[PeterisP]

US is exactly the place where those techniques would make waves because of what the US is paying for radiology; in countries where radiologists don't have the same monopoly/monopsony powers it's not nearly as lucrative to replace them.

For example, I'm distantly involved in a project with non-US-radiologists about ML support for automating radiology note dictation (which is a much simpler and much "politically cleaner" issue than actual radiology automation), and IMHO they and their organization would be happy to integrate some image analyis ML tools in their workflow to automate part of their work. However, the current methods really aren't ready, and the local market isn't sufficiently large to make the jump and make a startup to make them ready, that would have to wait until further improvements, most likely done by someone trying to get the US radiologists' money.

[hik]

There's not really a way to disambiguate the two though - the fact that there are lots of medical technology startups and new drugs coming out of the US is because of the costs involved and how much can be harvested by being a little better. This creates new technologies that the US can't really protect against proliferation - so all of the money has to be harvested from the US market.

This isn't necessarily a bad thing - I for one happen to think it's great that our expensive medical system is financing all kinds of wonderful new technologies that benefit the world overall. However, the major problem here is that things that would be useful for other places simply don't have the market to support it, so most medical innovation exists in the context of the US medical system and it's problems - some of which are widespread, some of which are not. I do wish there were some other testbed healthcare systems out there for companies to try to disrupt, but I don't think it is (by itself) a call for medical reform.

My preferred medical reform is to "legalize insurance markets" (ie: repeal laws that state that insurance companies operating in state Y cannot sell insurance to people in state X because state Y policies are not legally compatible) and try to break the monopoly that doctors and nurses enjoy....somehow. Telehealth? Maybe?

[sudosysgen]

But, is it? Almost half of the funding for Healthcare innovation is governmental even in the US, and a competent public health system already has a strong incentive to reduce costs. So if a technology has the potential to reduce costs, a more efficient healthcare system would also pay for it - and if one doesn't there are dozens that can too - and if there is no path to it providing value overall in such a system, then it's going to be on the balance less efficient anyways.

To note, a big issue in public innovation is that rich western countries, led by the US, HATE governments competing against the private sector. So if a government comes up with an innovative solution, they are generally disallowed from selling it, which hurts everyone except private companies.

This happened in my city a few years ago, which had a very early innovation in bike sharing, much before any VC funded bike sharing company, and other cities had expressed interest in paying my city for implementing this service locally.

But because of laws banning public endeavors from engaging in commercial activities, this was struck down, hurting all the taxpayers in my city, citizens of my city that would have benefited from better service from the experience, and millions of citizens from interested cities which would have received better service and who would have saved money.

Or another case in my province was the invention by the electricity utility of the electric hub motor - which is now over 40 years later in widespread use due to its efficiency and low cost - but instead of exploiting that patent and selling those things, it had to partner with a private company which got exclusivity and mostly squandered it. Again, hurting almost everyone which might have benefited from lower cost electric transportation as well as the taxpayer here.

This is actually part of why China is eating everyone's lunch, they used their size and never really agreed to these rules, leaving themselves the opportunity to profitably invent at the state level, leading into more efficient state owned enterprises that can often profitably outcompete the private sector.

[watwut]

> I for one happen to think it's great that our expensive medical system is financing all kinds of wonderful new technologies that benefit the world overall.

Does it factoring in situation of people unable to pay medical bills?

[bradleyjg]

If the entire rest of the world isn’t a big enough market to be worth developing for then maybe we don’t need ml radiology we just need medical reform.

[PeterisP]

The entire rest of the world isn't a market, it's many separate markets that need to be entered separately by overcoming different moats. Market fragmentation matters, especially in regulated industries like medicine.

But yes, medical reform is definitely something that might be helpful - technological solutions almost always aren't the best way for solving social/political problems.