4 ms·

I don’t understand how you can ignite market forces in health care. How else can you balance priorities for all the different uses that people’s financial resou

I don’t understand how you can ignite market forces in health care. How else can you balance priorities for all the different uses that people’s financial resources can be used for? What does it even mean to let science decide? No cap on spending?

mathgeek 3y ago
> What does it even mean to let science decide? In the case of cancer, it means a patient should be given the appropriate dose for their diagnosis, as determined by what science has shown to be effective.
- MoreSEMI 3y ago
  This principle would just be summed up as an inelastic good in economic terms. Market forces apply wether or not we want them too. To me it seems, this would result in us being willing to pay any price for it, which may even be the correct principle. It should however, then not be surprising when cancer treatments cost 100s of thousands.
- changoplatanero 3y ago
  Like imagine a few decades ago when it could have cost more than 1 billion dollars to sequence the dna of a cancer tumor. If science could show that it is effective in treating cancer to have the dna sequenced should the tax payers have paid 1 billion dollars to save one persons life? That would plainly be absurd.
tialaramex 3y ago
> What does it even mean to let science decide? No cap on spending? Typically, QALYs, Quality Adjusted Life Years. We decide how much (in dollar terms if you're just that fundamentalist about it, but person hours or other metrics are fine too) a QALY is worth, and we will spend no more than that on healthcare interventions. The set of situations where there's a viable intervention but it's too expensive isn't empty, but it's not large either, so, you just build a bureaucracy to handle those cases.
- candiodari 3y ago
  For the love of God, don't do this. This will mean MBA's do 2 things: 1) on the medical provider end, find every possible excuse to charge 1% more and pay it out to themselves, not using it for patient care 2) on the insurance/government end, find every possible way to charge 1% less, no matter the cost So yes "let science decide" means to let doctors decide what care to provide (meaning you'd need a difficult admissions test for this class of people). Yes, they will cheat, which will benefit themselves, but also patients. And there's a limit, because doctors are fundamentally limited. And then you just eat the cost, and have a board (IMPORTANT: of doctors) weed out the worst abusers on a regular basis. And yes, if a doctor says "spend X on this patient", then we spend X on that patient. End of discussion. And yes, this is probably "mercantilist" instead of capitalist, and provides a fundamentally unfair advantage in the economy to people who manage to get the degree of medical doctor. In trade, you get good health care.

mathgeek 3y ago

> What does it even mean to let science decide? In the case of cancer, it means a patient should be given the appropriate dose for their diagnosis, as determined by what science has shown to be effective.

MoreSEMI 3y ago
This principle would just be summed up as an inelastic good in economic terms. Market forces apply wether or not we want them too. To me it seems, this would result in us being willing to pay any price for it, which may even be the correct principle. It should however, then not be surprising when cancer treatments cost 100s of thousands.
changoplatanero 3y ago
Like imagine a few decades ago when it could have cost more than 1 billion dollars to sequence the dna of a cancer tumor. If science could show that it is effective in treating cancer to have the dna sequenced should the tax payers have paid 1 billion dollars to save one persons life? That would plainly be absurd.

tialaramex 3y ago

> What does it even mean to let science decide? No cap on spending? Typically, QALYs, Quality Adjusted Life Years. We decide how much (in dollar terms if you're just that fundamentalist about it, but person hours or other metrics are fine too) a QALY is worth, and we will spend no more than that on healthcare interventions. The set of situations where there's a viable intervention but it's too expensive isn't empty, but it's not large either, so, you just build a bureaucracy to handle those cases.

candiodari 3y ago
For the love of God, don't do this. This will mean MBA's do 2 things: 1) on the medical provider end, find every possible excuse to charge 1% more and pay it out to themselves, not using it for patient care 2) on the insurance/government end, find every possible way to charge 1% less, no matter the cost So yes "let science decide" means to let doctors decide what care to provide (meaning you'd need a difficult admissions test for this class of people). Yes, they will cheat, which will benefit themselves, but also patients. And there's a limit, because doctors are fundamentally limited. And then you just eat the cost, and have a board (IMPORTANT: of doctors) weed out the worst abusers on a regular basis. And yes, if a doctor says "spend X on this patient", then we spend X on that patient. End of discussion. And yes, this is probably "mercantilist" instead of capitalist, and provides a fundamentally unfair advantage in the economy to people who manage to get the degree of medical doctor. In trade, you get good health care.