4 ms·

Disingenuously left out of your arguments here is the fact that a medical education costs a hell of a lot of money, and your economic measures would remove the

Disingenuously left out of your arguments here is the fact that a medical education costs a hell of a lot of money, and your economic measures would remove the ability to study medicine from a lot of people who might be willing to learn, but don't have massively rich parents. Deregulating university fees, getting rid of social security, and so fourth massively reduces the number of people who are able to study medicine.

maxharris 10y ago
Disingenuously left out of your arguments here First, this is way out of line. I'm going to reply anyway, but please don't do this kind of thing in your next reply. Second, instead of treating it like a black box that has a fixed cost that we have to accept, take a medical education apart the way Musk would do when figuring the ultimate cost of one his cars or rockets: Putting people in a room, books in their hands, and having them sit in front of a lecturer is not actually that expensive. I won't name names, but two medical students I knew in the last fifteen years actually skipped most of their lectures, studied straight out of the book and did just fine. It is true that the hands-on aspect of medical training is more expensive, but people in much poorer countries manage to do it. Even if you managed to show that this education outlined above is inferior to the ones available today, right now I'd still be overjoyed to see a doctor educated in this manner. It's better than waiting two months (note that this is not even for treatment - it's just a biopsy!) while I can feel this thing getting bigger, with sharper pain as time goes on. Finally, what is the point here? An more economically "equal" society, or a society where people like me don't die waiting in line for care? I stridently advocate for the latter.
- ZenPsycho 10y ago
  "Finally, what is the point here? An more economically "equal" society, or a society where people like me don't die waiting in line for care? I stridently advocate for the latter." this is a false dichotomy. To get more doctors you need more people who can afford the education. Not less. I'd say check your privilege- Any of those options you listed for getting an education still take a vastly greater amount of resources, than you are giving credit for. You can't study out of a book if you don't have a house to live in. as for whether my comment was out of line, I'd say if your argument is to take away government subsidy for infrastructure, force people to pay for their own education, leaving out the basic costs of the education is a critical part of the argument you left out, and for a transparently self serving purpose.
  - maxharris 10y ago
    > I'd say check your privilege That is not the right advice for any human being, no matter where they start. I'm fighting for my life right now - a life I had to strive for. I don't take a moment for granted, even with the pain and the uncertainty that I'm under right now. I paid for my education (UW-Madison, class of 2011). I've never wanted anything but to earn my place in the world. You say that I'm motivated by a self-serving purpose? You're goddamned right that I am. I have the moral right (like anyone else) to strive for existence, your ideas be damned.
    - ZenPsycho 10y ago
      When I say self serving purpose, I mean your Ayn Randian ideology. What you are arguing for would actually produce fewer doctors.
      - maxharris 10y ago
        How would removing a federal cap on doctor training - that our own congress wrote into law in 1999 - produce fewer doctors? (https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html)
        ZenPsycho 10y ago
        Sorry, I misread your original post. 180 degrees off from what I thought you wrote. In your link, it looks like putting a cap on residents that can join educating hospitals is in place as a measure to save on medicare costs. it seems like training doctors is the sort of thing a country should be pouring more money into, as an investment in the future.
- TFYS 10y ago
  > Finally, what is the point here? An more economically "equal" society, or a society where people like me don't die waiting in line for care? I stridently advocate for the latter. So only the amount of economic value a person can produce should decide the value of the persons life, is that what you are saying? The more money you have, the more your life is worth? This kind of neoliberal ideology sounds absolutely horrible to me. Just because you have the ability to produce more than some other person doesn't mean that your life is more important. What you are experiencing now with the wait is nothing compared to what poor people would have to endure in the system you advocate.
  - maxharris 10y ago
    What you are experiencing now with the wait is nothing compared to what poor people would have to endure in the system you advocate. First, you do realize that not everyone that goes into the hospital today comes back out alive, right? There are a lot of things medicine can't yet cure - today - for any price. Second, if you block high-priced medical advances, you are also blocking the low-priced ones that inevitably follow in a free market. Just as UNIX workstations sold for tens of thousands in the early 1990s, and were supplanted by desktop computers costing a tenth as much in the following decade, expensive medical technology would become cheap quickly under freedom. We haven't seen this happen with most of medicine because of the controls placed on it. For example, I learned (via this thread) of a new machine that administers anesthesia. Its use would make my biopsy $1800 cheaper, in addition to reducing my wait time (you can't have an endoscopy without general anesthesia): https://www.washingtonpost.com/business/economy/new-machine-could-one-day-replace-anesthesiologists/2015/05/11/92e8a42c-f424-11e4-b2f3-af5479e6bbdd_story.html https://www.washingtonpost.com/business/economy/new-machine-... This device was ready to go six years ago, but the FDA rejected it initially (under pressure from anesthesiologists). Three years later, after much foot-dragging, it finally approved it. And yet today it's not available in most places because the American Society of Anesthesiologists lobbied hard for a "narrow indication" and "restrictive guidelines." Note that it's not up me or my doctor as to whether or not I might opt-in to this. Nor is it even a choice that can be made by any of the local hospitals around me (I would shop around if it would help, believe me!) What happened here is a direct and inevitable consequence of regulatory control over which innovations are permitted to enter medical use. (The only tool the government has in regulatory matters is more regulation or less. Therefore there is no way to prevent regulatory capture in a mixed economy except to steadily de-control it.) What good is it to me that the device has been vetted more? Every minute I wait allows my condition to worsen, increasing my risk of death. The facts I've outlined here are not just some "neoliberal ideology" intended to offend you. This is a thing that I (and hundreds of thousands of other people like me) need desperately. All I'm advocating for is a society that recognizes the life-saving role of freedom in medicine. And I'm advocating for that only because nothing else could possibly work. You can't just throw your hands up in the air and say "to heck with early adopters, they shouldn't be allowed to pay more to be a year ahead!" If the government forced all the tech companies to do that, tech would be about as slow to improve as medicine currently is. This is because there would be no money put into the right hands (and it is a constantly changing group of people and organizations), at the right time to make the technology steadily improve.

maxharris 10y ago

Disingenuously left out of your arguments here First, this is way out of line. I'm going to reply anyway, but please don't do this kind of thing in your next reply. Second, instead of treating it like a black box that has a fixed cost that we have to accept, take a medical education apart the way Musk would do when figuring the ultimate cost of one his cars or rockets: Putting people in a room, books in their hands, and having them sit in front of a lecturer is not actually that expensive. I won't name names, but two medical students I knew in the last fifteen years actually skipped most of their lectures, studied straight out of the book and did just fine. It is true that the hands-on aspect of medical training is more expensive, but people in much poorer countries manage to do it. Even if you managed to show that this education outlined above is inferior to the ones available today, right now I'd still be overjoyed to see a doctor educated in this manner. It's better than waiting two months (note that this is not even for treatment - it's just a biopsy!) while I can feel this thing getting bigger, with sharper pain as time goes on. Finally, what is the point here? An more economically "equal" society, or a society where people like me don't die waiting in line for care? I stridently advocate for the latter.

ZenPsycho 10y ago
"Finally, what is the point here? An more economically "equal" society, or a society where people like me don't die waiting in line for care? I stridently advocate for the latter." this is a false dichotomy. To get more doctors you need more people who can afford the education. Not less. I'd say check your privilege- Any of those options you listed for getting an education still take a vastly greater amount of resources, than you are giving credit for. You can't study out of a book if you don't have a house to live in. as for whether my comment was out of line, I'd say if your argument is to take away government subsidy for infrastructure, force people to pay for their own education, leaving out the basic costs of the education is a critical part of the argument you left out, and for a transparently self serving purpose.
- maxharris 10y ago
  > I'd say check your privilege That is not the right advice for any human being, no matter where they start. I'm fighting for my life right now - a life I had to strive for. I don't take a moment for granted, even with the pain and the uncertainty that I'm under right now. I paid for my education (UW-Madison, class of 2011). I've never wanted anything but to earn my place in the world. You say that I'm motivated by a self-serving purpose? You're goddamned right that I am. I have the moral right (like anyone else) to strive for existence, your ideas be damned.
  - ZenPsycho 10y ago
    When I say self serving purpose, I mean your Ayn Randian ideology. What you are arguing for would actually produce fewer doctors.
    - maxharris 10y ago
      How would removing a federal cap on doctor training - that our own congress wrote into law in 1999 - produce fewer doctors? (https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html https://www.aamc.org/advocacy/gme/71178/gme_gme0012.html)
      - ZenPsycho 10y ago
        Sorry, I misread your original post. 180 degrees off from what I thought you wrote. In your link, it looks like putting a cap on residents that can join educating hospitals is in place as a measure to save on medicare costs. it seems like training doctors is the sort of thing a country should be pouring more money into, as an investment in the future.
TFYS 10y ago
> Finally, what is the point here? An more economically "equal" society, or a society where people like me don't die waiting in line for care? I stridently advocate for the latter. So only the amount of economic value a person can produce should decide the value of the persons life, is that what you are saying? The more money you have, the more your life is worth? This kind of neoliberal ideology sounds absolutely horrible to me. Just because you have the ability to produce more than some other person doesn't mean that your life is more important. What you are experiencing now with the wait is nothing compared to what poor people would have to endure in the system you advocate.
- maxharris 10y ago
  What you are experiencing now with the wait is nothing compared to what poor people would have to endure in the system you advocate. First, you do realize that not everyone that goes into the hospital today comes back out alive, right? There are a lot of things medicine can't yet cure - today - for any price. Second, if you block high-priced medical advances, you are also blocking the low-priced ones that inevitably follow in a free market. Just as UNIX workstations sold for tens of thousands in the early 1990s, and were supplanted by desktop computers costing a tenth as much in the following decade, expensive medical technology would become cheap quickly under freedom. We haven't seen this happen with most of medicine because of the controls placed on it. For example, I learned (via this thread) of a new machine that administers anesthesia. Its use would make my biopsy $1800 cheaper, in addition to reducing my wait time (you can't have an endoscopy without general anesthesia): https://www.washingtonpost.com/business/economy/new-machine-could-one-day-replace-anesthesiologists/2015/05/11/92e8a42c-f424-11e4-b2f3-af5479e6bbdd_story.html https://www.washingtonpost.com/business/economy/new-machine-... This device was ready to go six years ago, but the FDA rejected it initially (under pressure from anesthesiologists). Three years later, after much foot-dragging, it finally approved it. And yet today it's not available in most places because the American Society of Anesthesiologists lobbied hard for a "narrow indication" and "restrictive guidelines." Note that it's not up me or my doctor as to whether or not I might opt-in to this. Nor is it even a choice that can be made by any of the local hospitals around me (I would shop around if it would help, believe me!) What happened here is a direct and inevitable consequence of regulatory control over which innovations are permitted to enter medical use. (The only tool the government has in regulatory matters is more regulation or less. Therefore there is no way to prevent regulatory capture in a mixed economy except to steadily de-control it.) What good is it to me that the device has been vetted more? Every minute I wait allows my condition to worsen, increasing my risk of death. The facts I've outlined here are not just some "neoliberal ideology" intended to offend you. This is a thing that I (and hundreds of thousands of other people like me) need desperately. All I'm advocating for is a society that recognizes the life-saving role of freedom in medicine. And I'm advocating for that only because nothing else could possibly work. You can't just throw your hands up in the air and say "to heck with early adopters, they shouldn't be allowed to pay more to be a year ahead!" If the government forced all the tech companies to do that, tech would be about as slow to improve as medicine currently is. This is because there would be no money put into the right hands (and it is a constantly changing group of people and organizations), at the right time to make the technology steadily improve.