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Every day it gets harder for me to believe that the medical and pharmaceutical industrial system's configuration of incentives can ever lead to improvements in
by smeej 2y ago
Every day it gets harder for me to believe that the medical and pharmaceutical industrial system's configuration of incentives can ever lead to improvements in health for people.
I don't doubt there are many, many researchers and physicians who genuinely want to help people. It's possible to me that virtually everyone does.
But if that's the case, the incentive structure has apparently gotten away from everyone and become some sort of monster working at cross-purposes toward them at all times, keeping them from succeeding.
I don't know the specific numbers, but what fraction of the U.S. workforce and economy is involved in medical/pharmaceutical or related insurance research, treatment, or administration? It has to be well into the double digits.
If people started actually being cured of things, actually being well, whole segments of this structure would collapse--and if that percentage figure is high enough, so would the economy.
I don't think we even need to posit that there are actually malevolent people involved who are trying to keep people sick. It could all just be a consequence of a whole system that depends on it to keep operating, and consequentially nudges just enough of every benevolent, neutral, or merely self-interested person's work in a direction that keeps it from making people well.
- 29athrowaway 2y agoDo you think that people that are bullied by their parents to become doctors are doing medicine to help people?
- smeej 2y agoMaybe. Or at least it's probably one of the factors that helps them sleep at night and get up in the morning. I don't really see what that has to do with my point, though. I'm saying we don't have to assume anyone has ill will to explain why the system is failing. I'm not saying it's impossible that some people do.
- RandomLensman 2y agoHealthy people tend to be more productive - so the net effect of having a lot of non-healthy people being treated might well be economically negative. Moving 5-10% of the GDP into something else is disruptive (overall total healthcare is more like 18% GDP in the US, I think), but nothing that didn't happen before. Also, curing people is hard in a lot cases.
- FredPret 2y agoInstead of pontificating on the efficacy of the healthcare system, why not just look at the actual outcome? Lifespans are going up, including the length of time spent being relatively healthy; infant mortality is down; cancers are getting healed; there’s even a miracle cure for obesity.
- smeej 2y agoLifespans were going up, for older generations who were raised under different conditions than we have today. Today's young people are much more sickly than their forebears.
- readthenotes1 2y agoI have been training myself to call it the medical industry, not the health or healthcare industry. It does very little to promote and preserve health. E.g., There was some noise a few years ago about the obstacles Louisiana faced in changing the medicine for hep C from the expensive lifetime subscription model to a cure. https://www.nola.com/news/healthcare_hospitals/louisiana-offers-treatment-to-more-hepatitis-c-patients-than-ever-before-even-as-some-gaps/article_ddf84210-a8d4-11e9-ae1b-b7037c312d9a.html https://www.nola.com/news/healthcare_hospitals/louisiana-off...