An American Sickness
Highlights
Imagine if you paid for an airplane ticket and then got separate and inscrutable bills from the airline, the pilot, the copilot, and the flight attendants. That’s how the healthcare market works.
The cost of hospital services has grown faster than costs in other parts of our healthcare system. From 1997 to 2012, the cost of hospital services grew 149 percent ,while the cost of physician services grew 55 percent. The average hospital cost per day in the United States was $4,300 in 2013, more than three times the cost in Australia and about ten times the cost in Spain.
To pay a nurse near $150k and the ghost doctor another $500k to do the same task is just an example of how the medical community is pilfering.
… today there is generally far less careful scrutiny of new devices than new drugs, even though most drugs can be stopped in an instant if problems emerge and many devices are permanently implanted in the body. Many devices are not even tested in animals before they are placed into humans; in fact, there are often no clinical trials at all for devices. When claiming “substantial equivalence,” manufacturers don’t have to prove that their class 1 and class 2 products are “safe and effective.”
Uninsured and underinsured Americans often get less testing and fewer services than they need. Poor Americans are less likely to get crucial recommended screenings for colon cancer and blood pressure. But well-insured Americans suffer often from too much treatment—particularly as they age—with tests and services meted out not for health but for money.
“If the March of Dimes was operating according to today’s foundation models, we’d have iron lungs in five different colors controlled by iPhone apps, but we wouldn’t have a cheap polio vaccine.”
… a 2015 study found that when patients were switched into a high-deductible health plan, they didn’t become smarter, more cost-conscious shoppers for medical care. The exorbitant prices demanded by the U.S. healthcare system meant that they mostly just avoided any interaction with medicine at all.
It would be simple to set up a government program that forgives loan repayment for young doctors who go into lower-paying fields or set up practice in underserved areas—and keeps forgiving repayments as long as they stay there. If you choose to become a dermatologist or an ear, nose, and throat surgeon in suburban New York or Miami—fine, you pay back every penny you’ve borrowed. But if you want to deliver babies in rural Oklahoma or practice pediatrics on the South Side of Chicago, then you get to keep your salary.
Health technology can be deployed for enormous patient good, but often all it offers up are useless, but profitable, services. If a company exists to untangle or parse the data in our convoluted system, the real answer is not to add another layer designed by entrepreneurs looking for profit, but to make the system simpler.
Good reminder for anyone thinking about starting something in the healthcare space.