4 ms·

It boots nothing to subsidize that which is in restricted supply. So long as there are only 350 othodontists allowed to graduate per year, there's a correspond

by Eliezer 10y ago

It boots nothing to subsidize that which is in restricted supply. So long as there are only 350 othodontists allowed to graduate per year, there's a corresponding limit on how many patients are allowed to have straight teeth regardless of who pays for what or what software is used. Improve the software, and the price of orthodontia must still equalize demand to the limited supply. Offer free dollar bills, and a line will form until the cost of staying in line burns more than $1. Medicine isn't costly because it's inefficient, rather it can end up inefficient because the limited supply means it must somehow end up costly. It is not possible to solve the healthcare crisis without somewhat deregulating the supply of healthcare and allowing it to increase. Until then, every subsidy just raises the price, and every efficiency improvement just creates room for more inefficiency elsewhere. You can't solve the housing problem in San Francisco by building more efficient software for selling houses. Only interventions that somehow increase the total supply of living space can cause more total people to be able to live there.

lkbm 10y ago
The article claims that 40% of the cost is operational inefficiencies, fraud, and ineffective care citing [0]. If all orthodontists are fully occupied and there's no demand being cut, then yes, removing those inefficiencies will just boost orthodontic pay. But it sounds like at least some of those inefficiencies involve: 1. People getting unnecessary orthodontic treatments (eliminating those cuts demand [not just quantity demanded]) 2. People getting ineffective treatments and needing a second treatment (same as 1) 3. Orthodontists being allocated in a way that lowers their overall productivity--empty time in their schedules, doing stuff they're less skilled at, etc. If my orthodontist spends less time on administrivia or repeat procedures, he can fix more people's teeth without us training a second orthodontist. Similarly, if there are apartments sitting empty for a month because it's hard to match people with apartments, better software can fit more people into San Francisco. (Going deeper, my bedroom is empty 12+ hours a day. I could totally sublet it to someone who works the night shift. I just need an efficient system to find such a person who's as interested in saving money as much as I am. Or as much as I was a few years ago. Now, I might not opt for this plan.) [0] http://www.who.int/whr/2010/10_summary_en.pdf?ua=1 http://www.who.int/whr/2010/10_summary_en.pdf?ua=1
coolgeek 10y ago
> So long as there are only 350 othodontists allowed to graduate per year I'm (moreso, but not completely) sympathetic to this argument when we're talking about (significantly) lesser skilled providers such as barbers or taxi drivers. But in the context of health care providers, you're hand-waving the inescapable fact that there is a fundamental limitation in the supply of persons capable of acquiring the education and skills, and delivering competent patient services. I've worked at a top 2 US dental school. I've seen that - even there - there were students that couldn't hack it and failed out. Others failed to graduate on time, requiring remedial and/or additional work. The relative quality of students generally correlates with the relative quality of the school. So it's relatively downhill from there. Now, maybe the natural limit is higher than the limit you cite. (Is that even some kind of mandated (by whomever) limit, or is it simply the result of the limited number of seats available in accredited dental schools. If it's the latter, is it really honest to say "allowed")? Or maybe the work in orthodonture could be unbundled in such a way that much of it could be delivered by lesser skilled, and thus less costly providers. But this is a poor - and lazy - argument.

by Eliezer 10y ago

lkbm 10y ago

The article claims that 40% of the cost is operational inefficiencies, fraud, and ineffective care citing [0]. If all orthodontists are fully occupied and there's no demand being cut, then yes, removing those inefficiencies will just boost orthodontic pay. But it sounds like at least some of those inefficiencies involve: 1. People getting unnecessary orthodontic treatments (eliminating those cuts demand [not just quantity demanded]) 2. People getting ineffective treatments and needing a second treatment (same as 1) 3. Orthodontists being allocated in a way that lowers their overall productivity--empty time in their schedules, doing stuff they're less skilled at, etc. If my orthodontist spends less time on administrivia or repeat procedures, he can fix more people's teeth without us training a second orthodontist. Similarly, if there are apartments sitting empty for a month because it's hard to match people with apartments, better software can fit more people into San Francisco. (Going deeper, my bedroom is empty 12+ hours a day. I could totally sublet it to someone who works the night shift. I just need an efficient system to find such a person who's as interested in saving money as much as I am. Or as much as I was a few years ago. Now, I might not opt for this plan.) [0] http://www.who.int/whr/2010/10_summary_en.pdf?ua=1 http://www.who.int/whr/2010/10_summary_en.pdf?ua=1

coolgeek 10y ago

> So long as there are only 350 othodontists allowed to graduate per year I'm (moreso, but not completely) sympathetic to this argument when we're talking about (significantly) lesser skilled providers such as barbers or taxi drivers. But in the context of health care providers, you're hand-waving the inescapable fact that there is a fundamental limitation in the supply of persons capable of acquiring the education and skills, and delivering competent patient services. I've worked at a top 2 US dental school. I've seen that - even there - there were students that couldn't hack it and failed out. Others failed to graduate on time, requiring remedial and/or additional work. The relative quality of students generally correlates with the relative quality of the school. So it's relatively downhill from there. Now, maybe the natural limit is higher than the limit you cite. (Is that even some kind of mandated (by whomever) limit, or is it simply the result of the limited number of seats available in accredited dental schools. If it's the latter, is it really honest to say "allowed")? Or maybe the work in orthodonture could be unbundled in such a way that much of it could be delivered by lesser skilled, and thus less costly providers. But this is a poor - and lazy - argument.