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It's interesting when this comes up. Having grown up in a medical family I think there are some interesting misunderstandings about medicine between laymen (see
by christkv 14y ago
It's interesting when this comes up. Having grown up in a medical family I think there are some interesting misunderstandings about medicine between laymen (see fancy words here).
1. The treatment outcome between the standard treatment and the deluxe treatment is more often than not statistically insignificant. Basically medicine is still a barbarically primitive science where we barely understand what happens in a body. Thus trials take years and years and yet even if new drugs are approved they end up hurting people.
2. The medical "market" will never be a perfect, due to information asymmetry between the doctor and you the patient. Even if you think you know it's unlikely you are able to understand if option A is better than option B for your treatment.
3. If you have a heart attack you are in no position to negotiate what is a fair price or not, nor are you able to take a rational decision about what treatment is the best cost/benefit for your acute condition. Thus the "provider" has all negotiation power and can charge you what they want (you can of course refuse treatment but that's unlikely to happen).
4. Throw in a boondoggle of more or less serious insurance providers that creates what amounts to hundreds of "distinct" overstaffed administrative systems and you've got the recipe for a dysfunctional expensive non sustainable health care system where more and more "non-poor" people will outside any sensible coverage for themselves and their families.
Any solution to this problem will be drastic both for the industry as a whole and for society.
That said there are some possible good things happening over the next decade. Having a dad that works on cancer vaccines I can tell you that for certain cancers in the next decade the treatment will be as easy as a shot in the arm every week and the prognosis will be much better than the "literal" clubbing of people half to death with inaccurate drugs and chemotherapy.
- photorized 14y agoI would add: 5. Some patients like to file lawsuits, hence expensive lawyers, malpractice insurance etc. Vicious cycle (involving hospitals, big pharma, lawyers, insurers) - can't just fix one aspect. However, as you said - the latest advancements in personalized treatment of cancers are very encouraging. Treatments are becoming more effective, and doctors are finally starting to treat the untreatable.
- cma 14y agoAddressing this was W Bush's solution to the healthcare cost problem. But payouts due to malpractice suits are around 1% of medical expenditures and not all of those payouts are bogus.
- gbhn 14y agoDirectly, yes. But there's a significant effect in overtreatment that is substantially higher. Hard to tell how much higher, because of course, all this overtreatment is justified somewhere. What we know is that we're paying about $10k/family/yr more than we should. The article treats this pretty well -- noting that malpractice isn't the only solution, but admonishing democrats for being too swayed by trial lawyers who want to keep feasting at the malpractice trough.
- cma 14y agoIt is easy. The US pays twice as much as comparable industrialized countries for the same outcomes. Doctors in the US make twice as much, overhead is twice as much, and we pay twice as much for prescription drugs.
- ams6110 14y agoThe US also does most of the innovation, develops most of the drugs, equipment, devices, and treatment regimens, and/or improves on or develops feasible products and treatments based on foreign research and development elsewhere.
- cma 14y agoMost of drug R&D is done as basic research in universities. Drug companies do do research, but their marketing budgets are higher than their R&D budgets. A large portion of the research is looking for baldness-cure/dick/sex pills, along with a substantial sum spent on patent work-around research which isn't setting out to create anything new, just do the same thing in a new way to work around someone else's patent. The cost of the drug R&D you are talking about (aside from publicly funded NSF/NIH research) is minuscule in comparison to the healthcare spending expenditures we are talking about. Device/procedure research is even less of a blip.
- newman314 14y agoAmend #2 to say: Sometimes, neither does the doctor.
- brazzy 14y ago> If you have a heart attack you are in no position to negotiate what is a fair price or not But that's not what's described in the article: "his wife Stephanie knew she had to get him to MD Anderson Cancer Center in Houston. Stephanie’s father had been treated there 10 years earlier" If you consciously choose to consider only a single provider, it's nobody's fault but your own that they now have all the negotiation power.