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Can Technology Fix the Health Care System?

samzenpus posted more than 6 years ago | from the here-is-your-digital-liver dept.

Businesses 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....

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570 comments

The healthcare market has only one impediment. (2, Insightful)

dada21 (163177) | more than 6 years ago | (#18965115)

The biggest impediment to a great health care system is, and will always be, regulation. Regulation comes from one monster: the State.

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 relief for corporations and not individuals), and then tossing new entitlements into the system (medicare, medicaid, VA, etc) that made everyone's prices go up.

What's the old adage about insurance? Invite all your friends to dinner, and most will have burgers instead of steak. Agree to split the bill equally, and a few will order steak, but pay less for their share. Eventually, everyone will want steak, and they'll wonder why no one can afford dinner. It is no different with State-forced health care, and State-regulated healthcare.

To fix healthcare, start by dumping your AMA doctors. Ask your doctor if they are affiliated with the AMA, and if they are, walk. Find a great AAPS [aapsonline.org] doctor, and pay them cash (they are MUCH cheaper paying cash than most deductibles with insurance). Start saving a nice nest egg, and then start increasing your deductible as high as you can -- $10,000 or more once your nest egg gets there. Insurance is for detrimental emergencies, not to check out that cough or find out why your nose is running.

Then, lose weight. Watch your carbs (starches and sugars). You'll have little need likely for doctors once you are healthy.

Finally, go the self-employment route. It works, once you have a big savings account, a high deductible, and are truly healthy because you're not another fat American. By being self employed, you can walk away from the monstrosity that is called "employer-sponsored health care." What a farce.

It isn't the market that made healthcare bad, it isn't corruption or greed -- it is your very government, trying to fix mistakes that the State of past generations has slowly caused. Don't spew garbage about the U.K. either, I have a few ex-patriate friends living there who has mentioned how terrible it is.

Links to good info:

Lowering the Cost of Health Care [lewrockwell.com], Dr. Ron Paul

Free Market Medicine [lewrockwell.com], Dr. Ron Paul

Subsidizing Sickness [lewrockwell.com], Llewellyn Rockwell

Re:The healthcare market has only one impediment. (5, Insightful)

belgar (254293) | more than 6 years ago | (#18965201)

Those who care only for themselves, and have no consideration for the world around them, depress me.
 
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. (5, Insightful)

bheer (633842) | more than 6 years ago | (#18965445)

> Libertarians make me sad.

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. (4, Insightful)

Prysorra (1040518) | more than 6 years ago | (#18965455)

Why is it whenever someone blasts the negative role of government control, somebody has to remark about the person being "cold" or "indifferent" to the poor? Where did he say that the unfortunate should be left to die? He didn't, did he? Are some people seriously this programmed to believe that giving the State control is automatically more humane? If there is a solution more efficient and more effective than the State, then that is what should be.

Re:The healthcare market has only one impediment. (4, Insightful)

Copid (137416) | more than 6 years ago | (#18965717)

Why is it whenever someone blasts the negative role of government control, somebody has to remark about the person being "cold" or "indifferent" to the poor? Where did he say that the unfortunate should be left to die? He didn't, did he?
Well, when somebody advocates taking the state out of the picture without a proposal for replacing benefit that the state provides (e.g. making sure that people get basic health care, even when they have no money), it's not totally out of line to infer that they believe that doing away with that benefit is no big deal. "Get the government out of health care" is all good and fine, but the question remains, how do we keep people with no money from being left to die? If I see a proposal that answers that question while fixing the broken half-assed market that is our health care system, I'll start taking it seriously. Until then, we're just waxing nostalgic about how great it would be if everything was more like a Charles Dickens novel again.

Re:The healthcare market has only one impediment. (1)

billcopc (196330) | more than 6 years ago | (#18965597)

Amen brother! I still wish our hospitals were more efficient, seems like a lot of waiting time is due to the bureaucracy, but it's one of many Canadian perks that have kept me from selling out to the more lucrative IT opportunities south of the border. I'm a relatively health guy, but the very thought of paying through the nose for basic healthcare is enough of a threat to make me want to stay home in chilly old Ontario.

exactly (5, Insightful)

circletimessquare (444983) | more than 6 years ago | (#18965605)

libertarianism is nothing but a code word for selfishness, dressed up in political signals and philosphical portents. but if you dress up a cheap whore in a fine dress, she's still a cheap whore. so it is with libertarians and anyone who spouts that nonsense

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

Re:The healthcare market has only one impediment. (1)

CannonballHead (842625) | more than 6 years ago | (#18965227)

It's not only the government, though - we don't like paying for our own medical care. We have seemed to come to the understanding that it's the state's job to keep us healthy, and if we can't pay to have our back adjusted three times a week, the government needs to provide.

It's really hurt the doctors and hospitals, too... when you aren't actually paid... well, it can make it hard. Lots of docs don't like HMO's. I guess it's like buying a car. There may be financing options, sure, but the government shouldn't help you pay for your car, and car dealerships are a lot happier when you can pay in cash. Money speaks a lot more than promises of money.

Health care isn't a right, it's a privilege. Interestingly, the same appears to be happening with social security and things like that. Way back before social security, people actually thought about it, and provided for their own future at a partial expense of splurging in the present. Funny thought, that... actually planning ahead, thinking about what you pay for! Wow.

Re:The healthcare market has only one impediment. (1)

HomelessInLaJolla (1026842) | more than 6 years ago | (#18965267)

we don't like paying for our own medical care
I have no problem paying for my own medical care. Most of the people I know have no problem paying for their own medical care.

What we have a problem with is paying for our own medical healthcare and paying for the hyperextended government oversight of it as well. We didn't ask for the enormous expenditure of superfluous government involvement.

Amen for the government driving UP healthcare cost (0)

Anonymous Coward | more than 6 years ago | (#18965933)

And Amen again... apparently people don't realize how much cheaper healthcare would be if the government would just leave healthcare professionals alone and let a free market run it's course.

If you had any idea how much money the healthcare industry had to spend on being 'compliant' with all the government's rules and regulations, you'd be bitching about how much the "government" was making you pay for your healthcare, and not the doctors.

But hey, at least it creates lots of jobs for accountants, right?

Re:The healthcare market has only one impediment. (2, Insightful)

Anonymous Coward | more than 6 years ago | (#18965421)

So a person that's born with a life threatening disease that needs (multiple) major surgeries and that hasn't had enough time to begin earning money (still in College) should basically just die or have to rely on charity? Since that pretty well describes me, let's just say I'm glad I live in one of those 'socialist' European countries that actually gives a damn about keeping it's citizens healthy.

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 for telling us to STFU and die already. Hey I know what! I'll go away and think about it a bit like you suggested and then I'll magically be better right?

Re:The healthcare market has only one impediment. (1)

timmarhy (659436) | more than 6 years ago | (#18965271)

your plan is great in theory, however in the real world perfectly healthy people get sick and require hospital care which would chew up your $10,000 in the first week.

this is what health insurance is for.

your only 1/2 right about the state breaking the health care system. believe it or not, their ARE things where free markets do not work, and health care is one of them. reason being that health care doesn't deal in money, it deals in peoples health which is priceless. all the typical measures used in a free market don't apply to health care. the only way to fix health care is to find a way where making money comes 2nd to treating peoples problems.

there is also a LOT of waste in health care, we could probably start by looking at that

Re:The healthcare market has only one impediment. (0)

dada21 (163177) | more than 6 years ago | (#18965327)

your plan is great in theory, however in the real world perfectly healthy people get sick and require hospital care which would chew up your $10,000 in the first week. this is what health insurance is for.

Which is what I advocate -- health insurance, with a $10,000 deductible (and max annual out-of-pocket payout). You save $10,000, you're covered for that real emergency. My AAPS doctor is never more than $25 a visit, and he does home visits. He also will never accept medicare or medicaid, so he is under no obligation to overcharge me. He prefer cash payments up front, and I even tip him. AAPS doctors are the way to go for non-major health needs.

your only 1/2 right about the state breaking the health care system. believe it or not, their ARE things where free markets do not work, and health care is one of them. reason being that health care doesn't deal in money, it deals in peoples health which is priceless. all the typical measures used in a free market don't apply to health care. the only way to fix health care is to find a way where making money comes 2nd to treating peoples problems.

Actually, the free market of health care DID work, it was all the new regulations added on top of the free market that destroyed the market's ability to perservere during problem streaks. I also disagree that peoples' healths is priceless -- if it was, people would spend any amount of time or money to stay healthy. When I look at teenagers in the US, I see that isn't the case -- they're more likely to be fat than skinny. When I look at retired folk, I see the same problem. People who don't care for their health in the first place can not consider their health priceless.

The majority of health problems in America can be pointed to the fact that the State has destroyed personal responsibility to prevent health issues. Heart disease is greatly worsened by being fat. Many cancers are related to lifestyle choices, including eating and the lack of intelligent decisions in other consumptions. Don't think for a minute that I think my life is not priceless, but I also prove that by eating healthy, exercising, and making wise decisions in putting my money into future concerns rather than spending it today.

If you don't, why should I pay for you? If you live an unhealthy lifestyle, you've already shown me that your life is NOT priceless because you don't care about the future.

Re:The healthcare market has only one impediment. (1)

YrWrstNtmr (564987) | more than 6 years ago | (#18965423)

Which is what I advocate -- health insurance, with a $10,000 deductible (and max annual out-of-pocket payout). You save $10,000, you're covered for that real emergency.

$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:The healthcare market has only one impediment. (1)

flacco (324089) | more than 6 years ago | (#18965607)

If you don't, why should I pay for you?



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 didn't have to participate, and you resent all those less-fortunate and less-observant "others" who you feel you're paying for. but you're not paying for them - you're paying for the distributed risk.

Re:The healthcare market has only one impediment. (1)

michaelnz (701047) | more than 6 years ago | (#18965851)

I'm honestly curious though with a $10,000 deductible (and max annual out-of-pocket payout) what happens when your sick for more than one year in a row? Assuming you can't work during that time and save up another $10,000. Doesn't that present a real problem for people who unexpectedly get a disease that takes years to cure? Not to mention families when something may go wrong with two different members.

Re:The healthcare market has only one impediment. (1)

timmarhy (659436) | more than 6 years ago | (#18965925)

" I also disagree that peoples' healths is priceless " and then you contridict yourself here "Don't think for a minute that I think my life is not priceless" - or is it you think your own life is pricless but not others?

I used to work in health care, and if you think you can put a price on any part of your body that would compensate you for it's loss, your sadly mistaken.

i do however agree with you that personal responsibility has a great deal to do with it. far too much is spent on diabeates which is preventable for many people.

Re:The healthcare market has only one impediment. (5, Insightful)

Original Replica (908688) | more than 6 years ago | (#18965497)

Over 75% of health care expenses (total) are at the beginning and end of life. I have no problem having Fed sponsored maternity wards, but I do have a problem with $5000-a-day geriatric care. Sure we have the tech to prop up a body that wants to die, but after the first 60 years I don't think we should. My parents are getting close to that age, and my remaining grandparents are well past it. When my grandfather was diagnosed with lung cancer, leukimeia, and alzhiemers with-in one year, he made his peace and died in his own bed at home. When we as a culture accept that growing old and dying are natural and that "fighting to the end" is not always the best choice, then the costs of health care in this country can begin to return to reasonable levels.

Re:The healthcare market has only one impediment. (4, Insightful)

geek (5680) | more than 6 years ago | (#18965817)

I don't know about anyone else but if I can "fight to the end" and wring out an extra 30 years of life from this body, I have every intention of do so. Just because someone is 60 doesn't mean their life is less valuable or that they have no more to contribute to this society. Your assertion that we "prop up" bodies wishing to die is assinine in the extreme. If we had taken that stance 100 years ago, or even 50 years ago, we'd never have extended the average life span by 20 years + and made the advancements in medicine we have.

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:The healthcare market has only one impediment. (1)

timmarhy (659436) | more than 6 years ago | (#18965981)

but i'm still a red six, right?

seriously, 60 isn't the end of the world, and you can't deny someone health care based on age. remmeber YOU will be that age one day to. lets see if you change your tune when it happens.

if a person wants to pay for their own health care and fight cancer to the end then fine, they have been paying into health insurance for decades by that time so they deserve that right.

Re:The healthcare market has only one impediment. (1, Insightful)

Anonymous Coward | more than 6 years ago | (#18965569)

People's health is priceless. [T]he only way to fix health care is to find a way where making money comes 2nd to treating peoples problems.
Wrong and wrong. The notion that 'people's health is priceless' is EXACTLY the problem society faces. Your health is NOT priceless. Your life is not worth 100 billion dollars. Not only that, but your life is not worth even a billion dollars. It probably depends on who you are, but I'm willing to wager that your life isn't even worth a million dollars. You may bristle at that notion, and you can bristle all you want, but this is a hard realization we all have to make. As soon as we do, then we (both as a society and as individuals) can weigh costs vs benefit much more rationally. It is also the only way you can ever hope to measure waste, otherwise every gold-plated treatment looks perfectly lean.

Get over you distaste for money. There is nothing dirty about money, it is simply a resource allocation mechanism. Do you think it is right to spend all of a society's resources on medical causes that provide a few bed-ridden months at the end of life when those same resources could be spent providing higher quality/effective care to children and young adults?

Re:The healthcare market has only one impediment. (2, Insightful)

daeg (828071) | more than 6 years ago | (#18965297)

MANY small clinics are switching to cash-only. Insurance? They don't care. Submitting insurance is incredibly expensive for small clinics. It requires many man hours of work. It requires computers, extensive records (above and beyond reasonable record keeping), etc. If you want your insurance to pay for it, you have to file it yourself, and hope you filed all the paperwork correctly, on time, with the correct proof and records.

Re:The healthcare market has only one impediment. (3, Interesting)

roscivs (923777) | more than 6 years ago | (#18965397)

The US healthcare system has two choices to get better: either socialist free health care, or divorcing health insurance from employment. Right now we have the worst of both worlds. If people were free to shop around for health insurance like they shop around for car insurance, I'm confident that a host of problems currently plaguing our health care system would be solved.

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:The healthcare market has only one impediment. (1)

goldspider (445116) | more than 6 years ago | (#18965947)

socialist free health care"

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. (1)

wizardforce (1005805) | more than 6 years ago | (#18965583)

Eventually, everyone will want steak, and they'll wonder why no one can afford dinner. It is no different with State-forced health care,
I wasn't aware adequate medical care was "steak." but seriously, I don't quite follow your logic here, how do you suppose that kicking out any controls it is somehow going to fix this? where you not on Earth when california had that electricity crisis caused by wait for it... deregulation? what needs to be done is find a way to lessen the cost of healthcare without the utter hell that are HMOs. when it stops costing nearly a billion dollars to bring the next "miracle" drug to market then we might see this get better, but the solution isn't to turn a blind eye to these things- there needs to be some regulation of things at the least to prevent the proliferation of monopolies...

Re:The healthcare market has only one impediment. (4, Insightful)

Holmwood (899130) | more than 6 years ago | (#18965587)

I've spent most of my life living under socialized health care systems. (Canada, Europe).

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.

Re:The healthcare market has only one impediment. (1)

michaelnz (701047) | more than 6 years ago | (#18965661)

I grew up, lived and worked in America for several years before emigrating to New Zealand so I've seen both sides of health care, state and private. From that experience I can tell you that the US health system is seriously fucked up. Oh, there are definite problems with the way things are in other countries; wait times for non-essential procedures can be frustrating. But you know what's the longest wait time of all? Never getting the procedure because you can't afford it. So for a large number of Americans (the millions without health insurance) they experience much a longer wait time than those in countries with socialized health care. Those Americans usually wait longer to have something checked out too so that preventable conditions get worse.

I've been away from America for a long time so maybe things have changed but why aren't there Health Care Unions in the model of Credit Unions? If there's one thing that should be non-profit it would seem to me to be health care. My credit union in the states was the best bank I ever had, the customer service was a thousand times better and they passed savings downward to customers and the community. If the US government won't provide health care to it's citizens why don't citizens do it for themselves? Chances are they could do it better.

Re:The healthcare market has only one impediment. (0)

Anonymous Coward | more than 6 years ago | (#18965663)

The biggest impediment to a great health care system is, and will always be, regulation. Regulation comes from one monster: the State.

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.


Although I do agree with all of this, I also believe that the real problem most all of our modern issues is the rise in power of the federal government and the collusion between them and the guys with the big bucks.

Look at the trend here. The federal government keeps rising in power and has been since WWII, and the federal government keeps siding more and more in favor of the guys with the big bucks.

Bush is at least the worst president since WWII, and look at what he has done, and what he keeps trying to do. He is the epitome of lets favor the federal government and the people with big bucks.

Back to healthcare for a minute. If you are wealthy or at least white collar (for today), the US has a great healthcare system. I'm a middle class guy with a white collar job, and I've had my healthcare subsidized by my work plus the money taken out of my checks _before I even get my check_ ever since I've had a full-time salaried job. Just a hint here, only 3 people take money out of my check before I get it. 1) The federal government 2) the "wealth management" retirement people and 3) medical insurance.

Now, something that is near and dear to the slashdot crowd. Take for example the RIAA and SCO. Both of those organizations are simply parasites of our society that are deemed OK simply because they are wealthy lawyers. Oh, and look who leads the federal government (hint, wealthy lawyers).

Look at what has happened since 9/11/01. Our freedoms and privacy have gone down. The Federal government has risen in size by over 10%. Another war has been waged w/o a clear and explicit reason. (BTW, I believe yesterday was the 4 year anniversary of Bush announcing our victory in Iraq). The wealthy are more wealthy, and the middle class is shrinking. Its not a pretty trend in my eye.

Now, I guess its easy for me to be on the "its not as good as it used to be" bandwagon, and all of that, but I'm looking at a 50+ year trend, and the last few years have not been good ones for the US. Maybe things will settle down once the baby boomers die off, but if things don't get better, I feel really sorry for the young people in this country and those the next couple of generations after that.

Can technology fix this? Nope.

Re:The healthcare market has only one impediment. (1)

easyfrag (210329) | more than 6 years ago | (#18965691)

What's the old adage about insurance? Invite all your friends to dinner, and most will have burgers instead of steak. Agree to split the bill equally, and a few will order steak, but pay less for their share. Eventually, everyone will want steak, and they'll wonder why no one can afford dinner. It is no different with State-forced health care, and State-regulated healthcare.

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 any time I want but I haven't. And if I did I certainly would not want to order more than I need even if it is free. Have you ever needed a medical exam or treatment? They are not "steak dinners" in any sense. The only people who would avail themselves of more than they need of these types of "products" are masochists and that fairytale of economics: the so-called rational actor.

Re:The healthcare market has only one impediment. (1)

yams69 (986130) | more than 6 years ago | (#18965869)

What the hell does being a member of the AMA have to do with the price of health care? It ain't a union, you libertarian troll.

The real culprits driving up the cost of healthcare are the for-profit HMOs (altruism, which health care is, should never be for-profit; read about the Knights Hospitallers who had the idea of the hospital) and the ambulance chasers that drive up the cost of doctors doing business. You might be able to make an argument about Medicare, granted, but it's the folks who look at your illness with dollars in their eyes that should be thrown off the boat.

Hello! I'm a Slashdot troll! (0, Informative)

Anonymous Coward | more than 6 years ago | (#18965131)

Please mod me down.

-1, Troll

Thanks!
A Slashdot troll

Maybe not technology per se.... (4, Insightful)

catbutt (469582) | more than 6 years ago | (#18965163)

But I'd suggest that proper application of game theory is key. Making a system that is hard to manipulate (i.e."game") is a very challenging problem, and frankly, I find it a lot more interesting one than the submitter seems to.

Re:Maybe not technology per se.... (1)

Chandon Seldon (43083) | more than 6 years ago | (#18965509)

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:Maybe not technology per se.... (1)

nbert (785663) | more than 6 years ago | (#18965531)

Agreed.

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 people don't start to "optimize" their diagnosis. In my country there is a abundance of people having studied medical science and there are various programs available helping doctors to shape their diagnosis in a manner which maximizes profit.

In my opinion it's outright impossible to find a reasonable tradeoff between health, profit and cost in such a system.

Re:Maybe not technology per se.... (2, Insightful)

catbutt (469582) | more than 6 years ago | (#18965789)

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 can't be improved? Or it's just not possible to improve it enough to meet your (presumably arbitrary) threshhold of "reasonable"?

The answer? (-1, Troll)

robyannetta (820243) | more than 6 years ago | (#18965169)

No.

The healthcare system is not broken. You see, humans program the technology. Humans are greedy and cannot survive without money. Humans then program the technology to keep humans just sick enough to make money off them and their insurance. This is why I still have cancer and the healthcare system is still broken.

(I was never bitter until I witnessed the healthcare keep me sick)
-----
Just my $0.02, take with a grain of salt, your mileage may vary.

Re:The answer? (1)

catbutt (469582) | more than 6 years ago | (#18965213)

So your solution is to fix humans?

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:The answer? (2, Insightful)

HomelessInLaJolla (1026842) | more than 6 years ago | (#18965235)

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 their spending?

Re:The answer? (1)

pete6677 (681676) | more than 6 years ago | (#18965417)

I've certainly heard this conspiracy theory before. The only problem is that if it were true, lifespans would have been longer 100 years ago, when medical technology barely existed and health care was certainly not big business. But of course this was not the case; people used to die young from diseases that are now easily treatable by health care professionals.

Steve Case? (0)

Anonymous Coward | more than 6 years ago | (#18965171)

Anyone else think Stevie Case would do a good job, too?

Can Technology Fix the Health Care System? (1)

WrongSizeGlass (838941) | more than 6 years ago | (#18965175)

I guess that all depends on if a robot masseuse can give you a massage with a happy ending.

Re:Can Technology Fix the Health Care System? (0)

Anonymous Coward | more than 6 years ago | (#18965847)

but seriously, would you really accept a happy ending from a robot?

forest, trees (0)

Anonymous Coward | more than 6 years ago | (#18965185)

HMOs are another part of a bigger issue.......everyone thinks they MUST live on forever and have EVERY miracle cure for everything. Same reason pharmaceutical companies can get away with charging insane amounts of money for the latest miracle drugs, even though they LIE THRU THEIR TEETH about the cost of R&D.

Diminishing marginal returns on healthcare... (2, Insightful)

TheNarrator (200498) | more than 6 years ago | (#18965189)

If you took the current medical system and had the government spent 10x as much on it prices would rise around 10 times. That's because doctors who want to work are all working, getting paid very well, and more money will just make them have to raise their prices or, if their prices were fixed, result in a shortage of available time slots for patients. The fix is is to make health care more efficient by not requiring someone who had to go to 8 years of college to give you a refill on your antibiotics, etc. There are serious medical cases that need expert attention but the vast majority of health care problems suck up the efforts of lots of highly trained accountants, overseers, inspectors, lawyers, claims adjusters and health professionals when the transaction could be so much simpler if they'd just trust people to have a bit more personal responsibility over their own health and not try to make sure that every single step of their treatment is authorized and approved by a limited pool of highly skilled professionals who are much better employed elsewhere.

Bingo! (2, Insightful)

swb (14022) | more than 6 years ago | (#18965917)

You got it right. The doctors have established what amounts to a state-sponsored cartel that prevents anyone from practicing medicine who isn't a member of their cartel, even well-trained people like nurses or patients themselves who may be much better in tune with their health than they're given credit for.

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. The DEA alone spends $2.5 billion (up from $1 billion from 1995!); add in the total expenditures of all state and local drug enforcement efforts and you have probably something on the order of $40 billion spent on an effort that obviously doesn't work well if at all.

$40 billion in spending would go a long way towards dealing with some of the skyrocketing costs.

This article contains numerous errors. (0)

Anonymous Coward | more than 6 years ago | (#18965191)

The article contains numerous errors in regards to # of uninsured, % of Americans uninsured, and the pricetag of the US healthcare system.

Expectations (1)

DigitalCrackPipe (626884) | more than 6 years ago | (#18965209)

It seems to me that the problem is expectations. If we set the bar lower, say providing 2001's level of capability, the costs for care would go down. Standard behavior with any product - cost of production for the original item goes down as time goes on (and patents expire, etc).

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 right now it is tilting towards more care for more cost.

Re:Expectations (1)

timmarhy (659436) | more than 6 years ago | (#18965449)

thats a stupid argument and ignorant to boot. would you expect anything but the best if it was your own life on the line? of course not.

Re:Expectations (2, Interesting)

cdrguru (88047) | more than 6 years ago | (#18965961)

The solution is Canada, Europe and the rest of the world. The are used to living with what is available even though they know it might not be the best.

Try and get that across to the American people. Just try.

The problem seems to be Greed... (4, Insightful)

gweihir (88907) | more than 6 years ago | (#18965245)

... and a strong believe in suvival of the fittest. Look to Europe: Afordable, reasonable healthcare for everyone is not a dream. Many countries have it. For example in Swizerland everybody has health-insurance, you cannot be without it, whether you have money or not.

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:The problem seems to be Greed... (1, Insightful)

Mr. Flibble (12943) | more than 6 years ago | (#18965439)

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.


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 times higher than anywhere else in the world. Health care costs the most in the US out of anywhere in the world, and the US spends the most out of any country on health care, but does not get the benefits of those costs. So, a true free market system would actually be better than what is currently in place, because competition would allow a decrease in prices for consumers seeking treatment.

Having said that, in most cases health care is a form of market failure as those who are unable to afford it cannot get it, so in that case, it can be warranted to have a system in place to correct for a failure.

except its not regulation that's the problem (1)

plasmacutter (901737) | more than 6 years ago | (#18965765)

it's the inflation and beurocratic burden that is private insurance. This is the same thing that happened with auto repair.

So yeah. remove greedy insurance companies, socialize healthcare, profit.

Re:The problem seems to be Greed... (2, Insightful)

cdrguru (88047) | more than 6 years ago | (#18965507)

Europe generally has a quite different attitude towards death and dying than folks in the US. If you are going to die, just hurry up and get it over with. Whereas in the US it is something to be put off as long as possible, even by extraordinary means.

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:The problem seems to be Greed... (1)

gweihir (88907) | more than 6 years ago | (#18965839)

Europe generally has a quite different attitude towards death and dying than folks in the US. If you are going to die, just hurry up and get it over with. Whereas in the US it is something to be put off as long as possible, even by extraordinary means.

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 transferral of funds from you to the medical system. And there is zero morality in living longer. You get a certain time, and when its over, it is over. Strangely I would expect a religious society as the US to understand this better than the more secular Europe. But is seems religion is (again) more of a hinderande than a boon in this question. Living additional days at the cost of some poor people not getting basic healthcare is obviously highly immoral.

Maybe the basic problem is that the ones with money in the US typically have both religion and the knowledge that they did not live good lives as by the standards of their religion. Thus they want to defer meeting their maker and being judged as long as possible.

Disclaimer: I do not really understand religion. Personally I believe in some form of reincarnation, but the believe in some "super-supervisor" that has ultimate power seems to be the ultimate denial of personal, individual responsibility to me. So I can only speculate on what drives religious people (and those that claim to be religious). Still, dying with dignity and not at the last possible moment is pretty high on my list of priorities, even if I statistically should have several decades left.

Re:The problem seems to be Greed... (4, Insightful)

malsdavis (542216) | more than 6 years ago | (#18965561)

The USA will never have European style universal free health-care while the large pharmaceutical companies hold so much power. Currently pharmaceutical companies from all over the world love the USA as they can pretty much charge whatever they want.

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:The problem seems to be Greed... (0, Troll)

Just Another Poster (894286) | more than 6 years ago | (#18965609)

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.

And heavily-armed tax collectors coercing money from people upon penalty of imprisonment or death is "warm", "humane" and "Christian"?

Is it more "warm", "humane" and "Christian" when the State goes a step further and bans private health care altogether, as is the case in Canada?

Re:The problem seems to be Greed... (1)

gweihir (88907) | more than 6 years ago | (#18965711)

And heavily-armed tax collectors coercing money from people upon penalty of imprisonment or death is "warm", "humane" and "Christian"?

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:The problem seems to be Greed... (0, Troll)

goldspider (445116) | more than 6 years ago | (#18965811)

Long ago our country decided that everyone should have the opportunity and responsibility to provide for their own well-being.

Today we have people like you who believe that people should be able to do whatever they want to their bodies and compel the rest of us to pay for their inevitable health problems.

If being angry that my insurance costs pay for people who smoke 3 packs a day, eat fast food 5 times a week, and consider channel-surfing exercise makes me greedy and unsympathetic, then I am proud to be greedy and unsympathetic.

Re:The problem seems to be Greed... (1)

timmarhy (659436) | more than 6 years ago | (#18965871)

the swiss pay 80% income tax. next please.

Re:The problem seems to be Greed... (1)

gweihir (88907) | more than 6 years ago | (#18965909)

the swiss pay 80% income tax. next please.

A direct lie. I pay 10.5% income tax here, which is fairly typical. The highest rate I know of is 18%.

Technology the cure ... possibly (3, Funny)

Anonymous Coward | more than 6 years ago | (#18965259)

A collar that shocks it's wearer every time they try to stuff a Big Mac, Twinkee, Slurpee or Hoagie down their gullet.

Re:Technology the cure ... possibly (0)

Anonymous Coward | more than 6 years ago | (#18965285)

and sick rabid insane cheetahs to chase them daily....

Mirror of Article, in case it gets Slashdotted. (-1, Troll)

Anonymous Coward | more than 6 years ago | (#18965261)

Mirror here [hideffreeporno.com]

Bureaucracies can be modeled (0)

Marxist Hacker 42 (638312) | more than 6 years ago | (#18965273)

Anything human beings can do with a bureaucracy, computers can do lots faster and more accurately. Thanks to data mining techniques pioneered in the last few years, expert systems can even find efficiencies and improve themselvs.

So to me, the answer is yes. What is wrong with our health care system is that it is a human run, for-profit bureaucracy. Replace that with a computer run, single payer system and you will realize billions of dollars in immediate resource allocation savings- dollars which can then be used to feed back into the system and used to provide health care to more people.

That, and I trust a computer more than I trust a politician any day.

Tech can't really fix it (3, Interesting)

esconsult1 (203878) | more than 6 years ago | (#18965329)

I mean, come on. People just want a pill to fix their woes. How many times have you met someone that you know have a condition that can be easily fixed through diet and exercise alone?

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:Tech can't really fix it (0)

Anonymous Coward | more than 6 years ago | (#18965575)

What do you mean about only some medications helping?

You need to take into account that many times medication is a fine balancing act that is designed to buy you time now because you may not live otherwise.

For example, many people, myself included will take warfarin a drug that increases you chance of bleeding to death, but the payback is that you have a far reduced chance of clotting. At the end of the day, this is worth it for the vast majority of people.

You also have to consider that mostly the side effects are worse then what the drug is preventing. In the example above excessive bleeding is far more manageable (at least in people below retirement age) then a deadly clot. As always with medications YMMV.

Technology is part of the problem. (3, Insightful)

bcrowell (177657) | more than 6 years ago | (#18965365)

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:Technology is part of the problem. (0)

Anonymous Coward | more than 6 years ago | (#18965635)

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.
No, the reason medical supplies cost 10-50 times more than the equivalent (effectively identical) item purchased at a pharmacy is the much more stringent quality control, and the associated paperwork, traceability, insurance, etc. When QC is higher, you have greater inefficiencies and more product lost (although you may be able to sell it on the normal market). This is just like processors, where the perfect ones can be sold for more than the semi-defective ones (which are underclocked or whatever and sold under a different name).

The rest of your argument still holds, and indeed the having massive liability insurance built-into the price of every medical supply is not necessarily a good thing. But other things (like stringent quality control) do indeed cost money, and you cannot expect medical-grade supplies to cost the same as consumer-grade equivalents.

Re:Technology is part of the problem. (1)

Copid (137416) | more than 6 years ago | (#18965985)

No, the reason medical supplies cost 10-50 times more than the equivalent (effectively identical) item purchased at a pharmacy is the much more stringent quality control, and the associated paperwork, traceability, insurance, etc.
I'd be very interested in seeing a detailed accounting of something like a box of bandages. I'm highly skeptical that the numbers work out the way you say they do.

No. (1)

Mr. Flibble (12943) | more than 6 years ago | (#18965367)

Technology cannot. The system is broken from the implementation. I wish I had the reference material with me, but as explained in this TTC Course on Economics [teach12.com] the American system is set up to charge too much for services. The professor of those lectures recommends the German system over all other popular systems for being most efficient and manageable. He also suggests that the Canadian system is broken (which I use) but it is not currently as badly broken as the US system.

Technology is not a solution for all problems. In this case, the underlying system and procedures are flawed, and technology will not fix those problems.

Absolutely! (0, Troll)

955301 (209856) | more than 6 years ago | (#18965369)


Sure it can fix healthcare! Just look what it's done for the FAA, Bureau of Indian Affairs, the Russian submarine K-141 Kursk, and the myriad of undisclosed technology related disasters to pick from.

We don't have this right yet. Perhaps somewhere else, but definately not in the US. I just left a project where IBM had their weasels walking the halls and inviting executives to the golf course in an effort to grab a sale versus a really good product that specialized in the area my client was purchasing for. We need about another 30 years in this country before anything but specialized systems are applied against healthcare.

Hell, fix the transportation system first and replace cars with PRT's and you'll eliminate a good percent of the hospital visits in the first place.

In Healthcare, where does all the money go anyway? (3, Interesting)

TheNarrator (200498) | more than 6 years ago | (#18965409)

I was in the emergency room for a few hours because I got suddenly very sick after a tooth extraction to the point that I was going to die. They ran a bunch of tests and gave me a saline iv and then sent me home shivering with a 102 fever.

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 (5, Insightful)

pete6677 (681676) | more than 6 years ago | (#18965457)

The money doesn't go towards $3000 toilet seats. It goes towards $3000 worth of treatment given to an uninsured person, as the hospital is required by law to do. They make up for unfunded charity care by sticking it to anyone who has good insurance.

If nothing else, it can help. (2, Informative)

cduffy (652) | more than 6 years ago | (#18965425)

I'm senior tech staff at a late-stage startup making an EHR product (consider my bias declared), and I have a fairly decent window into at least a few of the places where the healthcare system is broken.
  • 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:If nothing else, it can help. (1)

cdrguru (88047) | more than 6 years ago | (#18965915)

You mention giving a patient a flash drive with their records on it. How do you deal with patients modifying (or attempting to modify) the data?

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, this is a psychological problem and should be treated as such. Today most people are just shunted off somewhere and it doesn't do too much harm. But digital records, especially portable digital records give an opening to these kinds of people.

Socialized medicine is here already (4, Interesting)

DebateG (1001165) | more than 6 years ago | (#18965435)

My friend and I just had a conversation about this last night. The fundamental problem is that your health is my responsibility, no matter what.

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?

US medical system (4, Interesting)

SimonInOz (579741) | more than 6 years ago | (#18965453)

The US medical system is definitely sick. US citizens spend drastically more on medical care than other countries. If you are poor you cannot get decent medical help. If you are a visiting tourist and you get sick then you are in for bills that will make your eyes water.
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 ... The list is far too long, guys - you come below Ireland in the Human Development Index. It's about time to pull your socks up America.

And getting a fair and equitable medical industry would be a good start.

Re:US medical system (2, Interesting)

Mr. Flibble (12943) | more than 6 years ago | (#18965559)

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.


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 which it was also founded. And finally, the political system in the US is structured to realistically allow for only a 2 party system (as no other parties can compete effectively) and because of this, it is difficult to enact any real change.

The sad irony is that the "patriots" in the US should be wrapping themselves in the constitution, and not the flag. I am disappointed as a Canadian, where I live in a non Constitutional Republic, and I feel that I have more freedoms than my neighbors to the South. Realistically, it should not be this way.

Re:US medical system (0)

Anonymous Coward | more than 6 years ago | (#18965807)

It isn't true in the UK, or Australia, or Europe. So it doesn't HAVE to be so.


The last time I checked, the UK was in Europe.

People are the problem, not technology (2, Insightful)

Ngarrang (1023425) | more than 6 years ago | (#18965481)

I worked in a hospital for 9 years in the IT department. Trust me when I say that technology was NOT the impediment, but nurses and doctors who refused to use the technology. Instead of thinking about the positive uses (checking drug interactions, streamlining data collection, improved imaging times), the mere idea of "technology" was shunned by these supposedly-educated professionals.

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! (1)

plasmacutter (901737) | more than 6 years ago | (#18965551)

The insurance industry is the reason the healthcare system is so screwed up.

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 they don't actually ACCEPT anyone who has the slightest physical malfunction. I have crohn's disease, a mild case which can be remedied by periodic medication, but i can't get arrested, let alone get an individual policy.

Third, they don't have a standardized/centralized claim process, meaning extra beurocratic costs on medical offices. Some estimates are that as high as 30% of medical costs can be attributed to the beurocratic mess that is insurance red tape.

Finally, their prolonged presence has resulted in inflation of medical costs in the same way legal mandation of auto insurance has inflated auto repair costs.

Socialized healthcare would fix this problem if implemented properly, and more importantly would bring proper medical and dental care to the over 40 million and growing americans who can't get it right now.

Yes other nations have their problems with it, and that gives US better perspective to make a better system than theirs.

And for those who will cry "oh no i will not take more taxes", you won't have the monthly payments into insurance. It would balance out.

Re:Socialization WILL fix the healthcare system! (1)

cdrguru (88047) | more than 6 years ago | (#18965841)

Almost nobody in the US pays directly for health insurance. The number is way, way less than 20% of the population. So, yes, there would be significant restructuring in costs that would shift things around.

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 the publiclly funded hospital where they have to take you and get taken care of.

technology has a HUGE role (1)

schwaang (667808) | more than 6 years ago | (#18965563)

For the US healthcare system, technology has a huge role to play in improving things. Lots of low-hanging fruit, and an important mission given the state of things:

- 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 fully aware of everything the patient is getting. And sometimes these combinations are dangerous.

- Datamining. This is the really really big one. And it's not about marketing to patients. It's about being able to learn from all that data out there that is currently locked up in paper and kept in separate silos (not shared between organizations).

The Commonwealth Club had a recent talk given by George Halvorson, CEO of Kaiser Foundation Health Plan and Hospitals. It includes a lot on how Kaiser is trying to improve their healthcare system using technology. Here is the podcast [commonwealthclub.org] , worth a listen if this topic interests you.

One take-away I did get from Mr. Halvorson is that healthcare in the US won't be saved by technology, but the data tells us what would save it. The majority of costs come from just a few chronic illnesses, including heart-disease and diabetes (but not cancer, which is only 5% surprisingly). These diseases are largely preventable, but it will require widespread behaviour change in America: diet and exercise, I hate to say.

Re:technology has a HUGE role (1)

cdrguru (88047) | more than 6 years ago | (#18965793)

A significant problem with record portability is the amount of patient fraud that can be introduced. What doesn't your doctor want to give you a sheaf of paper to take to another doctor? Because you might decide to make changes.

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 might not have this disease and the tests to really determine it are best done at autopsy, you might convince the new doctor you really do have it. Of course, if the treatment is Percodan you have a new alternative source of income.

Do you believe people would not do this? You'd be wrong. It goes on plenty.

Sure, your medical records are technically "yours" but at the same time they are not yours to modify or "correct". A non-technical solution for this exists today - you don't get to have the paper. Technology isn't a perfect solution to this and would generally create a situation where this type of fraud would be even easier to pull off.

Doctors are understandabily concerned about this. If you manage to do this it would be difficult today to track modified records back. When the records are digital it would be almost impossible if they are in truth portable. And who wants a centralized health care database with everyone's information in it for every doctor or healthcare worker to have access to?

Re:technology has a HUGE role (0)

Anonymous Coward | more than 6 years ago | (#18965827)

From the perspectives of people who value their privacy, "datamining" is NOT an improvement.

And don't tell me about anonymity and "de-identification" of medical data. Neither of those is a synonym for privacy. Privacy entails individual control of data about yourself. Even de-identified data can be used to harm you.

(Example, conservative political administration sees, "Hmmm, Hospital X is performing lots of abortions. Let's see how we can harm Hospital X, maybe find a way to revoke their tax exempt status or something").

You may want to be data-mined. Not me.

blah blah libertarian nonsense blah (0)

Anonymous Coward | more than 6 years ago | (#18965573)

I hate Europe as much as the next guy, but the fact remains that Eruoscum pay less per capita for their nationalized health care systems, and they are on average healthier and longer-lived than Americans, even when you correct for factors like lifestyle and the odd campus shooting spree.

Just suck it up, Slashbots, nationalized health care is superior.

How the hell.. (1)

jvagner (104817) | more than 6 years ago | (#18965631)

..did this "journal" post make it to the front page of Slashdot? Looking at the day's posts, apparently there's no a damn thing interesting happening in the world of "geeks".

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.

Other healthcare fixups (1)

caywen (942955) | more than 6 years ago | (#18965641)

I think the article states some good points. I like the idea of using technology to help the elderly maintain their medication more reliably.

However, I think one of the biggest pitfalls is the constant battle between the practitioners and insurance companies. Practitioners realize they only get paid for 10% of their procedures, so they charge 10x as much. Insurance companies refuse to pay even in cut and dry cases, causing rates to soar. All this lands on the patient's lap as a big bill.

Kaiser Permanente really has the right idea. Expensive, yes, but arguably worth it. Service is prompt and predictable, and when you need real work done, it costs next to nothing. Preventative medicine is where it's at. If they can take this to the next level and start providing proactive health advice for patients at risk for certain diseases, healthcare companies can avoid paying huge costs for big procedures.

Who controls pricing? (1)

peacefinder (469349) | more than 6 years ago | (#18965669)

While Mr. Grove's suggestions are not terrible, they are attacking problems that are ancillary to the efficient operation of the health care system as a whole.

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 insurance companies. (All those profits? They come from our premiums.)

Private insurance has - oddly - a much higher administrative cost per healthcare dollar than public payors such as Medicaid. Strange but true. [slashdot.org] And the majority of US heatlhcare dollars are flowing through these inefficient private payors. Of course, when I say inefficient I mean inefficient for the patients... they are excellently efficient at enhancing shareholder value.

We spend enough to have very good healthcare for every person in the US, but the way we pay for it is not well adapted to that goal. More home care, retail healthcare outlets, and a unified EHR may be beneficial, but they will not solve this structural economic problem.

Iron Ships, Wooden Men (1)

pg--az (650777) | more than 6 years ago | (#18965757)

(( "Iron Ships" "Wooden Men" )) is a nice Google query. Every time you want to think of yourself as say "genetically superior" to poor savages, the gut reaction is however "but the poor savages are healthy as horses, due to selection pressure". I remember reading in some Australian digression on Aborigines "Don't bother hitting a blackfella with your fist, he won't even feel it". The 45ACP was invented, because although a 38 was good enough for shooting white people, it would not reliably put a savage down. Musashi style, we must (( "research this deeply" ))

Inappropriate use of technology is the problem (1)

davidc (91400) | more than 6 years ago | (#18965759)

The most significant problem with modern Western health care is not the technology per se, it's the inappropriate use of it. It's all too tempting for doctors to order more and more sophisticated tests whereas, in reality, "take an aspirin and see me in the morning" would do. It's great to have access to the latest, expensive, whiz-bang technology; but it the majority of cases it isn't appropriate, nor needed. There's a similar story for antibiotics - use these prophylactically and you eliminate the odd 0.1% infection rate (until the bugs become resistant). Either our doctors need to cool it with the technology a little, or the population as a whole has to realize that it some want to stay alive for a little longer, it's going to cost everyone very dearly.

The other problem with our health care system is that there are too many costly administrators. But that's another story.

Can it be fixed without it? (2, Insightful)

obeythefist (719316) | more than 6 years ago | (#18965803)

Seriously, if you were going to try to fix the health system, would you try to do it without use of technology?

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.

As a nurse... (0)

Anonymous Coward | more than 6 years ago | (#18965887)

For the record I read half TFA, and skimmed the rest really hard.

I didn't see much talk of tech, but I can tell you this: The more crap there is between me and you (the sick guy) the less time I get to think about how best to care for you and then actually do it.

I once worked in a hopsital where each item used in patient care was accounted for by a large electronic cabinet. A nurse has to login, use a password, unlock the drawer, and retrieve the item. Then they have to go to a barcode scanner and scan the item, pull the barcode sticker off, and put it in a ledger book. Medications are accessd this way as well. Before these systems came out, if we needed an item, we would simply enter a room, and pull it off a shelf. If we needed a med, we'd walk up to a cabinet, and unlock it! I guess back in the good old days, someone had a *job* accounting for the supplies we used. Is this progress?

Not when you need a shot of Narcan STAT because your lungs are shutting down....

"Haste makes waste", let's not forget

In short, no. (1)

reedk (43097) | more than 6 years ago | (#18965941)

The fix is not technology - it is to extract government as the middleman and favor dispenser and put it back in the hands of the free market. Technology won't improve government health care any more than it "helped" build German census machines. It only takes you where you are going more quickly.
Why is it people acknowledge that socialism is bad as a whole but fool themselves into thinking it's OK if approached in small increments? I'll concede, I've never understood that.
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