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Notes -
Some quick hits:
A) Cremieux argues that much of the gap in life expectancy between America and Europe is due to obesity. But America is good at one thing at least – spending money on health care. Combine high spending with effective weight loss drugs, and the U.S. is on track to significantly narrow its life expectancy gap with Europe.
Self-driving cars will close the gap further.
B) Drug overdose deaths are down in King County (Seattle area) this year after more the tripling between 2019–2023. This is probably because fentanyl has already killed a significant percentage of the junky population. There has also been some modest progress in cracking down on open air drug markets. In the last 2 years, about 1 in 1000 King County residents died of a drug overdose.
C) Health insurance companies have a terrible reputation. But it's hard to fix. It's a viscious cycle which goes something like this:
Company has bad reputation
Due to bad reputation, the company has trouble getting talent, so they compensate by paying a lot
This selects for people who care more about money than reputation
Money-grubbing behavior leads to bad reputation
If you were next in line at United Health, how would you fix the problem?
Note: Many societies in the past (India, Japan) created special undercastes to do necessary but unsavory work such as working with dead bodies. Should we do likewise and create a special caste of health insurance workers that are not allowed to work in other fields and we can treat like shit with impunity? Reddit probably thinks so.
D) Epistemic status: uncertain.
Many people in the China tariff post said that China is "not expansionist".
But what is today China was, 2500 years ago, just a small collection of states along the Yellow River. Gradually, over the millenia, they absorbed more and more territory into their country.
It's as if the Roman Empire still existed today and controlled all of Europe.
Genetically speaking, the Han people seem to have done much better than Rome. The Romans, the people who lived in the city of Rome circa 500 BC, essentially all died out. For centuries, Rome's population could only be sustained from continual influxes of people from the countryside, and later, far flung areas of the Roman sphere. This doesn't seem to be the case in China. Even today, there are people who can trace direct male lineage to Confucius who lived around 500 BC.
Seems like they’d be even more money-grubbing assholes.
Not a problem. We'll just have a pogrom every once in a while to take back our money and let off some steam.
I'm joking obviously, but the way that people on Reddit are talking about this murder is frankly concerning. These simpletons think that the reason health care is fucked up is because of insurance company profits, and if only the CEO was less evil everything would work out. Worse, they are fine with murdering this person because of their own incoherent beliefs.
Curious, why doctors rather than hospital administrators?
At least hospital administrators pay attention to how much things cost.
In many cases, doctors literally do not know how much the treatments they provide cost. This means that they simply don’t do any cost-benefit analysis. They will prescribe an expensive brand-name drug instead of a generic drug that does basically the same thing for no reason other than because they heard about it more recently.
Doctors will also just blithely lie to you and make stuff up. They'll tell you to your face, in the exam room, that something is totally covered, but as you say, they have no idea whatsoever. You have to either force them to have someone actually verify it (which will annoy them, as they'll view it as just a waste of their precious time), or roll the dice and hope to not get slapped with a huge bill after the fact (that could be literally anything, could be gigantic enough to make whatever the service is completely not worth it to you).
I've said it before, and I'm becoming more obstinate about it; the entire medical industry is absolutely addicted to complete and total price opacity. This is only one of the many dysfunctions, but it's a big one. Forcing them to put their prices up on some website, in a way that would require you writing your own JSON or whatever parser, make your own interface, and still not be able to figure out what the price is because the doctor can't even tell you what the procedure code is... has simply failed as a "price transparency" law. I would be open to literally any other solution that anyone can think of, but I can't think of any other than simply forcing them to give you a price. Could declare that patients cannot exercise legally-valid informed consent to a procedure unless they've already been provided a price, in writing, for example.
EDIT: Forgot to add that when you call up the billing department to ask, "What the hell? I thought this was supposed to be covered?" they'll just bluntly tell you that the doctors don't have a clue and that "they probably just guessedsorrybut not sorry enough to have you not pay this".
I'm not sure I fully understand this, even a car mechanic won't give you a price up front, they'll give you an estimate, and sometimes, even with a machine, a repair doesn't go the way they expect, and your bill is higher than the estimate. Are you asking for medical care to have set, up-front pricing unlike car repair, or are you saying their estimates are significantly worse / harder to get?
What mechanic are you going to? Every mechanic I've seen has standard prices based on hours worked and cost of parts. I mean if I bring in a car without knowing what's wrong with it, yeah the cost of "Make this car work again" is unknown. But with a known problem the cost is fixed and they can tell you the exact price to replace a transmission, change the breaks, swap out a strut, you name it.
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