How Big Data Is Destroying the US Healthcare System 507
KindMind writes "Robert Cringely writes on the idea that technological advances have changed the health care system, and not for the better. The idea is that companies now rate individuals instead of groups, and so move to a mode of simply avoiding policies that might lose money, instead of the traditional way that insurance costs were spread over a group. From the article: 'Then in the 1990s something happened: the cost of computing came down to the point where it was cost-effective to calculate likely health outcomes on an individual basis. This moved the health insurance business from being based on setting rates to denying coverage. In the U.S. the health insurance business model switched from covering as many people as possible to covering as few people as possible — selling insurance only to healthy people who didn't much need the healthcare system.'"
Re:Sounds like a problem... (Score:5, Informative)
Before people go apoplectic keep in mind the concept of medical tourism, where people go overseas to places like India for heart or other major surgeries for ten cents on the dollar or less, with success rates that are only marginally worse than that in the US.
There's more to competition than just nominal competitors. Hampering, even due to well-meaning regulations, transparently occurs, and to our detriment.
Go watch the Tucker film, about the guy trying to start a competitor to the big car companies in the 1950s. The big companies used every manner of regulation, requiring expensive development and lawyers and nitpicking, just to satisfy, and used it to effectively bar entry into the market.
All done 100% "in the name of the people's safety".
Fair enough, if you still wanna defend utterly massive regulation, but you pay for it in increased costs. Apparently about 5-10x in increased costs in medicine in the US.
Using Big Data to MAXIMIZE Healthcare Cost (Score:4, Informative)
Medicare Bills Rise As Records Turn Electronic [slashdot.org]: The goal was not only to improve efficiency and patient safety, but also to reduce health care costs. But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care. Hospitals received $1 billion more in Medicare reimbursements in 2010 than they did five years earlier, at least in part by changing the billing codes they assign to patients in emergency rooms, according to a NY Times analysis.
Re:Sounds like a problem... (Score:5, Informative)
If you think the US is "laissez-faire anarcho-libertarian" you're stupider than you are a troll.
Read Moryath's post again, Gothmolly.
... the USA which is run by lunatics who still think laissez-faire anarcho-libertarian economic theory does anything ...
I suspect Moryath is quite aware of what the US really is, but is also aware that our elected representatives live in a fantasy world that reflects the reality they wish they could live in, not the reality they impose on those they "represent".
Re:Sounds like a problem... (Score:5, Informative)
Paying $100 per week is a price point that has become acceptable
And that's the problem in a nutshell, Americans think it's acceptable to be ripped of by big business if the alternative is a government scheme has a that whiff of socialism about it.
US/AU dollars have been close to parity for a while. Currently in Australia a single man on $100K/yr pays ~$30 for UHC, a family of four with a single bread winner on $50K/yr pays ~$15/pw. And yes we are near the top of the list for "health outcomes", in fact our hard working death panels would have to work overtime to kill the extra 20K people per year it would take to catch up with the US. And yes, the government encourages you to buy private insurance if you want first dibs on a private bed, plastic tits, etc. Private insurance won't buy you better doctors, nor will it get you to the front of the queue for anything except cosmetics and a private bed. Nobody pays more that $1200/yr for medicine, once you hit that limit they are free.
For zero extra cost I get the same treatment anywhere in the EU should I fall ill while on vacation, as I did a few years back in the UK. I offered to pay the bill but the doctor just laughed and said - We have a deal with Australia to look after each other's citizens, it's only the silly Yanks who have to pay.
Comment removed (Score:2, Informative)
Re:Sounds like a problem... (Score:4, Informative)
You are wiser than most to realize that there is a distinction between Constitutionally granted rights and what many people are now declaring is a right.
You are right in a sense, but I think you are seeing "rights" too narrowly. The distinction that is generally made is between classical, negative rights (the ones in your 'bill of rights') and the positive, modern, or social rights (such as in your "equal protection" clause and in many european constitutions and also in some articles of the universal and European declarations of human rights.
The right to free speech is a "classic" (human) right. It is something between you and the government, and it acts as a prohibition on the government. It is a 'negative right' in that the government isn't forced to *do* anything, they're forced to not do stuff, like putting you in prison if you say stuff. The bill of rights used the phrase "congress shall pass no law" for a reason. The right doesn't mean that the government has to pay publishing cost for your newspaper, and it also doesn't mean that other citizens are forced to listen to you or banned from telling you that you're a twit if you 'exercise' your basic right. These rights can be "absolute" in the sense that they allow no exceptions, although it often isn't (the classical example being yelling 'fire!' in a crowded cinema) and in principle they cannot clash, since every negative right bans the government from doing something. The right to the freedom of the press and the freedom of religion do not clash: if you exercise your press freedom to say that not all Catholics are holy, there is no clash of rights, since the freedom of religion never prohibited you from saying that, it simply prohibits the government from establishing, favoring, regulating, or banning any religion.
The right to healthcare (and education, housing, property non-discrimination, etc) are all "social" (human) rights. They are generally positive rights, where the government has to provide something for the citizen. These rights are never absolute, in the sense that it is obvious that no one can receive all the education, health care, etc that money can buy. Also, these rights can clash with each other and with the classical rights: my right to self-expression can clash with your right to non-discrimination.
Sometimes, a right can be both 'positive' and 'negative'. For example, the right to "life" in the universal and European declaration of human rights (and implied in your declaration of independence) is mainly negative, in prohibiting the government of killing you in most circumstances, but can (and is) also interpreted positively as a positive duty to prevent certain loss of life and/or to investigate suspicious death. Similarly, the right to own property (e.g. article 17 UDHR but see also the 3d-5th amendment in the US Bill of Rights) is a negative right in prohibiting the government from taking your stuff (except through taxes, eminent domain etc.). However, it also implies a duty for the government to protect your property by banning and investigating theft etc, although the US Bill of Rights is phrased to exclude those duties by listing prohibitions against search, seizure, and quartering by the government, and does no list a "right to property".
Sources:
- http://en.wikipedia.org/wiki/United_States_Bill_of_Rights [wikipedia.org]
- http://en.wikipedia.org/wiki/Positive_obligations [wikipedia.org]
- http://www.un.org/en/documents/udhr/ [un.org]
- www.echr.coe.int/Documents/Convention_ENG.pdf
Re:Sounds like a problem... (Score:3, Informative)
Positive rights such as public safety and national defense are different from the classical (negative) rights that the parent referred to. Classical rights (e.g. the negative rights listed in the US Bill of Rights such as freedom from censorship, cruel punishment, illegal search and seizure) do not need a government to enforce them, since without a government you wouldn't need those rights.
Of course, the negative rights that protect you from the government are worth an awful lot without a bunch of positive rights which indeed need a government to enforce them, such as the right to life and property. The thinking of the Bill of Rights is that the (U.S.) government would naturally provide for positive rights such as the right to property (by enforcing already existing common law) and the national security (since fighting the Brits was the raison d'etre of the U.S. government); but that the government would need to be forced to provide for the 'negative' rights.
Also, positive rights are generally political choices: how much healthcare, education, and public safety is reasonable and when is the cost (in dollars or liberty) too high? So, it can be wise to leave those to the political process, while the negative rights are best enshrined in the constitution and left to the judiciary; although it is easy to argue that by not updating the constitution to reflect such positive rights such as non-discrimination and privacy the US supreme court was forced to become more political than similar bodies in other states such as the German Bundesverfassungsgericht.
Re:Sounds like a problem... (Score:2, Informative)
Just remember when your healthcare premium triples next year (if you're young): no Republicans voted for it.
And don't forget that when you're NOT young health care DOESN'T triple next year...
Re:Sounds like a problem... (Score:5, Informative)
Long waits and second-tier care for the many, immediate boutique care for the few.
As someone who's taught many pre-med students and has family who've taught med students, I'll take a moment to dispute that point.
Almost all of the student's I've had whose primary interest was money and status were, without a doubt, the worst students in the class. They had no real interest in the subject matter and no passion for what they'd be expected to do. The idea of abandoning patients in need to give liposuction to old rich women is repulsive (in many ways) to genuinely passionate doctors. As long as normal doctors in a single payer system are making a decent salary, I would put my trust in them and not the greedy sociopaths that are so attracted to medicine today.
If you look back though history, traveling quacks were always eager to feed upon the stupid rich. It still happens in our time, too. There is no shortage of witch doctors and alternative healers. Ask Jobs... he saw it firsthand and he could afford the best medicine we have to offer.
Re:Yeah, beacuse... (Score:5, Informative)
As a Canadian, here's the thing I don't get about the American "fear" of single-payer health care system : "Oh my god, the paperwork! And the bureaucrats that deny care!"
Now here's how it works for a Canadian : You go see a doctor, you give them your single-payer card and... That's it. There's no additional charges or paperwork to fill out, no administrative useless bullcrap. Heck I got surgery done a few years back and all I had to do was to show up at the hospital on time and show them my little card. No cash needed, no bill, just care.