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by wswin 164 days ago
It's inefficient and not living to its potential
4 comments

And "disruption" (a pretty ill-defined term) is the solution to that?
The solution is single payer. Any attempt to solve this with technological band aids is completely futile. We know what the solution is because we see it work in every other developed nation. We don't have it because a class of billionaire doners doesn't want to pay into the system that allowed them to become fabulously wealthy. People who are claiming AI is the solution to healthcare access and affordability are delusional or lying to you.
There are good reasons to think single payer systems are not the answer. The numerous documented inefficiencies and inconveniences they suffer from don't need repeating here.

And many single payer systems around the world only appear to work as well as they do because the US effectively subsidizes medical costs through its own out of control prices.

Maybe for R&D but your outsized costs are also due to your liability environment and direct incentives against preventative healthcare.
We'd rather have medical bankruptcy than a functional system.
That's because it's incredibly corrupted, not because it needs disruption. Unless the disruption comes in the form of jail time.
The inefficiency is the buying of yachts for billionaires.
Compare: Google's founders can buy all the yachts they could possibly eat, yet Google Searches are offered for free.

If we could get healthcare to that level, it would be great.

For a less extreme example: Wal-Mart and Amazon have made plenty of people very rich, and they charge customers for their goods; but their entrance into the markets have arguable brought down prices.

> Google's founders can buy all the yachts they could possibly eat, yet Google Searches are offered for free.

Google searches cost many billions of dollars: your confusion is because the customer isn’t the person searching but the advertisers paying to influence them. Healthcare can’t work like that not just because the real costs are both much higher and resistant to economies of scale but, critically, there aren’t people with deep pockets lining up to pay for you to be healthy. That’s why every other developed country sees better results for less money: keeping people healthy is a social good, and political forces work for that better than raw economic incentives.

Wal-Mart and Amazon have reduced wages for employees and the quality of purchased goods more than they have improved prices for consumers.
How do we know that?

And why do customers come back to shop there?

We know that from observing evidence such as how much the government pays out in welfare to Wal-Mart employees.

Customers continue shopping there because human beings are typically incapable of accepting a short-term loss (higher price) for a long-term gain (product lasts more than three uses).

> We know that from observing evidence such as how much the government pays out in welfare to Wal-Mart employees.

That's a weird metric. If tomorrow Wal-Mart laid off all employees and replaced them with robots, they would surely be worse off, but by your metric Wal-Mart would look less evil?

> Customers continue shopping there because human beings are typically incapable of accepting a short-term loss (higher price) for a long-term gain (product lasts more than three uses).

Groceries typically only last one use.

And Google search, a service on the level of a public utility, has been degrading noticeably for years in the face of shareholders demanding more and more returns.
How is Google Search a public utility?
Comparing something to a public utility is not me saying it's literally a public utility. Google runs a monopolistic service that is essential to a lot of our public life, in a segment that has high cost of entry and infrastructure cost. They make the service worse to make more money. It should be a regulated utility like electricity or railroads, we should have a public alternative like the post office is to UPS, or it should be nationalized. The situation gets more dire when you consider their browser monopoly.
Other search engines exist. Bing is right there, and Microsoft is more than willing to eat the high cost of entry and infrastructure cost.

> It should be a regulated utility like electricity or railroads, we should have a public alternative like the post office is to UPS, or it should be nationalized.

I agree that electricity and railroads should be regulated like Google Search.

It's really weird that snail mail in the US is a government monopoly. When even social democratic Germany managed to privatise them.

> The situation gets more dire when you consider their browser monopoly.

Don't a lot of people in the US use iPhones? They don't ship with Chrome as the default browser, do they?

(And yes, Safari is built on top of the same open source engine as Chrome. But you can hardly call using the same open source project a 'monopoly'. Literally anyone can fork it.)

There's also plenty of other browsers available.

IDK, the owners of retail clothing chains buy yachts and yet that sector is jaw-droppingly efficient at delivering clothes to people. Executives can be annoying tools but I don't think their pay is the problem.
Shame those same owners have plenty of money for buying yachts and not enough money to pay their sweat-shop employees a living wage or to provide decent work conditions. Executives don't "earn" huge paychecks, they merely exploit others by figuring out a way to not pay them their worth.
It's inefficient and not living to its potential

Yeah, because we saw what a great job the tech bros did making government more efficient.