I admit that there’s an element here of the question involving “macrofacts” and a sort of game of chicken between stupid voters and evil politicans.
My claim is something like: if the health care system’s main challenges weren’t trust, paperwork, followthrough, adherence, price discrimination, and other essentially economic and communication problems (which the US sucks at)...
...then the main problem might finally about medical technology (which the US is good at), and the is/ought gap between possible and actual health outcomes would be smaller, and achieved for a smaller percent of GDP.
I don’t blame the wage slaves, I blame the wage masters.
If you built a causal model, I think it would be possible to DO() some variables (that represent either or both of the choices of the wage slaves vs the wage masters) to CAUSE better aggregate outcomes.
But I think if you look back 20 years, or forward 20 years, total number and cost of the DO() operations to get better health outcomes would be minimized if we spend it on things like:
It would take more than 1 piece of structural legislation, I grant.
The cost in bribes and threats to change the behavior of various negligently oblivious congress critters (to make them redirect trillions from “pointless waste and fraud” to “something sane”) might be millions and millions of dollars.
And maybe the momentum has built up in the wrong direction and can’t be fixed in a single 5 year period?
Deciding that the problem is the stupid patients acting stupid is (to me) like deciding the government should elect a new people… it is fundamentally upside down.
The suffering of many people (which is, tragically, baked in at this point) should be used as the fuel to fix the bad laws that prevent us from building a new system while the old medical system burns to the ground.
I admit that there’s an element here of the question involving “macrofacts” and a sort of game of chicken between stupid voters and evil politicans.
My claim is something like: if the health care system’s main challenges weren’t trust, paperwork, followthrough, adherence, price discrimination, and other essentially economic and communication problems (which the US sucks at)...
...then the main problem might finally about medical technology (which the US is good at), and the is/ought gap between possible and actual health outcomes would be smaller, and achieved for a smaller percent of GDP.
I don’t blame the wage slaves, I blame the wage masters.
If you built a causal model, I think it would be possible to DO() some variables (that represent either or both of the choices of the wage slaves vs the wage masters) to CAUSE better aggregate outcomes.
But I think if you look back 20 years, or forward 20 years, total number and cost of the DO() operations to get better health outcomes would be minimized if we spend it on things like:
DO(“congress passes and the president signs a repeal of the Kefauver-Harris amendment”) and
DO(“the insurance industry and medical diagnosis processes and hospital systems are jointly reformed”),
and DO(“we delete the CDC that works on ‘whatever public health means to them now’ and instead ‘actually fight communicable diseases’ by testing people at the border n’stuff”)?
It would take more than 1 piece of structural legislation, I grant.
The cost in bribes and threats to change the behavior of various negligently oblivious congress critters (to make them redirect trillions from “pointless waste and fraud” to “something sane”) might be millions and millions of dollars.
And maybe the momentum has built up in the wrong direction and can’t be fixed in a single 5 year period?
Image source.
Deciding that the problem is the stupid patients acting stupid is (to me) like deciding the government should elect a new people… it is fundamentally upside down.
The suffering of many people (which is, tragically, baked in at this point) should be used as the fuel to fix the bad laws that prevent us from building a new system while the old medical system burns to the ground.