4 ms·

With respect to health care, you may be able to make such educated decisions, almost no one else can. There isn't enough signal, and almost no one has the abili

With respect to health care, you may be able to make such educated decisions, almost no one else can. There isn't enough signal, and almost no one has the ability to distinguish signal from noise, and correctly interpret it. What happens is that when given the opportunity, business will pollute the market with proxy signals (like brand trust, or fear based selling) that people instinctively respond to. These proxy signals will be subject to manipulation by well-capitalized actors and will not in general reflect outcomes or value. They will interfere with the fundamental signal, making it even harder to detect and interpret. Therefore the market will not work, in the sense of delivering the best outcomes for costs. (Note that I am strictly speaking of healthcare, where even experts are often unsure of causal relationships and the relative value of various therapies. In general I think markets are a wonderful thing. Here is an experiment to try... take a mild condition treatable by OTC medication, such as the symptoms of colds, allergies, etc, and see how long it takes you to identify, characterize and factor the available therapies, and then map this to available products. Evaluate interactions, cautions, effectiveness, risk, convenience, costs, etc. Now ask yourself, where did you get your information? Who did you have to trust? Why did you trust them? Is the basis for your trust and understanding available to the average person? I've done the experiment. My conclusion is that healthcare large and small is not like other goods.)

achillesheels 7y ago
You assume medical bureaucracies are needed to protect from self-harm; ironically the current healthcare state is harmful! I have firm belief in the fact that the market can more efficiently aggregate medical information but above all else create more rapid responsiveness to care. Bad products and actors are always seeded out over time in a society.
- rtikulit 7y ago
  I really wish that all markets worked like that. When they work, markets are an amazing mechanism for pricing, driving value creation, allocating capital, and searching the economic and technological solution space. But they don't work like this all the time, for all goods. Tetraethyl lead, which quite probably caused material long-term harm to entire generations, is gone because the bureaucrats banned it. The free market would never have phased it out organically in a reasonable time-frame, we know this because it didn't. The market participants fought for its continued use and obfuscated the issues to their advantage. GlacierMD was explicitly an attempt to filter, aggregate and make available high-quality health-care information (i.e. improve the quality of the signal, which is necessary for efficient market functioning), and it did not find a value proposition in the market.
  - wayoutthere 7y ago
    > GlacierMD was explicitly an attempt to filter, aggregate and make available high-quality health-care information (i.e. improve the quality of the signal, which is necessary for efficient market functioning), and it did not find a value proposition in the market. Except it doesn't -- what GlacierMD was trying to do is something that's currently done by humans at scale. Which he would have known if he understood the market better. This is a centralized function that is performed much higher up the chain and ends up in clinician / patient hands in the form of clinical guidelines. This is maybe a useful tool for researchers to be used as one input in the development of clinical guidelines. But the functionality it delivers can be done manually (and will continue to be for liability reasons). In this case, the market worked. The author should be thankful he was able to get out of it only $40k in the hole.
  - achillesheels 7y ago
    I’m not trying to be divisive, but allow me to counter that all markets need consumer advocacy. High fructose corn syrup has been substituted in certain soft drinks now because of the diligence of consumer activism. I take it as a mathematical certainty that bureaucrats take longer to respond than the fluidity of market economics. I just find it appalling I can’t order my methotrexate medication without having to physically see a rheumatologist, with the man-hours to get that script embarrassing for a digital society.

achillesheels 7y ago

You assume medical bureaucracies are needed to protect from self-harm; ironically the current healthcare state is harmful! I have firm belief in the fact that the market can more efficiently aggregate medical information but above all else create more rapid responsiveness to care. Bad products and actors are always seeded out over time in a society.

rtikulit 7y ago
I really wish that all markets worked like that. When they work, markets are an amazing mechanism for pricing, driving value creation, allocating capital, and searching the economic and technological solution space. But they don't work like this all the time, for all goods. Tetraethyl lead, which quite probably caused material long-term harm to entire generations, is gone because the bureaucrats banned it. The free market would never have phased it out organically in a reasonable time-frame, we know this because it didn't. The market participants fought for its continued use and obfuscated the issues to their advantage. GlacierMD was explicitly an attempt to filter, aggregate and make available high-quality health-care information (i.e. improve the quality of the signal, which is necessary for efficient market functioning), and it did not find a value proposition in the market.
- wayoutthere 7y ago
  > GlacierMD was explicitly an attempt to filter, aggregate and make available high-quality health-care information (i.e. improve the quality of the signal, which is necessary for efficient market functioning), and it did not find a value proposition in the market. Except it doesn't -- what GlacierMD was trying to do is something that's currently done by humans at scale. Which he would have known if he understood the market better. This is a centralized function that is performed much higher up the chain and ends up in clinician / patient hands in the form of clinical guidelines. This is maybe a useful tool for researchers to be used as one input in the development of clinical guidelines. But the functionality it delivers can be done manually (and will continue to be for liability reasons). In this case, the market worked. The author should be thankful he was able to get out of it only $40k in the hole.
- achillesheels 7y ago
  I’m not trying to be divisive, but allow me to counter that all markets need consumer advocacy. High fructose corn syrup has been substituted in certain soft drinks now because of the diligence of consumer activism. I take it as a mathematical certainty that bureaucrats take longer to respond than the fluidity of market economics. I just find it appalling I can’t order my methotrexate medication without having to physically see a rheumatologist, with the man-hours to get that script embarrassing for a digital society.