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I found the following blurb from the article interesting as it tries to make the information relevant the gun control debate: Gun use emerged as a factor: Amer

I found the following blurb from the article interesting as it tries to make the information relevant the gun control debate: Gun use emerged as a factor: Americans were seven times more likely to die in a homicide and 20 times more likely to die in a shooting than their peers. In all, two-thirds of the mortality disadvantage for American men was attributable to people under the age of 50 -- and slightly over half of that resulted from injuries... However, why is this article interesting to the Hacker News crowd?

npsimons 14y ago
Why is health interesting to anyone? Viewed in a more hackish light: here's a problem; how can we fix it?
- 127001brewer 14y ago
  I find the entire "health care" topic interesting because I believe it to be "broken" (as a general term). But what to fix?
- roc 14y ago
  It's not a problem that can be 'hacked'. Much like hunger in the third world: it's a political problem. Practical solutions have long since been developed and proved in other places. The problems persist where they do, because there's no political will to actually implement the solutions in those places.
  - viraptor 14y ago
    > It's not a problem that can be 'hacked'. While I agree it's a political problem in general, there's apparently a lot that can be hacked. Starting with lowering the cost of diagnostics and improving the information flow... There were a couple of interesting companies interviewed on Mendelspod (http://mendelspod.com/ http://mendelspod.com/) - if you're interested in what can be hacked, give it a go. There are also projects like http://nhshackday.com/ http://nhshackday.com/
    - dtkuhn 14y ago
      Agree. Patients need better information if we are ever going to be serious health care consumers. Doctors have very little incentive to help us shop for services. Co-payments, lack of reimbursement, etc are all tools used by insurers to reduce cost (combat moral hazard, etc), but very little has been done by patients historically to systematically lower costs.
  - maxerickson 14y ago
    Most health care systems are grappling with costs and the demand for care outstripping the supply. It isn't a solved problem.
    - roc 14y ago
      They're grappling with costs because their professional ethics require they treat people who can't pay, yet their business obligations require they don't treat those people until it's serious and likely expensive. So because X number of people get X-Rays that will never be paid for, providers have to try to find some amount they can charge those who do pay, to cover the difference. And the trick with that, is that insurance companies know damn well what X-Rays should cost and have the bargaining power to squeeze out much of the padding in the cost of an X-Ray. [1] Which means those costs are eating into profits in a big way and has healthcare providers struggling to make the math work out. Particularly for those that service poorer areas, where fewer well-ensured patients can offset the cost of uninsured patients. And when you don't have a lot of slack in your budget, it's pretty difficult to add beds and professionals to increase your ability to supply healthcare. [1] Which is another perverse incentive for the hospitals to use new machines/drugs/methods when old ones will do just fine. Firstly, they're incentivized because their profit is largely function of the percent of raw cost the insurance companies allow for profit. So an X-Ray++ brings in more profit than a bog-standard X-Ray for the same amount of professional time. Secondly, because newer tools are by definition not yet commoditized, they can squeeze more 'buffer' into those prices, until the insurance companies can sort out what it 'should' be and more hospitals get in on tool X and begin essentially competing with one another, by accepting lower rates.
      - maxerickson 14y ago
        I meant national health systems. Costs are going up everywhere (or at least, spending) and lots of places are having some issues providing enough treatment.
- dtkuhn 14y ago
  (1) Help Medicare track cost-effectiveness of tests/procedures involving really expensive technology (development of which will only get more & more expensive); (2) Teach Medicare patients how to become actual consumers of health care (how to shop for price/compare treatment options) -- i.e. help transfer some of the burden of reducing cost from payers to patients w/out causing mass hysteria
  - tdfx 14y ago
    I don't think #2 will work without reforming the system to incentivize that kind of behavior. My grandmother goes to the podiatrist to have him cut her toenails (diabetes). There's barely any risk of her doing it herself, but he charges $200 every week for this treatment to Medicare. With her supplemental insurance, she pays nothing for these visits out of pocket. Why wouldn't she go?
    - dtkuhn 14y ago
      Chicken/egg. I'm not sure reform is practical until consumers have the help necessary to shop / compare. Otherwise, you basically have a bunch of old, angry voters.
    - 127001brewer 14y ago
      Interestingly, the trimming of toe nails can be abused with "up-coding" as "minor surgery". When I worked with a group investigating Medicare/Medicaid fraud, this procedure was a commonly abused (with up-coding). The point being is that fraud is a significant problem, but it's not easily solvable.

npsimons 14y ago

Why is health interesting to anyone? Viewed in a more hackish light: here's a problem; how can we fix it?

127001brewer 14y ago
I find the entire "health care" topic interesting because I believe it to be "broken" (as a general term). But what to fix?
roc 14y ago
It's not a problem that can be 'hacked'. Much like hunger in the third world: it's a political problem. Practical solutions have long since been developed and proved in other places. The problems persist where they do, because there's no political will to actually implement the solutions in those places.
- viraptor 14y ago
  > It's not a problem that can be 'hacked'. While I agree it's a political problem in general, there's apparently a lot that can be hacked. Starting with lowering the cost of diagnostics and improving the information flow... There were a couple of interesting companies interviewed on Mendelspod (http://mendelspod.com/ http://mendelspod.com/) - if you're interested in what can be hacked, give it a go. There are also projects like http://nhshackday.com/ http://nhshackday.com/
  - dtkuhn 14y ago
    Agree. Patients need better information if we are ever going to be serious health care consumers. Doctors have very little incentive to help us shop for services. Co-payments, lack of reimbursement, etc are all tools used by insurers to reduce cost (combat moral hazard, etc), but very little has been done by patients historically to systematically lower costs.
- maxerickson 14y ago
  Most health care systems are grappling with costs and the demand for care outstripping the supply. It isn't a solved problem.
  - roc 14y ago
    They're grappling with costs because their professional ethics require they treat people who can't pay, yet their business obligations require they don't treat those people until it's serious and likely expensive. So because X number of people get X-Rays that will never be paid for, providers have to try to find some amount they can charge those who do pay, to cover the difference. And the trick with that, is that insurance companies know damn well what X-Rays should cost and have the bargaining power to squeeze out much of the padding in the cost of an X-Ray. [1] Which means those costs are eating into profits in a big way and has healthcare providers struggling to make the math work out. Particularly for those that service poorer areas, where fewer well-ensured patients can offset the cost of uninsured patients. And when you don't have a lot of slack in your budget, it's pretty difficult to add beds and professionals to increase your ability to supply healthcare. [1] Which is another perverse incentive for the hospitals to use new machines/drugs/methods when old ones will do just fine. Firstly, they're incentivized because their profit is largely function of the percent of raw cost the insurance companies allow for profit. So an X-Ray++ brings in more profit than a bog-standard X-Ray for the same amount of professional time. Secondly, because newer tools are by definition not yet commoditized, they can squeeze more 'buffer' into those prices, until the insurance companies can sort out what it 'should' be and more hospitals get in on tool X and begin essentially competing with one another, by accepting lower rates.
    - maxerickson 14y ago
      I meant national health systems. Costs are going up everywhere (or at least, spending) and lots of places are having some issues providing enough treatment.
dtkuhn 14y ago
(1) Help Medicare track cost-effectiveness of tests/procedures involving really expensive technology (development of which will only get more & more expensive); (2) Teach Medicare patients how to become actual consumers of health care (how to shop for price/compare treatment options) -- i.e. help transfer some of the burden of reducing cost from payers to patients w/out causing mass hysteria
- tdfx 14y ago
  I don't think #2 will work without reforming the system to incentivize that kind of behavior. My grandmother goes to the podiatrist to have him cut her toenails (diabetes). There's barely any risk of her doing it herself, but he charges $200 every week for this treatment to Medicare. With her supplemental insurance, she pays nothing for these visits out of pocket. Why wouldn't she go?
  - dtkuhn 14y ago
    Chicken/egg. I'm not sure reform is practical until consumers have the help necessary to shop / compare. Otherwise, you basically have a bunch of old, angry voters.
  - 127001brewer 14y ago
    Interestingly, the trimming of toe nails can be abused with "up-coding" as "minor surgery". When I worked with a group investigating Medicare/Medicaid fraud, this procedure was a commonly abused (with up-coding). The point being is that fraud is a significant problem, but it's not easily solvable.