Can Technology Fix the Health Care System? 570
I was surfing through my usual tech sites for the latest news when I came across an article on Wired News. It turns out Steve Case is not alone in the quest to fix the health care system. I guess I don't get what the big attraction for these guys are.... I know the US's health care system is messed up, but I'm not sure technology can fix all of the aches, pains and dysfunction in our current system. I don't get why they don't just join a major company's board or start a hip/trendy start-up....
The healthcare market has only one impediment. (Score:2, Insightful)
The US had the greatest healthcare system in the world. Then the U.S. Federal State decided to start destroying it, piece by piece, through regulation. After the HMO Act of 1973, healthcare quickly degraded. Instead of removing the regulations, the State decided to make new ones, creating more aggressive monopoly powers (see: AMA), making costs go up (by providing tax rel
Re:The healthcare market has only one impediment. (Score:5, Insightful)
Sometimes we pay to help those who need it. That's the way a community functions. As a Canadian, while I maybe don't have the health care that I need the instant I need it, it's still pretty damn good -- especially when there's an emergency. I pay for it, but I also live in a healthier society as a whole. Perhaps if you had better national helath care, you'd have fewer working poor, who can't afford health care, but make too much for subsidy, and get caught in the nightmare treadmill of constant debt because of a trip to the hospital.
Libertarians make me sad.
Re:The healthcare market has only one impediment. (Score:5, Insightful)
As a libertarian, I must say that as long as your hand is out of my pocket, I don't give a flying frak about how happy or sad you are.
Re:The healthcare market has only one impediment. (Score:5, Insightful)
Re:The healthcare market has only one impediment. (Score:4, Insightful)
Re:The healthcare market has only one impediment. (Score:5, Insightful)
Re: (Score:3, Insightful)
Depends on what your definition of poverty is. Try telling someone impoverished in India or China that most of the "poor" in America are in poverty. Yes, capitalism creates large wealth difference. There's no dirty secret there, that's pretty much the definition of capitalism. But as the rich get richer, they drag the poor up with them. That's why someone i
Re: (Score:3, Insightful)
Re: (Score:3, Interesting)
So, the question remains open: How do you get government out of healthcare, yet ensure that the poor sick/wounded are not left to die ?
Will not happen. Once government gets into it, then it becomes a political lever on the people to increase taxation into perpetuity. People become complacent, dependent and scared to loose it so they pay up. Which is really the problem, who is going ot pay and how many tax increases will be used to pay for it.
If the US does go government health care, do it wisely. Mak
exactly (Score:5, Insightful)
i put it this way: human nature is both altruistic and selfish. any political philosophy you present to the world has to address both sides of this coin, or you have built a political philosophy which is a nonstarter in the real world, because it doesn't jive with the nature of the humans you are attempting to impose it on
we all understand why communism doesn't work: it depends upon altruism, and doesn't address human selfishness. in a communist system, selfishness still exists, in the human beings in the system, but unaddressed by the system imposed upon them, and so selfishness eats communism apart from the inside
if you will, if a whole country suddenly went libertarian, you'd have the exact same problems as a communist country, in reverse along the axis of human selfishness-altruism. it would fail. as miserably and as surely as communism did. for the same reasons, in mirror image reverse
libertarianism appeals to earnest but naive college students with too many philosophy books under their belt, but without any real life experience, who build castles in the sky in their minds about how the world should or would or could work if people just started behaving in ways people have never behaved in any culture or time period since the dawn of mankind
it also appeals to rural folk, who don't understand how they fit into the larger world, and firmly believe themselves to be islands completely owing nothing to anyone else. what they are of course is coccooned within a larger country and system upon which the relative peace and quiet of their worlds depend. but it is hard to see that from the hinterlands until madness marches across the countryside, which it does, unfortunately, in societies that have abandoned the simple common human responsibility we have to take care of each other
and it appeals to 40 something selfish assholes behind on their alimony payments, corrupt and personally bankrupt about any give and take in their lives. nothing more needs to be said of such people. we understand them, and we understand why libertarianism appeals to them on a deep level
libertarianism is a gem of modern foolishness, and you are a glorious fool if you swallow the pap called libertarianism
historical myopia (Score:4, Insightful)
clearly, the founding father's dream, right?
ever hear of a fancy word called "progress"?
libertarianism has nothing to do with what the founding fathers were getting at. the founding fathers were getting at liberty and freedom... freedom from things like disease and lives shortened by infirmary. things a little socialized medicine will fix. what will you lose? some money from your paycheck? you'd prefer to have people die in the streets? if a guy falls down and breaks his arm, do you walk by him and ignore him? no, you take care of him. here's a fancy phrase for you from the founding fathers, who you obviouslly adore, and SHOULD adore: "life, liberty, and the pursuit of happiness." hey genius. what's that first word in there?
LIFE
the fact is, i am more in tune with what the founding fathers wanted than you are
taxes DO infringe on your liberty (Score:5, Insightful)
the bite taxes take out is easy to see and quantify and immediate in effect
a community that doesn't take care of itself is more difficult to quantify, sparse and slow in effect
you are part of a community, you derive your riches from it. taxes are an investment you make to guarantee the health of your community, so that you derive more riches from it. do you think the money in your paycheck is yours by inception from god? no, you worked for it, you provided something to your commuity, and they paid you money
now, in a vacuum, taxes are obviously evil. but in the context of the reality you live in, taxes are a SMALLER imposition on your life than a sick community is
and in life, it is about difficult choices, not simple propagandistic choices presented in a vacuum without any context
do you understand?
there are plenty of things that infringe on liberty in life: sleep, eating. why do i have to sleep? seems like a horrible imposition on my freedoms. of course its a silly statement, because we understand why that imposition on my freeodm occurs
it is also equally silly to think you can live in a community without being taxed, and yet continue to think you can derive financial benefit from a community that you won't take care of
Re: (Score:3, Insightful)
And no, the Founding Fathers were not predominantly what we would describe as libertarian; some of them were to be sure, but they came from many diverse philosophical, political and religious backgrounds espousing a wide variety of ideas on how things should be done. The current idea that was least in evidence was probably socialism, but then again
Choice (Score:2)
The problems with healthcare, IMHO, really reflect a capitalistic, market oriented economy. We have excellent healthcare in terms of keeping us alive when we're nearly dead, but little that makes the time we're here better. most of those t
Re: (Score:3, Insightful)
Re:The healthcare market has only one impediment. (Score:4, Interesting)
Unfortunately, although I think government regulation may well have been the cause of employment and health insurance being conflated, I don't think that deregulation will successfully disentangle the two.
Re: (Score:2)
Do you mean "free" as in beer, speech, or taxpayer subsidized?
Don't you realize it's easier for the government to control you when you can't distinguish between free and subsidized?
Re:The healthcare market has only one impediment. (Score:5, Insightful)
These are very good for routine situations when the population is very healthy and the society (and hence government) is wealthy. They are ok for catastrophic situations when everything is well-funded.
They are, I grant, dreadful in other circumstances.
That said, the idea that 'federal regulation' is the only problem with US healthcare is decidedly simplistic -- with respect to the parent.
To simply pick one problem that doesn't have an easy left/right solution -- lawsuits (and threat of same) are a serious problem in the US. Legal compliance costs and malpractice insurance eat up a huge percentage of a good physician's income.
You want to ban lawsuits against physicians? Very bad idea for obvious reasons.
And yet looking at political manipulation of the health care situation: right-wing protection of drug patents MAY drive innovation, but definitely drives up drug costs. Left-wing protection of trial lawyers drives up the cost of certain procedures and the practice of medically irrational procedures (e.g. C-sections), though it in turn MAY protect some people.
On simple public health grounds a purely freemarket solution seems imprudent (consider what a pay for treatment approach would do to a poor person with some contagious plague?).
Yet the statists don't have it right either. All I can say is that this area merits considerable thought and care.
Ban Lawsuits against Doctors -- Arbitration? (Score:3, Interesting)
Current system, we do not award damages based upon merit, but based upon jury awards. While jury awards are a re
Re: (Score:2)
Give me a break. Health care is not the same as other "products". I can arrange an appointment to get a lower G.I.exam [deaconess.com] done for free
Re: (Score:2)
USA is spending TWICE as much per capita as countries with health care and still can not provide health care for every citizen.
There is nothing wrong with national health care for everyone, just with the US system. It's a sad proof of failure when you spend more and get much less, even compared to countries with higher cost than USA.
Re: (Score:2)
Yes, there is too much government in healthcare. And HMOs were a good idea that went bad very quickly. But look at the real factors in the rising health care costs:
A liability cap for negligence medical cases. Gross negligence shouldn't have a liability cap. Negligence, in legal terms, means you made an honest mistake, and is fairly easy to prove when it actua
Re: (Score:2, Insightful)
I may be reading you wrong, but if I'm not then I on behalf of many other people like me would like to thank you
Re:The healthcare market has only one impediment. (Score:5, Insightful)
Re:The healthcare market has only one impediment. (Score:5, Insightful)
Life is precious and until someone proves otherwise, we only get one shot at it. I don't see how you can put a price tag on that. Maybe your family puts such a low value on each others lives but mine certainly does not. I valued my grandmother and great grandmother all the way up till the end and would have paid any costs asked of me to keep them alive longer.
Re: (Score:3, Insightful)
Would you have paid, say, the cost of a house (call it $200k) to keep your grandparents alive for one more week?
If you would have, then, how about $500k, or $1M? How many years of debt was 1 more week for grandma worth to you, personally?
Assuming that indentured servitude still exi
Re: (Score:2)
It's not the last 5 years... (Score:5, Insightful)
The fact is you can't separate when the treatment is extreme and unreasonable, and when it was reasonable until after they go.
That said about the longer lifespans, the modern entitlement complex is a disaster. Social security solved two problems, getting the elderly out of the workforce (lowering the unemployment rate, we creates a drag on the economy beyond the fact that those people aren't working), and preventing the sickly elderly from being indigent, something reasonable to avoid.
If the retirement age was raised to be the equivalent in terms of life expectancy as it was when social security was created it would be 89 today. That's right, MOST PEOPLE didn't live to collect it, it was to help the helpless elderly. We decided that we were entitled to stop working at 65, while others were responsible for it. I'm not sure why that's an entitlement (I don't begrudge anyone that lived below their means and saved up for retirement), but because we didn't raise it continuously, there is no clean solution now.
I'm not suggesting the people should HAVE to work until their death... but retirement, like vacations, is a luxury that is expensive, and it's not clear why one has a right to ask others to pay for it. The true tragedy is the mythical trust fund, an accounting shell game, has given people the mistaken impression that their have "paid into the system" and therefore are entitled to social security, which is why the system is collapsing on itself.
Note that it's called social security, not a national pension, it's not a reward for payment into the system, it's a safety blanket for the disabled, orpaned, and elderly that need it, and never should have become a way of life.
Re: (Score:2)
$10k per person? Hubby, wife, 2 kids. $40k, in the bank, just for medical emergencies. Right.
1 emergency room visit for a possible broken ankle in a soccer game will easily eat up $5k per visit.
Re: (Score:2)
because i also pay for you.
as a society evolves, its members often choose to distribute certain catastrophic risks, so that by a small contribution from all, no individual need fear a devastating consequence, even if the likelihood is fairly remote.
and no, you can't opt out. i know, i know - you're in great shape and you take excellent care of yourself, and you stamp your feet and pout and dream of the third wide-screen HDTV you could put in the basement den if you di
Re: (Score:2)
Healthcare won't be fixed by what you describe. Especially those with illnesses they cannot cure.
A person born with Type I diabetes has an average out-of-pocket expense (without healthcare) of about $5K a year or more.
A person with chronic asthma is looking at similar costs, especially if they require emergency hospitalization.
A COPD patient (some of which does happen naturally, and not through smoking... chronic asthma patients come to mind) would spend double that amount in so
Re: (Score:2, Insightful)
Take me, for example. Perfectly healthy, decent weight, bike to work, and I hardly ever see a doctor. Except that I've also got an uncommon genetic condition, and need $40,000 of drugs every year until I die. Which might be a bit sooner than I'd like
Re: (Score:3, Insightful)
That's a little disingenuous. It sounds to me like the GP meant that peoples' health is important to everyone --- more important than say gaining wealth. I disagree with his statement as well. It is more than obvious that many folks are greedy and selfish.
When I look at teenagers in the US, I see that isn't the case -- they're more likely to be fat than skinny.
Uhhh, neither
yes, I do, as long as mclarens and bentleys sell. (Score:2)
yes, it is, as long as mclarens and bentleys sell.
0.02% of the world's population hordes 70% of it's wealth. As long as people like the waltons and ted turner are able to squirrel away billions of dollars (with a friggin B) which would otherwise be useful for the
Re: (Score:2)
It is like pouring water into the Indian ocean to fill up a cup in Lake Michigan. Sure, water is water and it is all connected, right? Wrong.
And finding out that it didn't really work that way created some interesting situations. I believe Illinois is now going down the same road of finding ou
Maybe not technology per se.... (Score:5, Insightful)
Re: (Score:2)
People can't even seem to accept that that applies to politics. Healthcare is even harder to get people to listen to policy suggestions about.
Re: (Score:2)
But I personally don't believe that there will ever be a system immune to betrayal. I've grown up in a country where almost everyone is insured (by legislation) and the health system works properly. The downside is that medical treatment is extremely expensive and those receiving treatment don't really care about it (since they don't directly pay for the cost they cause). This system works quite well as long as there is a reasonable amount of doctors offering service and as long as those treating peo
Re: (Score:3, Insightful)
But I personally don't believe that there will ever be a system immune to betrayal.
Immune? Probably not. The point is to make it better than the current one.
Slashdot's moderation system is good example of system that is difficult to game. Not impossible, but difficult. People will complain about it as well, but I'd like to see what people would think if Slashdot turned it off for a day and went back to "anything goes".
Comparitively, making healthcare hard to game is a problem of immense complexity. Doesn't mean it can't be addressed.
In my opinion it's outright impossible to find a reasonable tradeoff between health, profit and cost in such a system.
Are you suggesting that the current system
Broken for whom? (Score:2)
Sure, there are theoretically ways that these systems could be fixed, but in practice that would be very difficult to do.
Why? The people who have the positions and power to make the changes are benefitting from how the status quo, so why would they really want a change?
Healthcare workers get huge salaries, http://swz.salary.com/salarywiz [salary.com]
Diminishing marginal returns on healthcare... (Score:3, Insightful)
Bingo! (Score:3, Insightful)
Oddly enough, one part of the "health care" system that's ignored is the war on drugs. I include it since its ostensible mission is the public health goal of preventing addiction and substance abuse.
Expectations (Score:2)
However, whenever new technology in healthcare is unveiled, everyone expects that it should be available (new treatments, drugs, etc). Healthcare costs more now because more of it is available. There has to be a balance, and
Re: (Score:3, Interesting)
Try and get that across to the American people. Just try.
The problem seems to be Greed... (Score:5, Insightful)
However it is not possible with a free market, since that will charge customers whatever they still can pay and will let those that cannot pay die or live with problems that could be fixed. At the same time, hugely expensive treatments will be available for those that have the money and single wealthy individuals will be saved instead of hundreds without money. Face it: Despite its lip service to christian values, the US is one of the coldest, inhumane countries on this planet, were cristian values are preached but not practised at all. Instead there is this believe that the market can fix anything. It cannot were infrastructure questions like education, public transportation, healthcare, etc. are concerned, since all of these need a really long-term perspective and the will to make thinks work well instead of turning a profit.
Re: (Score:2, Insightful)
Health care in the US is not free market, it is heavily regulated. Because of these regulations, the costs of health care in the US are IIRC, 2.5 tim
except its not regulation that's the problem (Score:2)
So yeah. remove greedy insurance companies, socialize healthcare, profit.
Re: (Score:2)
Re: (Score:2)
Re: (Score:3, Insightful)
Until you can convince folks in the US that they just need to shut up and die with dignity, there are going to be serious differences between European and US healthcare.
Re: (Score:2)
Until you can convince folks in the US that they just need to shut up and die with dignity, there are going to be serious differences between European and US healthcare.
Well, yes. That certainly drives cost. By estension it improoves the income of the transfer
Re:The problem seems to be Greed... (Score:5, Insightful)
In European countries, national health systems buy drugs in bulk and so are able to leverage massive price-cuts which the pharmaceutical companies - who know they could risk loosing an entire national market - usually agree to.
It seems pretty obvious to me that the reason for this situation is that here, unlike in the European countries, the pharmaceutical companies here give large campaign donations to both major political parties and consequently successive governments (from both sides) then give pharmaceutical companies a blank cheque to rip everyone off.
Re: (Score:2)
As far as I can tell, the IRS is one of the nastiest tax enforcement agencies on the planet.
However the question is not about Tax. The Swiss healt-care system (were everybody is insured and Swiss medicine is both not cheap and world-class) is not tax funded at all. Pease quit your misdirection.
Re: (Score:2)
A direct lie. I pay 10.5% income tax here, which is fairly typical. The highest rate I know of is 18%.
Re: (Score:2)
Well, of course you have to accept some degree of freeloaders. That is fine by me, as long as it is under control. Some people do not have what it takes to stand on their own feet. Their lives are valuable nonetheless. And don't forget that medical care may take the edge of their self-abuse, but it cannot make them really well. Th
Technology the cure ... possibly (Score:3, Funny)
Kaiser (Score:2)
http://it.slashdot.org/article.pl?sid=07/04/27/12
Tech can't really fix it (Score:4, Interesting)
Besides cancers and other similar conditions, most problems facing the health care industry are caused by lack of exercise and eating the wrong kinds of food, and its a hard thing for people to change. And generally health care professionals are afraid to give definitive health advice because of the opportunity of lawsuits. How many times have doctors told patients that they should "reduce" instead of "eliminate" or "substitute" some offending substance?
There tons of evidence that most medications (some help) have horrendous side effects [medications.com] and yet people continue taking them as if there's no tomorrow. I think that no matter what doctors, tech, or the government does, its gonna take a sea change for Americans to wake up and smell the coffee and start taking their own health in their hands.
Re: (Score:2)
The answer is: No (Score:2)
Technology is part of the problem. (Score:4, Insightful)
Huh? I don't get it. How is technology going to fix anything? Sure, it's true that there are inefficiencies in the system, like being asked for your health history over and over, as described in the article, but you're not going to wring any major change out of this dysfunctional system just by digitizing people's health histories.
Technology is part of the problem. Technology costs money, and part of the problem with the US system is that it encourages people to spend inappropriately large amounts of money.
The fundamental problem is that it's a positive feedback system that's doing what positive feedback systems always do: wig out exponentially. If you really want to see something scary, look at an itemized hospital bill that includes the costs of things like bandages. The bandages cost 10 or 100 times more than they would at the drugstore. The reason they cost so much is that insurance companies are willing to pay it. Why are insurance companies willing to pay it? Because everything else is ridiculously expensive too, and anyway the insurance companies can raise their rates to cover it. Once the insurance companies raise their rates, the health-industrial complex smells money, and raises their prices.
If you like government regulation, one very simple, sensible thing to do would be for the government to penalize people who are affluent, but have a low deductible compared to their income. If my annual income is $150,000, then they should use tax incentives to browbeat me into not buying insurance that has a deductible any lower than, say, $40,000/year. That would make me treat all these expenditures like real money, not like other people's money. All of a sudden I'd be complaining bitterly about the overpriced bandages. When a nurse pulled out one of the hospital's bandages, I'd say, "No no no-- wait, don't open that! My wife went and got some bandages from CVS. Here, use one of these."
Re: (Score:2)
No. (Score:2)
Technology is not a solution for a
In Healthcare, where does all the money go anyway? (Score:4, Interesting)
So I got the bill a few weeks later. It was astronomical. Luckily the insurance covered it but it was of course filled up with all kinds of obscure bizarre codes that only insurance billers know anything about. What I'd like to see is some auditor look very closely at how the money flows around the medical system and find the $3000 toilet seats that I'm sure are lurking somewhere in their. I wouldn't be surprised if there were a few dirty HMOs that were taking kickbacks from hospitals for over-billing. Hospital over-billing would also be a perfect way to launder money I'm sure because everybody expects the costs to be unreasonable.
I think the best course of action would be for hospitals to sell their own insurance. Having the HMO and the hospital separate creates all kinds of incentives for fraud and over-billing not to mention many different sets of books to take care of.
Re:In Healthcare, where does all the money go anyw (Score:5, Insightful)
Re: (Score:3, Informative)
Amen! Amen! I was wondering when someone was going to get around to posting the truth about how the insured pay for the services that are rendered to the uninsured. Health care organizations "give away" a certain percentage of their services to uninsured or under-insured patients every year. The fancy hospitals in the suburbs that generate a healthy profit are being used to support the hospi
Re: (Score:3, Informative)
Look at an explanation of benefits for hospital treatment. If you have "good insurance", anywhere from 20-60% of the hospital bill is written off when insurance declares the amount charged to be higher than the industry established norm, then insurance pays their portion, and you pay whatever is left over. That "written off" portion neither you nor insurance pays for, the hospital just has to
Re:In Healthcare, where does all the money go anyw (Score:3, Informative)
That's how HMOs work. Instead of kickbacks, they negotiate lower charges for participating medical organizations.
I got Lyme Disease again last summer. I received a bill for $700 for a doctor's visit and several lab tests; my HMO paid $220, and the doctor's office was trying to get me to pay the difference. Not being a moron, I called my HMO, and they got me on a conference call with the docto
If nothing else, it can help. (Score:3, Informative)
- Overhead. Doctors need to hire transcriptionists and billing clerks to do work that could be largely automated. (Our product addresses this).
- Ease-of-use. Most of the EHRs on the market require an office to switch to a very low patient load for a very long training period. This makes migration to a product intended to improve communications and efficiency into an extremely expensive and cumbersome proposition. (Our product addresses this).
- Lack of communications (or standardized records formats). There are *some* standards (HL7 is what we use for integration with 3rd-party scheduling and billing systems where possible), but nothing widely accepted and comprehensive enough to be able to give a patient a flash drive with their complete medical history in a format any doctor's EHR product will understand. Worse, a lot of systems won't integrate with anything else without requiring the customer to fork out serious $$$ for the add-on functionality. (As just one small vendor, there's not so much we can do about this right now)
There are a bunch of other benefits that EHR vendors try to sell folks on -- automatic warnings about allergies, ability to guide the physician towards checking for symptoms that could indicate a serious problem, etc etc etc; I'm coming at this from the back-office geek point of view, though, so I really have no idea how significant these are in the grander scheme of things.Is adding more expensive IT products magic fairy dust that'll make healthcare cheap? Of course not. But technology that's well-thought-out, well-implemented and sanely priced certainly can help to make healthcare less expensive -- and putting records in a portable format benefits everyone.
(That said, there's a lot of poorly-implemented technology in healthcare... but that's a topic for a different, much more anonymous forum).
Re: (Score:2)
You know, they want to have some obscure disease and are sure they really do have it but there isn't any evidence to support them really having it. You hand them their records and when they give them to the new doctor, volia, they were being treated for disease X.
There are also the drug-seekers. Somewhat different problem but still pretty much the same thing.
Yes,
Re: (Score:2)
Re: (Score:2)
Socialized medicine is here already (Score:5, Interesting)
Let's say we went to a world where only private doctors existed and no one accepted insurance. The rich will be able to afford most care (although they're pretty much dead if they need something big like an organ transplant). With insurance so expensive these days, this isn't too far off from reality today.
Now, pretend that you're poor, and you come down with melanoma, despite your best attempt to avoid the sun. You can't afford care, so you wait until the last minute to get care at the ER. By then, your disease is probably advanced and much more expensive to treat, and the ER can't turn your away legally.
The ER charges you some really high price that you can't pay. They repossesses your car and foreclose on your home so you can pay for it. Maybe you can find a lawyer to declare bankruptcy. Meanwhile, the ER is still waiting for their payment, and the doctors have to be paid to pay off their student loans. So what do they do? They charge the rich people more to offset the cost.
Now you're now homeless, without a car to get to work, unemployed, and you're still in debt. Where do you go? Perhaps you turn to a life of crime and end up in prison. You definitely end up on welfare and Medicaid, probably living in a homeless shelter that is likely funded by tax-payer money.
This isn't some theoretical story. It happens to people all the time.
So, all of you who are terrified of having your tax dollars pay for "socialized health care," you're really missing the point. You're paying for it already. You're paying it in your hospital bills as cost shifting. You're paying for it via Medicare and Medicaid. You're paying for it in the prison system (which is the new mental health system). You're paying for it in terms of treating STDs by county clinics and through federally-qualified health centers.
Socialized health care is inevitable because it's already here, albeit in a horribly disorganized and inefficient state. If we kept everyone healthy, the cost of health care would drop for everyone. The question is, how can we do that while balancing quality care?
"How do we do that while balancing quality care?" (Score:5, Interesting)
Now many people reading what I just said are probably thinking, "That's inhuman." These are people's lives, not cars. Well, I'm sorry but this is exactly why health care costs are spiraling out of control. Just like the United States being a debtor nation because people cannot say, "No."
I worked in health care as an analyst and application developer for 3 years. For one: it's a nightmare to use technology to do anything because the systems are hugely complicated and entangled in an enormous amount of rules, regulations, qualifications, exceptions, and so on. For two: we have all the statistical information necessary to classify diseases and injuries by cost and come up with a budget that says, "We can treat that, but the cost is too great given the statistical occurrence of the problem, so we can not treat you."
The outcry against that would be tremendous. But I can tell you for a fact that this is exactly what happens on a battlefield. Any battlefield: a corporate takeover, war between nations, etc. People make brutal choices that have a huge negative impact on peoples' lives all the time. A company buys another because it is expedient and then they let go of 50% of the workers. We don't like that, but we accept it.
But if someone says to most people, "I'm sorry but we cannot treat 30% of these problems. We have the money on hand in the short-term, but in the long-term it will break the system for all of us." People are not altruistic. People will not accept the fact that they have cancer and are going to die because the treatment is available but too statistically expensive. People will not accept the fact that they need some expensive heart surgery because they have been pouring fat and sugar into their bodies for years and now it's time for someone to pay for that abuse.
Many people don't take responsibility for themselves, because we don't have a system that requires it. We put people in prison and relieve them of the responsibility of food and shelter and making adult ethical choices. We provide expensive treatments for people that need emergency treatment because an emergency has occurred as a result of years of abusing themselves. And so on.
We're not going to fix a damn thing until we get better at saying, "No" in the short-term when it is absolutely necessary for a sustainable long-term. And that's true in all aspects of society. Health care, the environment, economics, education, whatever. It's all the same single cause. Most people can't make personal short-term sacrifices for long-term gain. Debtor nation. The one's that can, don't spend much time talking about these things because it goes nowhere. They can't solve other people's problems. People need to take responsibility for themselves or the few that already do have to carry everyone else.
Re:"How do we do that while balancing quality care (Score:3, Insightful)
Re: (Score:3, Insightful)
Progress can be made and health care for everyone is not impossible. But abuses of that system must be curtailed. An example of abuse is one individual consuming enough health care resources to provide a basic level of health care to 20 others because they have some rare disease (congenital or otherwise) or they treated their body poorly (drug use, obesity, etc.). Another abuse is any individual that is sitting on billions of dollars in wealth or is making hundreds of millions of dollars a year. There'
US medical system (Score:4, Interesting)
If you are in a job it HAS to pay medical insurance. People are terrified, not so much of losing their jobs, but losing their medical cover. (Yes, I do know that ruling a frightened people is much, much easier).
Why?
It isn't true in the UK, or Australia, or Europe. So it doesn't HAVE to be so.
But then the USA is one of the most unbalanced countries on Earth. By unbalanced, I mean the rich-poor gap is horrendous. Here we have the richest country in the world, and yet it has large numbers of poor illiterates, sick and dying. It is very, very sad.
I think it is amazing how the USA has gone from being perhaps the most admired country on the planet - say after the 2nd world war, to one of the least admired - say now - in barely a single generation. Quite an achievement.
I think it's time the USA started doing things that the world could admire, instead of steadfastly serving its own interests. In the medium to long term, being greedy and acting like a spoilt, petulant child tends to result in nobody liking you.
What could they (you) do?
* clean up your own backyard
* Institute a decent national medical system. Increase taxes to pay for it. Kill off the medical insurance companies, push back the tide of wealth in the medical profession
* Fix the schools. Put money into the system (gosh, there's tax again) especially in the poor areas. You NEED those scientists and business folk who drive you economy - and if they don't get a decent education because they were born poor, black, Hispanic, Muslim, female (or any of the other sins of America), you won't get them
* stop messing up the world. Stop starting wars (USA has started more than any other country since the 2nd world war ended). Try to do some good - but not with soldiers
* start doing thing that need to be done. How about really, really investing in sensible power generation (and stop giving tax breaks to oil and coal companies - maybe that would save you some of the tax). Do some decent research. Put some people on the moon. Make the world proud! You've done it before - do it again
Mind you, a good start would be just stop driving those horrible little trucks (called truck so they can break their own rules on fuel consumption - I mean really, guys).
Sweden is a far easier country to admire. Finland
And getting a fair and equitable medical industry would be a good start.
Re: (Score:3, Interesting)
Externally, looking in I agree with this statement. I think that the systemic problems in the US right now stem from the fact that the US has begun moving away from a free market system such as it was originally founded upon. The US has begun moving away from personal liberties upon whic
Re: (Score:2, Insightful)
People are the problem, not technology (Score:3, Insightful)
I will never work in a hospital ever again. It was too painful the first time around. I understand that not all users are going to be computer proficient, but to have a user BRAG how little they know about computers, and they will be retiring in a few years, so they will just drag their heals...
Guh!
If ever there was a time to justify beating something with an ethernet patch cord, that was the time.
Fix the people and you fix the single largest impediment in any system.
Socialization WILL fix the healthcare system! (Score:2)
First, theyre greedy as all gtfo. Medical insurance rates have skyrocketed to the point even large corporations can't afford group rates, let alone individuals affording individual rates, and the boards which are supposed to be regulating them are sitting on their hands and taking kickbacks.
Second, they're greedy as all gtfo. The function of insurance (just like the lending industry), is to spread risk among many people. Except t
Re: (Score:2)
Yes, you might get paid more and have to pay more taxes. It would eventually balance out, I'm sure - but not right away. Probably not for a long time.
And most of the Clintonesque 40 million aren't going to be paying taxes either. So their "coverage" would be about the same as it is today. You go to
technology has a HUGE role (Score:2)
- Efficiency. The inefficiency of paper is pretty obvious. Nuff said.
- Record portability. Again, an obvious win to anyone who has been referred to see specialists and must complete a separate history for *each one*. Truly ridiculous.
- Reduced error in prescriptions. Many people get multiple prescriptions from different doctors who aren't f
Re: (Score:2)
There are many reasons why people might do this. The obvious ones are things like you are convinced you have some disease. Your doctor doesn't agree. You get some of his letterhead and write a little note saying you do have it and take it to another doctor. If you might or migh
Re: (Score:2)
But preserving privacy is going to take some heavy lifting, especially if we want to enable organizations to share data. Centralized databases of any
Re: (Score:2)
Re: (Score:2)
But if you get a chance to listen to the podcast, the Kaiser guy gives some examples of where
How the hell.. (Score:2)
And yes, I agree, our national health care system (hah) is non-existent and needs addressing. And there are plenty of discussions to be had among reasonable and intelligent people. But this post isn't the prod for that kind of conversation. It's half a thought, and literally ends on an ellipsis.
Who controls pricing? (Score:2)
The biggest problems in the US healthcare systems are of access and funding. Not everyone can afford access to basic healthcare, and those that can are - generally - paying too much for it. The first contention is sufficiently obvious that I won't bother supporting it. The second should be pretty clear if we look at the profits generated by health ins
Inappropriate use of technology is the problem (Score:2)
Can it be fixed without it? (Score:3, Insightful)
Without I/T systems and infrastructure, obviously any new system you implement to replace the older, obviously inefficient systems would be paper based.
While paper based methods are necessary for some systems (see George W. Bush, US Elections for clarification), I cannot see that being applicable to health care.
No (Score:2)
Doctors don't want IT systems (Score:2)
The problem (Score:3, Insightful)
We don't buy health care, we buy insurance. While insurance works great for catastrophic needs, it falls flat when it comes to ordinary day to day needs, regardless of domain. Automobile insurance works because automobile accidents are (relatively) rare. But our costs are skyrocketing because we are using the insurance mechanism for day to day healthcare. It's as silly as buying food insurance to provide our groceries. The problem is further exacerbated because insurance companies are disinterested agents. They want to keep their costs down, but as long as we pay them, they have no interest whatsoever in keeping *our* costs down. The market system is working, but it's not working for us because we are not a part of it.
This isn't about whether healthcare is funded by the government or not. We can have government funded healthcare in a market based system. We just need to get the patient back in the role of consumer. If you give the poor vouchers for healthcare, and then allow everyone to purchase their day to day health maintenance needs out of pocket, the system can get start getting back on track.
Groan, here we go again.. (Score:3, Insightful)
Unless you fix the setup structurally so it's managed in a decent way instead of by deadbeats and get a consistent strategy and approach in place you'll be throwing money away as you're not fixing the real problem.
The irony is that fixing the real problem would be a huge money saver as well - but that would stop several gravy trains at once, of course..
Re: (Score:2)
Yes, I suppose humans are greedy (although I'm not sure relative to what). You can't change that. "Technology" (which, in the general sense, includes things like laws and law enforcement, locks, etc) keeps it in check. Some places have more room for improvement than others. Healthcare, in my opinion, being one of them.
I'm sorry you are sick, but it seems like you are not helping by simply blaming human nature and suggesting it is unsolvable.
Re: (Score:2, Insightful)
Humans are greedy and cannot survive without money
Why? Is there a shortage of the stuff someplace? Did they forget to print enough? If too many people at the top are keeping too much of it is it possible that they're writing the rules specifically for the purpose of allowing themselves to keep more?
Don't be bitter, but what can we do about it? One set of legislators is just as likely to write the rules in their favor as the next set. How can we possibly opt to stop giving them money when tax collection is automated and we have no direct control over
Re: (Score:2)
Re: (Score:2)
Re: (Score:2)