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How incredible would it be if Alphabet spent, say 1% of their total healthcare venture budget, just running models on all of the different ways that the cost of
by thr0wawayf00 4y ago
How incredible would it be if Alphabet spent, say 1% of their total healthcare venture budget, just running models on all of the different ways that the cost of healthcare could be reduced and access to care could increase. And maybe they do this already (we have no idea if they do, it might be nice to share that information if they did). It's just become so clear that many people believe the anti-science stuff that gets thrown around these days because they can't even afford to participate in the healthcare system anymore. And who can blame them? Figuring out how to get medical records systems to talk to each other isn't going to solve this problem.
But no, let's throw billions of dollars at anti-aging instead...
- jdminhbg 4y ago"Running models" can't fix problems that are political conflicts between competing interests. You don't need DeepMind to tell you Certificate of Need laws reduce access and increase price; you need a political coalition that can overturn them.
- HWR_14 4y agoRunning models is literally the way to satisfy the Certificate of Need. It's the way to fix the problem.
- metadat 4y agoPlease explain further, this makes no sense to me.
- nopenopenopeno 4y agoYou are not alone.
- HWR_14 4y agoThe certificate of need is literally based on a justification for why those government subsidized hospital beds aren't wasteful. The way to demonstrate that is with a model. A better/cheaper model is the way to go there. Therefore, an AI that generates good models is valuable.
- thatfrenchguy 4y agoYou're not getting cheaper healthcare by using more machine learning, it's a hard problem for a reason.
- thr0wawayf00 4y agoIt's actually not. The CBO already built these models last year and reported that they reduced costs in nearly all cases, across the board[0]. It's only a hard problem because some billionaires want us to believe that it's a hard problem. From the summary: > The report makes many sound assumptions but also some questionable ones that are overly pessimistic. Yet, overall, its bottom-line estimates should reassure those concerned about the economic feasibility of single payer: The CBO projects that such reform would achieve universal coverage, bolster provider revenues for clinical services, and eliminate almost all copayments and deductibles—even as overall health care spending fell. 0: https://www.healthaffairs.org/do/10.1377/forefront.20210210.190243/full/ https://www.healthaffairs.org/do/10.1377/forefront.20210210....
- sumy23 4y agoThere are political concerns as well. As the article mentions, healthcare spending is 17% of U.S. GDP (which is an absolutely insane figure). Healthcare jobs account for 14% of the workforce according to Census Bureau's 2019 American Community Survey. You can't get the first number down (17% of GDP) without impacting the second number (14% of jobs). I agree that single-payer would be a net benefit, but the U.S. hasn't shown much appetite for such tough political decisions.
- nopenopenopeno 4y agoThe same logic can be applied to literally anything in a capitalist society. If the current way of doing things employs people, we can’t possibly do it any other way.
- sumy23 4y agoYes, but 14% of jobs is a huge number. Healthcare is one of the biggest, if not the biggest, employment sectors.
- scarmig 4y agoHealthcare isn't expensive because there are huge swaths of spending unexamined by human intelligence that might become tractable with an automated process. On the contrary, it's one of the sectors that has the most eyes and brains pointed at costs and extracting as most money as possible. On the topic of EMR systems in particular, they suck because the people using them hate them and because the people purchasing them, building them, and mandating them aren't the people using them. If it were just a matter of having enough money to throw at the problem, Epic would have done so already.
- xcskier56 4y agoBilling is the original sin of healthcare. EMRs (excluding the VA’s old MER VistA) were not developed to improve clinical workflows or outcomes, they were originally conceived to improve and streamline billing. This orientation has massively contributed to the overhead that EMRs like Epic and Cerner introduce. On the startup and health improve lament side, billing is the rock that so many great ideas break on. It doesn’t matter if the model or business improves care or reduces cost unless it will make a provider more money.
- deleted 4y ago[deleted]
- mountainriver 4y agoSo your telling me EMR is the Jira of healthcare
- bergenty 4y ago[flagged]
- rayiner 4y agoYes, because what we need is more gerontocracy. People should instead just make peace with the fact that their purpose in life is to reproduce, die within a reasonable time, and hand the world over to the next generation.
- tptacek 4y agoI mean, I guess, tell that to every important artist, author, architect, craftsperson, and humanitarian. Paul Farmer and Norman Borlaug both had children, but it's hard to argue that their real purpose in life was to reproduce. Could you get more Paul Farmer time? Seems like a worthy goal.
- forgingahead 4y agoIn a nutshell, your comment illustrates well the issue facing many western nations. The uniqueness of an individual is somehow extended to being applicable to the average person, and then folks hand-wring about why things seem to be trending in a bad direction. Sure, Paul Farmer was special, but most people are not. To make any policy, or social conditioning, that is fine for an individual but bad for a collective, can result in some pretty terrible consequences, most critically this recent drive to discourage folks from having children due to whatever made-up reason, or cling onto power until others have to pry it from one's cold dead hands.
- tptacek 4y agoI'm pro-natalist. I think raising children is intrinsically good. I have two kids of my own (both grown and in college now). I'm not a pro-natal absolutist. I do not think the exclusive purpose of life is to reproduce. That's the sentiment I responded to, and the one you're arguing in favor of.
- googlryas 4y agoIsn't it fairly obvious how the costs could be decreased? Dozens of other countries have figured it out, there isn't some secret.
- GiorgioG 4y agoWell, what we have here is the unique snowflake syndrome or not invented here syndrome. At this point I’ve lost all hope that we’ll see a single payer system in the USA in my lifetime.
- rayiner 4y agoAnd what’s the secret? Having the government do it can’t be the reason, because there’s plenty of government-run things, such as education and transit, where the US pays more to get less, just as in healthcare.
- Atreiden 4y agoThe secret is representative government. In the US there are only two parties, and they have entirely opposite goals. The democrats want more Government spending programs, Republicans want less. So when Democrats are in charge and the US tries to expand things like healthcare, education, and transit, the Republicans step in and do everything in their power to create the most ineffectual legislation that they can. Obamacare is the perfect example of this. They then use those broken, ineffective programs as evidence of "the governments" incompetence (ignoring the fact they they _are_ the government), bolstering their arguments for rolling back government regulation and spending. This way, private interests are able to dominate the market and the money keeps flowing 'round. I'm convinced this is the mechanism behind both the increasing income/wealth inequality in the US, and the broken state of public infrastructure/services. The solution is election reform. The data has shown that neither party represents the actual interests of the people, and they only get away with it because of the Game Theory around our election system. Get rid of the Electoral College and FPTP - 1 Person:1 Vote & Ranked-Choice voting would create a cataclysmic shift in US politics in short order.
- adamredwoods 4y ago>> anti-science stuff that gets thrown around these days It wasn't just anti-science but deliberate attempts to stop Obamacare, the ONLY initiative ever attempted to fix the US healthcare system. Then came the Republicans to stop it. https://www.heritage.org/health-care-reform/commentary/why-trumps-executive-order-health-care-positive-step https://www.heritage.org/health-care-reform/commentary/why-t... IMO, the Pacific coast states need to reject national health care, create a health-care pact between states that slowly grows larger by adding new states. If another state doesn't want to join, then, so be it. Enough of splintered policies that change across state lines. Reduce health care insurance costs by allowing continued and universal care to states that elect this policy. The strength of change is in the states themselves, not the federal level. https://www.gov.ca.gov/2020/04/13/california-oregon-washington-announce-western-states-pact/ https://www.gov.ca.gov/2020/04/13/california-oregon-washingt...
- rayiner 4y ago> IMO, the Pacific coast states need to reject national health care, create a health-care pact between states that slowly grows larger by adding new states. If another state doesn't want to join, then, so be it. It blows my mind that they don’t do this. During most of the 20th century, Democrat-run states wanted to tax Republican California to pay for social programs. So doing things at the national level was critical. But now that the states that have all the money are also run by Democrats, that roadblock is gone. California can just tax California to pay for universal healthcare for California. They have no reason to care what Iowa chooses to do.
- tptacek 4y agoHow do you avoid the obvious adverse selection problem? California can't prevent the most expensive people in the country from moving there, and the system we're talking about would be a powerful incentive for those people to do so.
- bhupy 4y agoI think you're overstating just how "obvious" this adverse selection problem is, because we haven't seen this play out historically. It sounds like a purely theoretical problem. Canada established its single payer system provincially, one-by-one, and they didn't have this adverse selection problem. Saskatchewan was the first Province to offer single payer in 1947, followed by Alberta in 1951, etc. By 1961, all Provinces had some form of a single payer healthcare system. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110239/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110239/ > Taxpayer-funded medicare in Canada did not appear at a single point in time: it emerged over a quarter century from 1962, when physician services were covered across Saskatchewan, to 1987, when the demise of optional “full billing” in Ontario began. So at any given point in time between 1962 and 1987, there was (in theory) this adverse selection problem among certain provinces; and yet that was never really a major problem in Canada. Even to this day, the Canada Health Transfer which provides block funding to Provinces by the Federal government for the purpose of funding these single payer systems covers ~22% of the cost (https://www.cmaj.ca/content/192/45/E1408 https://www.cmaj.ca/content/192/45/E1408). Additionally, even in present day, the European Union has open borders and free immigration between member states, and certain member states have far more generous welfare systems than others, and you still don't have this adverse selection problem, at least in a manner that meaningfully renders those welfare systems unsustainable. Even domestically, we didn't really see dramatic net migration from states that refused to take the Medicaid expansion to those that did. The reality is that people don't choose where to live strictly on the basis of which state provides taxpayer funded healthcare. In fact, those that are most likely to do that (poor people) are likely already covered by Medicaid or heavily subsidized ACA plans (https://www.kff.org/policy-watch/millions-of-uninsured-americans-are-eligible-for-free-aca-health-insurance/ https://www.kff.org/policy-watch/millions-of-uninsured-ameri...). And even if one were to engage with the purely theoretical problem, there are ways to mitigate the adverse selection, e.g. by requiring a minimum number of years of residency in order to qualify. This is what US States do today to establish residency for the purpose of in-state university tuition. Given the plethora of historical (and current) data points that suggests that this isn't really a problem, States can choose to cross that bridge if/when they get there.
- yalogin 4y agoIMo, The ballooning costs in healthcare are not from not knowing how to reduce the costs or make the system more efficient. There is entrenched interests/ businesses that will lose 100s of billions if it were replaced or shifted. They absolutely will not let it happen. Spending a few billions to buy politicians is justifiable for them. That is the main reason we are in this mess and will always be. May be I am too pessimistic, but Google, Amazon put together is not enough to change it
- beej71 4y agoI think a lot of the players don't want to reduce costs.
- aliswe 4y agoThey do run a number of long-shot altruist projects now and then, by the way. They did some tests of UBI in the poorest parts of the world iirc.