technology get cheaper over time?