8 ms·

Healthcare and profit don't go together. This is just exhibit n° 31415926535897932384626433. What happens in the software world when you see twentyseven useles

Healthcare and profit don't go together. This is just exhibit n° 31415926535897932384626433. What happens in the software world when you see twentyseven useless levels of abstraction? Exactly the same. You smell a rat. In my ideal world: * Healthcare research funding to come from the public sector and donations only.[0] * Healthcare products can only be sold once the production process is verifiably fully publicly documented. This means independent reproduction by multiple reputable non-profits. * Market based generics manufacturers handle production. Competitors (for profit or non-profit) jump in if pricing gets out of hand. * Healthcare education free to students. * Only non-profit healthcare services allowed. * Compensation for people providing healthcare services is linked to median income. [0] This is not such a big difference as one would think, as more than half of the basic research in the field is actually publicly funded already.

arethuza 8y ago
"Only non-profit healthcare services allowed." Not sure if this is required - the UK manages to have a socialist health care system (the NHS) for the vast majority and a relatively small private healthcare system for those who want treatments not covered by the NHS, or a nicer room etc. I'm not sure I'd be happy with completely banning access to private healthcare - although I'd prefer it if the NHS was resourced to a level where there really wasn't much need to to go private (which certainly used to be the case).
- ollie87 8y ago
  The NHS is a partnership with the private sector any way, because GPs are greedy. All GP practices in the UK are privately run.
- Khaine 8y ago
  I wouldn't hold the NHS up as a paragon of virtue. I got sick on a recent trip to London and tried to get in to see a GP under the NHS and it was impossible. The clinics near my hotel only accepted same day bookings. I tried calling just after opening hours and the phone was engaged. I managed to get through 15 minutes after the clinic opened and the clinic was booked out for the day and I would have to call back the next day. I tried a number of clinics and they were all booked out. I was lucky that I wasn't that sick and got better. Otherwise, I was looking at an exorbitant fee to see a private doctor. I was shocked, as I always assumed that the NHS was better than the system we have in Australia. I think that there are lots of perverse incentives involved in Medicine and Healthcare. Government intervention is required to balance out these incentives from profit takers and consumers (i.e. smokers, obesity, etc). I'm not sure that any model in the world right now gets the balance right.
  - arethuza 8y ago
    Note my comment about "I'd prefer it if the NHS was resourced to a level".... The issue with not getting GP appointments quickly seems to have been a relatively recent thing - due to lack of resources and mismanagement rather than fundamental problems with the approach.
    - Ntrails 8y ago
      That's not entirely true. If you're actually emergent and require a same day apptmnt then they've got held appointments for you. However this has led to an extremely strange system where often GP receptionists are essentially gatekeeping services (as a pre requisite to accessing the GPs who gatekeep the other services...)
    - toasterlovin 8y ago
      > I'd prefer it if the NHS was resourced to a level You know what a great system for allocating resources in an incredibly complex system is? Prices.
- stronglikedan 8y ago
  > a relatively small private healthcare system for those who want treatments not covered by the NHS, or a nicer room etc. From what I've heard about the Charlie Gard [0] and Alfie Evans [1] cases, that isn't always allowed, and even being an Italian citizen or an offer from the Pope can't sway the decision [3]. [0] https://en.wikipedia.org/wiki/Charlie_Gard_case https://en.wikipedia.org/wiki/Charlie_Gard_case [1] https://en.wikipedia.org/wiki/Alfie_Evans_case https://en.wikipedia.org/wiki/Alfie_Evans_case [3] https://www.telegraph.co.uk/news/2018/04/23/protesters-storm-hospital-terminally-ill-alfie-evans-parents/ https://www.telegraph.co.uk/news/2018/04/23/protesters-storm...
  - namdnay 8y ago
    ??? Alfie Evans had nothing to do with the NHS not wanting to cover the treatment. From the first paragraph of the wikipedia article you linked to: > Alder Hey Children's NHS Foundation Trust sought a declaration that continued ventilatory support was "unkind and inhumane", and not in Evans' best interests
    - stronglikedan 8y ago
      Some people liken that to a "death panel", in that it was not unanimously agreed with by other medical professionals, including those that thought there may be other forms of treatment for the same affliction that were not being covered by the NHS.
      - Ntrails 8y ago
        Yes, doctors here (as, indeed, in most countries) can take cases to court when they believe the best interests of their patients are not being looked after by the legal guardians. And these are not mediocre doctors, nor was this being done lightly. The treatments not covered were not even approved for use in the UK privately afaik - it was entirely unrelated to the NHS budgets.
MertsA 8y ago
>31415926535897932384626433 This should be 31415926535897932384626434.
- deleted 8y ago
  [deleted]
- deleted 8y ago
  [deleted]
creaghpatr 8y ago
>Healthcare research funding to come from the public sector and donations only. And I suppose the public will indirectly vote on where research goes and where it does not? I don't trust any party in power to have a monopoly on healthcare research without a private sector counterbalance. But I'm open to reconsidering the current allocation.
- markvdb 8y ago
  The freedom to research would stay! If anything, researchers should have more freedom to research. An example. Imagine a researcher invents cheap medication that obviates the need for some kind of eye surgery. What would happen now? Surgeons don't like it, insurance companies don't like it. It might never catch on. The silly researcher certainly wouldn't get rewarded for his idiotic idea. What would happen in an ideal scenario? Better health with less side effects for the patients. Cheaper for the community.
  - lern_too_spel 8y ago
    Exactly. Institute proper nutrition at school lunch programs and easy access to clean water throughout the day, and watch what happens to healthcare costs, dental costs, test scores, etc. It costs more, but society currently pays the cost later times ten. Same with sunlight to prevent the onset of myopia, etc. These are things we already know about and can have huge impact, but it's politically infeasible to solve these problems correctly.
- jacobwilliamroy 8y ago
  I was watching some NASA scientists ask the federal government for money on C-SPAN and the NASA people said that they decide what research to fund by surveying the scientific community. I forget what they call the system exactly. EDIT: I found it. They use something called a "decadal survey" https://science.nasa.gov/earth-science/decadal-surveys https://science.nasa.gov/earth-science/decadal-surveys
  - craftyguy 8y ago
jbob2000 8y ago
This all assumes that healthcare is a human right, which I am not so sure about. Why should health education be free but not engineering education? I'd hazard an argument that not everyone deserves healthcare, so it would be difficult to make it a Right.
namdnay 8y ago
> Only non-profit healthcare services allowed Honestly, this isn't necessary, as long as you have single payer (or close to it). When the government is the one paying for 99% of healthcare, they have huge clout enforcing razor-thin margins and high efficiency on the provider side. Just look at how the massive supermarket chains are able to keep the margins of the upstream supply chain at a minimum.
- AnthonyMouse 8y ago
  > Honestly, this isn't necessary, as long as you have single payer (or close to it). When the government is the one paying for 99% of healthcare, they have huge clout enforcing razor-thin margins and high efficiency on the provider side. Just look at how the massive supermarket chains are able to keep the margins of the upstream supply chain at a minimum. The problem is that governments don't work that way. When a purchasing officer at a business negotiates a lower price he gets a large bonus. What does a Congressman get when he negotiates a lower price, compared to what he gets (from the people he's negotiating with) if he "negotiates" a higher price? What about the government bureaucrat who will be working in that industry soon? That is the problem. Meanwhile who is more knowledgeable about produce if you have a question, the staff at Walmart or the farmers at the local farmer's market? It's easy to order cost cutting from the top of the tower, but if you don't know what's happening on the ground, you don't know what you're actually cutting. What you need is for people -- the people who are actually consuming services and can choose to go somewhere else if the price is wrong -- to be able to choose based on published price information. The argument people sometimes make about this is that you don't get to choose which hospital an ambulance takes you to when you're unconscious, but the majority of healthcare spending isn't that, and that doesn't explain why we have no price transparency for non-emergency surgical procedures or diabetes or cancer treatment.
  - namdnay 8y ago
    > The problem is that governments don't work that way Well, they can... Just look at France. Amazing healthcare, a lot of it private, relatively cheap > What does a Congressman get Nothing, they don't negotiate > What about the government bureaucrat A performance bonus, a raise, a promotion? Just like any other organisation? > What you need is for people to be able to choose based on published price information OK, go and buy a pound of ground meat. Or an LCD screen. Are you seriously telling me you can get a better deal than McDonalds or Apple?
conanbatt 8y ago
If the us tried to become your ideal world, you would lose a huge chunk of the doctors you have, and the amount of medical services you would provide will be lower than it is today.

arethuza 8y ago

"Only non-profit healthcare services allowed." Not sure if this is required - the UK manages to have a socialist health care system (the NHS) for the vast majority and a relatively small private healthcare system for those who want treatments not covered by the NHS, or a nicer room etc. I'm not sure I'd be happy with completely banning access to private healthcare - although I'd prefer it if the NHS was resourced to a level where there really wasn't much need to to go private (which certainly used to be the case).

ollie87 8y ago
The NHS is a partnership with the private sector any way, because GPs are greedy. All GP practices in the UK are privately run.
Khaine 8y ago
I wouldn't hold the NHS up as a paragon of virtue. I got sick on a recent trip to London and tried to get in to see a GP under the NHS and it was impossible. The clinics near my hotel only accepted same day bookings. I tried calling just after opening hours and the phone was engaged. I managed to get through 15 minutes after the clinic opened and the clinic was booked out for the day and I would have to call back the next day. I tried a number of clinics and they were all booked out. I was lucky that I wasn't that sick and got better. Otherwise, I was looking at an exorbitant fee to see a private doctor. I was shocked, as I always assumed that the NHS was better than the system we have in Australia. I think that there are lots of perverse incentives involved in Medicine and Healthcare. Government intervention is required to balance out these incentives from profit takers and consumers (i.e. smokers, obesity, etc). I'm not sure that any model in the world right now gets the balance right.
- arethuza 8y ago
  Note my comment about "I'd prefer it if the NHS was resourced to a level".... The issue with not getting GP appointments quickly seems to have been a relatively recent thing - due to lack of resources and mismanagement rather than fundamental problems with the approach.
  - Ntrails 8y ago
    That's not entirely true. If you're actually emergent and require a same day apptmnt then they've got held appointments for you. However this has led to an extremely strange system where often GP receptionists are essentially gatekeeping services (as a pre requisite to accessing the GPs who gatekeep the other services...)
  - toasterlovin 8y ago
    > I'd prefer it if the NHS was resourced to a level You know what a great system for allocating resources in an incredibly complex system is? Prices.
stronglikedan 8y ago
> a relatively small private healthcare system for those who want treatments not covered by the NHS, or a nicer room etc. From what I've heard about the Charlie Gard [0] and Alfie Evans [1] cases, that isn't always allowed, and even being an Italian citizen or an offer from the Pope can't sway the decision [3]. [0] https://en.wikipedia.org/wiki/Charlie_Gard_case https://en.wikipedia.org/wiki/Charlie_Gard_case [1] https://en.wikipedia.org/wiki/Alfie_Evans_case https://en.wikipedia.org/wiki/Alfie_Evans_case [3] https://www.telegraph.co.uk/news/2018/04/23/protesters-storm-hospital-terminally-ill-alfie-evans-parents/ https://www.telegraph.co.uk/news/2018/04/23/protesters-storm...
- namdnay 8y ago
  ??? Alfie Evans had nothing to do with the NHS not wanting to cover the treatment. From the first paragraph of the wikipedia article you linked to: > Alder Hey Children's NHS Foundation Trust sought a declaration that continued ventilatory support was "unkind and inhumane", and not in Evans' best interests
  - stronglikedan 8y ago
    Some people liken that to a "death panel", in that it was not unanimously agreed with by other medical professionals, including those that thought there may be other forms of treatment for the same affliction that were not being covered by the NHS.
    - Ntrails 8y ago
      Yes, doctors here (as, indeed, in most countries) can take cases to court when they believe the best interests of their patients are not being looked after by the legal guardians. And these are not mediocre doctors, nor was this being done lightly. The treatments not covered were not even approved for use in the UK privately afaik - it was entirely unrelated to the NHS budgets.

MertsA 8y ago

>31415926535897932384626433 This should be 31415926535897932384626434.

deleted 8y ago
[deleted]
deleted 8y ago
[deleted]

creaghpatr 8y ago

>Healthcare research funding to come from the public sector and donations only. And I suppose the public will indirectly vote on where research goes and where it does not? I don't trust any party in power to have a monopoly on healthcare research without a private sector counterbalance. But I'm open to reconsidering the current allocation.

markvdb 8y ago
The freedom to research would stay! If anything, researchers should have more freedom to research. An example. Imagine a researcher invents cheap medication that obviates the need for some kind of eye surgery. What would happen now? Surgeons don't like it, insurance companies don't like it. It might never catch on. The silly researcher certainly wouldn't get rewarded for his idiotic idea. What would happen in an ideal scenario? Better health with less side effects for the patients. Cheaper for the community.
- lern_too_spel 8y ago
  Exactly. Institute proper nutrition at school lunch programs and easy access to clean water throughout the day, and watch what happens to healthcare costs, dental costs, test scores, etc. It costs more, but society currently pays the cost later times ten. Same with sunlight to prevent the onset of myopia, etc. These are things we already know about and can have huge impact, but it's politically infeasible to solve these problems correctly.
jacobwilliamroy 8y ago
I was watching some NASA scientists ask the federal government for money on C-SPAN and the NASA people said that they decide what research to fund by surveying the scientific community. I forget what they call the system exactly. EDIT: I found it. They use something called a "decadal survey" https://science.nasa.gov/earth-science/decadal-surveys https://science.nasa.gov/earth-science/decadal-surveys
- craftyguy 8y ago

jbob2000 8y ago

This all assumes that healthcare is a human right, which I am not so sure about. Why should health education be free but not engineering education? I'd hazard an argument that not everyone deserves healthcare, so it would be difficult to make it a Right.

namdnay 8y ago

> Only non-profit healthcare services allowed Honestly, this isn't necessary, as long as you have single payer (or close to it). When the government is the one paying for 99% of healthcare, they have huge clout enforcing razor-thin margins and high efficiency on the provider side. Just look at how the massive supermarket chains are able to keep the margins of the upstream supply chain at a minimum.

AnthonyMouse 8y ago
> Honestly, this isn't necessary, as long as you have single payer (or close to it). When the government is the one paying for 99% of healthcare, they have huge clout enforcing razor-thin margins and high efficiency on the provider side. Just look at how the massive supermarket chains are able to keep the margins of the upstream supply chain at a minimum. The problem is that governments don't work that way. When a purchasing officer at a business negotiates a lower price he gets a large bonus. What does a Congressman get when he negotiates a lower price, compared to what he gets (from the people he's negotiating with) if he "negotiates" a higher price? What about the government bureaucrat who will be working in that industry soon? That is the problem. Meanwhile who is more knowledgeable about produce if you have a question, the staff at Walmart or the farmers at the local farmer's market? It's easy to order cost cutting from the top of the tower, but if you don't know what's happening on the ground, you don't know what you're actually cutting. What you need is for people -- the people who are actually consuming services and can choose to go somewhere else if the price is wrong -- to be able to choose based on published price information. The argument people sometimes make about this is that you don't get to choose which hospital an ambulance takes you to when you're unconscious, but the majority of healthcare spending isn't that, and that doesn't explain why we have no price transparency for non-emergency surgical procedures or diabetes or cancer treatment.
- namdnay 8y ago
  > The problem is that governments don't work that way Well, they can... Just look at France. Amazing healthcare, a lot of it private, relatively cheap > What does a Congressman get Nothing, they don't negotiate > What about the government bureaucrat A performance bonus, a raise, a promotion? Just like any other organisation? > What you need is for people to be able to choose based on published price information OK, go and buy a pound of ground meat. Or an LCD screen. Are you seriously telling me you can get a better deal than McDonalds or Apple?

conanbatt 8y ago

If the us tried to become your ideal world, you would lose a huge chunk of the doctors you have, and the amount of medical services you would provide will be lower than it is today.