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> how many [...] are actually solving problems [...] not a lot How is this specific to programming? Surely there are more pressing matters if we are looking fo

> how many [...] are actually solving problems [...] not a lot How is this specific to programming? Surely there are more pressing matters if we are looking for BS jobs that don't solve problems. > U.S. health care spending grew 9.7 percent in 2020, reaching $4.1 trillion or $12,530 per person. As a share of the nation's Gross Domestic Product, health spending accounted for 19.7 percent. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta... This is almost one out of every five dollars in this country. Now that is something actually worth talking about.

RhodesianHunter 4y ago
Particularly when you consider how poor our outcomes are relative to our spending.
- drjasonharrison 4y ago
  It's expensive to get good outcomes when you provide health care for a population with many older obese, inactive, and smoking members.
  - XorNot 4y ago
    The entire western world population is both aging and fattening, but the US has consistently had poor outcomes relative to spending. This explanation doesn't cut it: per-capita the US spends the most but it's demographic trends are not unique.
    - Retric 4y ago
      The US is unusually obese. https://en.wikipedia.org/wiki/Epidemiology_of_obesity#/media/File:Obesity_country_comparison_-_path.svg https://en.wikipedia.org/wiki/Epidemiology_of_obesity#/media... But US healthcare is also horrifically inefficient largely due to a combination of a private insurance system, poor management, and massive government subsidies. Unfortunately any effort to improve efficiency would lower profits or cost jobs.
Retric 4y ago
Not to detract from the overall point, but increased healthcare spending during a pandemic seems completely reasonable. I would also expect military spending to increase during a war. What the US wastes so much money on isn’t really healthcare it’s healthcare adjacent tasks like medical billing, insurance, advertising, etc.
- astrange 4y ago
  > Not to detract from the overall point, but increased healthcare spending during a pandemic seems completely reasonable Public health spending yes, healthcare spending maybe not. (For instance, if everyone's staying home they can't get injured in workplace or car accidents.) I've seen this argument used for universal healthcare in the US too, but it doesn't really make sense. Formal healthcare couldn't do much for you if you got covid since there weren't treatments for it, and now there is an antiviral and vaccine you don't need to go visit a doctor to get them.
  - Retric 4y ago
    Supplemental care was shockingly effective even when we didn’t have disease specific treatments. It’s hard to make an exact estimate supplemental care like IV’s, oxygen, and in extreme case ventilators roughly cut peoples likelihood of dying in half. Unfortunately that shit gets expensive. Mean intensive care unit cost and length of stay were 31,574 +/- 42,570 dollars and 14.4 days +/- 15.8 for patients requiring mechanical ventilation and 12,931 +/- 20,569 dollars and 8.5 days +/- 10.5 for those not requiring mechanical ventilation. Daily costs were greatest on intensive care unit day 1 (mechanical ventilation, 10,794 dollars; no mechanical ventilation, 6,667 dollars), decreased on day 2 (mechanical ventilation:, 4,796 dollars; no mechanical ventilation, 3,496 dollars), and became stable after day 3 (mechanical ventilation, 3,968 dollars; no mechanical ventilation, 3,184 dollars). Adjusting for patient and hospital characteristics, the mean incremental cost of mechanical ventilation in intensive care unit patients was 1,522 dollars per day (p < .001). https://pubmed.ncbi.nlm.nih.gov/15942342/ https://pubmed.ncbi.nlm.nih.gov/15942342/ Meanwhile because people assumed there was little medicine could do many preventable deaths occurred at home.
qbasic_forever 4y ago
The dirty little secret is that the country's GDP depends on expensive healthcare. Imagine if something overnight dramatically cut spending and the knock-on effects for drug companies, healthcare providers, etc. losing massive amounts of profit, having down quarters, and their stocks tanking (which also tank all the mutual funds and retirement accounts that see them as dependable and good investments). It's an insane house of cards we have built up and expensive healthcare is a sick 'feature' not a bug of America today. All of this was kind of laid out with the push for Obamacare and refusal to consider Medicare for all. It was a clear decision by Congress that the status quo of the healthcare industry being a huge part of the American economy would be solidified in law. Anything that tries to rock the boat or change that is going to be facing extreme resistance at all levels from the political and financial elite.
- anu7df 4y ago
  It is for precisely these kinds of reasons that I always thought GDP was a flawed or at the very least an incomplete measure. At constant "efficiency" for whatever definition of efficiency is appropriate for a given sector/activity/industry increase in GDP is a net positive. But what is happening in health care is a travesty. From my first real hospital visit (other than annual health checkup) to when my daughter was born the actual cost of care and the billed amount were so ridiculous, billing so confusing, that I decided to from now on not pay any out of pocket amount till may be a sternly worded letter gets to me. At least I would wait for bill number 3 before deciding to pay. Learned it the hard way after I ended up paying a few thousand dollars extra for maternity care. In a span of a 3 week I got 3 bills for the same service all progressively getting lower for some mysterious reason. Not collecting my mail often, I, idiotically paid the first one as soon as I opened it, not knowing that the lower amount is just 2 envelopes down in the pile.
  - wincy 4y ago
    Our first daughter was born in a hospital while they were being acquired by another hospital. Then they shut down the maternity ward soon after. They then called us two years later claiming insurance hadn’t gone through. My wife said that was their problem. The bill magically disappeared. We never paid a dime. We just sort of fell through the cracks.

RhodesianHunter 4y ago

Particularly when you consider how poor our outcomes are relative to our spending.

drjasonharrison 4y ago
It's expensive to get good outcomes when you provide health care for a population with many older obese, inactive, and smoking members.
- XorNot 4y ago
  The entire western world population is both aging and fattening, but the US has consistently had poor outcomes relative to spending. This explanation doesn't cut it: per-capita the US spends the most but it's demographic trends are not unique.
  - Retric 4y ago
    The US is unusually obese. https://en.wikipedia.org/wiki/Epidemiology_of_obesity#/media/File:Obesity_country_comparison_-_path.svg https://en.wikipedia.org/wiki/Epidemiology_of_obesity#/media... But US healthcare is also horrifically inefficient largely due to a combination of a private insurance system, poor management, and massive government subsidies. Unfortunately any effort to improve efficiency would lower profits or cost jobs.

Retric 4y ago

Not to detract from the overall point, but increased healthcare spending during a pandemic seems completely reasonable. I would also expect military spending to increase during a war. What the US wastes so much money on isn’t really healthcare it’s healthcare adjacent tasks like medical billing, insurance, advertising, etc.

astrange 4y ago
> Not to detract from the overall point, but increased healthcare spending during a pandemic seems completely reasonable Public health spending yes, healthcare spending maybe not. (For instance, if everyone's staying home they can't get injured in workplace or car accidents.) I've seen this argument used for universal healthcare in the US too, but it doesn't really make sense. Formal healthcare couldn't do much for you if you got covid since there weren't treatments for it, and now there is an antiviral and vaccine you don't need to go visit a doctor to get them.
- Retric 4y ago
  Supplemental care was shockingly effective even when we didn’t have disease specific treatments. It’s hard to make an exact estimate supplemental care like IV’s, oxygen, and in extreme case ventilators roughly cut peoples likelihood of dying in half. Unfortunately that shit gets expensive. Mean intensive care unit cost and length of stay were 31,574 +/- 42,570 dollars and 14.4 days +/- 15.8 for patients requiring mechanical ventilation and 12,931 +/- 20,569 dollars and 8.5 days +/- 10.5 for those not requiring mechanical ventilation. Daily costs were greatest on intensive care unit day 1 (mechanical ventilation, 10,794 dollars; no mechanical ventilation, 6,667 dollars), decreased on day 2 (mechanical ventilation:, 4,796 dollars; no mechanical ventilation, 3,496 dollars), and became stable after day 3 (mechanical ventilation, 3,968 dollars; no mechanical ventilation, 3,184 dollars). Adjusting for patient and hospital characteristics, the mean incremental cost of mechanical ventilation in intensive care unit patients was 1,522 dollars per day (p < .001). https://pubmed.ncbi.nlm.nih.gov/15942342/ https://pubmed.ncbi.nlm.nih.gov/15942342/ Meanwhile because people assumed there was little medicine could do many preventable deaths occurred at home.

qbasic_forever 4y ago

The dirty little secret is that the country's GDP depends on expensive healthcare. Imagine if something overnight dramatically cut spending and the knock-on effects for drug companies, healthcare providers, etc. losing massive amounts of profit, having down quarters, and their stocks tanking (which also tank all the mutual funds and retirement accounts that see them as dependable and good investments). It's an insane house of cards we have built up and expensive healthcare is a sick 'feature' not a bug of America today. All of this was kind of laid out with the push for Obamacare and refusal to consider Medicare for all. It was a clear decision by Congress that the status quo of the healthcare industry being a huge part of the American economy would be solidified in law. Anything that tries to rock the boat or change that is going to be facing extreme resistance at all levels from the political and financial elite.

anu7df 4y ago
It is for precisely these kinds of reasons that I always thought GDP was a flawed or at the very least an incomplete measure. At constant "efficiency" for whatever definition of efficiency is appropriate for a given sector/activity/industry increase in GDP is a net positive. But what is happening in health care is a travesty. From my first real hospital visit (other than annual health checkup) to when my daughter was born the actual cost of care and the billed amount were so ridiculous, billing so confusing, that I decided to from now on not pay any out of pocket amount till may be a sternly worded letter gets to me. At least I would wait for bill number 3 before deciding to pay. Learned it the hard way after I ended up paying a few thousand dollars extra for maternity care. In a span of a 3 week I got 3 bills for the same service all progressively getting lower for some mysterious reason. Not collecting my mail often, I, idiotically paid the first one as soon as I opened it, not knowing that the lower amount is just 2 envelopes down in the pile.
- wincy 4y ago
  Our first daughter was born in a hospital while they were being acquired by another hospital. Then they shut down the maternity ward soon after. They then called us two years later claiming insurance hadn’t gone through. My wife said that was their problem. The bill magically disappeared. We never paid a dime. We just sort of fell through the cracks.