A Thought Experiment

Updated on December 23, 2020 in General Stuff
7 on December 22, 2020

I doubt this is original in any way.

I was reading Kevin Williamson’s column this morning

https://www.nationalreview.com/the-tuesday/whats-wrong-with-american-health-care/

And it occurred to me…

Suppose you did a poll of 1000 random Americans and asked “What would you do to improve health care?”

I assume the answers would almost exclusively have something to do with changing or replacing the financial systems that swirl around health care. The general tenor would be something like “More subsidies for me (or, perhaps, for those groups I deem to be dependent on me for protection) at someone else’s expense”.

Something like that.

Which is to say, I highly doubt you would get many responses having to do with actually improving health care. EG, “cure cancer” or “cure Parkinson’s” or anything like that.

Then I started wondering if there was a population you could poll…instead of polling at random…that would give answers like that. Substantive improvements to the actual art and science of health care rather than pushing various subsidy ideas around on the board.

Maybe nurses?

This feels like a “John Thought”. We’ve been perfectly trained. When we hear the words “health care”, we reflexively assume we are having a political/economic discussion, rather than a scientific/technical one. The parameters of the discussion are pre-loaded into the language we use.

 
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0 on December 22, 2020

Having been on the “watching people die” end of health care (I spent 5 years as a Respiratory Therapist in my college years which involved a lot of administering CPR until the doctors felt that they could declare death without being sued) I think that’s not even close to the correct question.

The correct question is, “How long do you want to stay alive?” Seriously. Do you comprehend the potential agony (physical, spiritual, family, etc.) of living well into the territory of rapidly diminishing returns? Do you really want to do that to those you love? Do you really want to do that to yourself?

The fact that that question is never asked from that direction pretty much defines the problem with death in the modern era in all it’s dimensions.

I’ve made it clear to everyone around me that I’m perfectly fine with my truly close loved ones (wife first, kids second) making that call and not taking an ounce of shit from anyone else. Mostly because I’ve seen it in all its graphic glory. If you love me, let me go peacefully. I try not to let any unresolved questions linger. When it’s time, we’re all good. Carry on as you must.

There’s the real thought experiment. 

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0 on December 22, 2020

Incidentally, my wife is talking to her niece Penny who is with her sister Jenny who is going through her first chemo treatment.

“I’ve been talking to Penny Lynn.  She is sitting with Jenny currently who is having her first round of chemo.  She said that Jenny is so angry and pissed.  Because she is super healthy with what she eats, all organic, juicing all the time, only the best.  She exercises religiously.  She does everything right.  

And she is so so pissed.”

I don’t know. Somehow it seemed appropriate to this topic.

Life’s never guaranteed. Make good use of whatever you get.

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0 on December 22, 2020

“Live now, life is short, time is luck”

-“Isabella,” Miami Vice, 2006

 

Apropos to the topic, transparency in pricing. JMO.

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0 on December 23, 2020

I’ll also add that healthcare is one of the most manipulated markets I know of, which results in the kind of artificial greed stoking that you refer to. Our healthcare didn’t evolve to match market needs, it evolved to create and over inflate a market.

Consider that I’m a diabetic and have been for 20 years. At various times of unemployment, I’ve been content to buy generic Humalog, an insulin that’s been available over the counter at Walmart for about $30 a bottle without a prescription with a bag of old fashioned syringes for another $10, again without a prescription. Walmart also sells blood sugar monitors for about $10 and a container of test strips for something like $15. All in all, that generally means I can manage the disease on my own without seeing a doctor for years at a time. And if I should actually need to see a doctor, I know from experience that the non-insurance price will typically be about $60-$70 cash.

Now when somebody in the house is working and we have insurance (currently courtesy of the Federal government, my wife’s employer) the game instantly changes.

Currently I’m on 2 insulins (one fast acting, one longer term) of the maybe 30 or 40 of the latest and greatest on the market. The list price of each is somewhere in the neighborhood of $600-$700 a box every 6 to 8 weeks. But I’ve mastered the subsidy game over the years. Once they’ve billed the insurance company they all offer some variant of “can’t afford your medications?” program which kicks back the out of pocket by reducing the price to roughly $20-$80 depending on how sorry they feel for you (and trust me, noone really needs to feel sorry for me). What I have yet to figure out how the kick back program is legal, but what it’s designed to do is to allow the manufacturers to get favored status through usage stats with the insurers.

I could go on about the technology I’m hooked up to (a blood sugar monitoring system that costs twice as much as an iphone annually) and the free surgeries I’ve had, but the game is to be able to vary whatever by just a bit to get in the good graces of insurance and have the system pay outrageous money that you’d never pay on your own. Thus creating market demand even though there’s not strictly a need for it.

And COVID is a brilliant distillation of the thinking behind it. No, you can’t take a 50 year old anti-malarial, you NEED a new vaccine. With billions of government cash to sweeten the pot.

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0 on December 23, 2020

Oh, and I think it was you, Jeff, that posted something a few years ago about the unraveling of the medical innovation industry in recent times that detailed all of the ways the “experimental method” and government regulation were allowing bad medicines into the market only to be recalled a couple months later.

Again, more like throwing stuff against the wall to see what sticks commercially rather than searching for real cures.

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0 on December 23, 2020

Yes, most people would think immediately in terms of changing nothing but the cost, namely the cost to them and theirs.

I have some other thoughts but they are, or they will at least sound, sociopathic, and it’s Christmas …

So I’ll maybe share them in February. 😃

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0 on December 23, 2020

LoL!

Well, then, happy f’ng new year!

 

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