Government Debt to GDP

[Knight]

These things seem to be a bit at odds to me. I may be misunderstanding it.

Those hi lit portions you did are confusing since they contradict each other.

The part I think was most telling of the cons was the reality I think America would face.

Overutilization: There is a concern about the system's long-term financial viability and overutilization of services.
Insufficient Compensation: Healthcare providers may not receive adequate compensation for their services.
These points provide a balanced view of Taiwan's healthcare system, highlighting both the strengths and weaknesses that the system faces.

The system now faces this.

Not as often as you might think. A new, cross-sectional study found that emergency department doctors and patients agree on the urgency level only about 38 percent to 57 percent of the time. The research, by Benjamin Ukert with the Texas A&M University School of Public Health and colleagues at the University of Alabama at Birmingham and University of South Carolina, was published in the journal of the American Medical Association.

“This is important because nearly 40 percent of emergency department visits are not medical emergencies, which is very costly financially and in terms of staffing and other hospital resources,” Ukert said. “As a result, state legislatures and health insurers have implemented policies to transfer less-urgent cases to doctors’ offices and urgent care centers, but clinicians face profound challenges in making this decision based on what patients tell them about their condition.”

Study Sheds Light On Non-Urgent Visits To Emergency Departments

 

[VaughanJB]

I agree in part. But no one would ever invent new drugs or new medical devices without the promise of a potential commercial payoff.

I think it's government's role to step in and limit extortionate pricing. A Medicare-for-all model would still allow for medical innovation, at least I would hope so.

I'd say, don't limit the profit motive - but limit the pricing to publicly funded healthcare. What's interesting is that people can give you numbers on the cost of research for new treatments, and their cost to deliver, but no-one tracks when that money is paid back, and pure profit begins. Let alone prices rising for drugs that were developed long ago.

Overutilization: There is a concern about the system's long-term financial viability and overutilization of services.

This line actually made me laugh. Can you imagine? You offer free health care, and too many people are sick!

 

[VaughanJB]

“This is important because nearly 40 percent of emergency department visits are not medical emergencies, which is very costly financially and in terms of staffing and other hospital resources,”

I personally know several people who go, or have been, to Emergency Rooms because it is the fastest way to access healthcare in the US. At least in their circumstances. It's a symptom of a broken system.

 

[VaughanJB]

The delivery of care system is so broken in the U.S. that no one knows where to begin to fix it. It's like entering a hoarder's attic -- you don't know where to start cleaning up.

Simply tying healthcare to your employment is a huge problem in my mind.

 

[bobcat]

Those hi lit portions you did are confusing since they contradict each other.

The part I think was most telling of the cons was the reality I think America would face.

Overutilization: There is a concern about the system's long-term financial viability and overutilization of services.
Insufficient Compensation: Healthcare providers may not receive adequate compensation for their services.
These points provide a balanced view of Taiwan's healthcare system, highlighting both the strengths and weaknesses that the system faces.

The system now faces this.

Not as often as you might think. A new, cross-sectional study found that emergency department doctors and patients agree on the urgency level only about 38 percent to 57 percent of the time. The research, by Benjamin Ukert with the Texas A&M University School of Public Health and colleagues at the University of Alabama at Birmingham and University of South Carolina, was published in the journal of the American Medical Association.

“This is important because nearly 40 percent of emergency department visits are not medical emergencies, which is very costly financially and in terms of staffing and other hospital resources,” Ukert said. “As a result, state legislatures and health insurers have implemented policies to transfer less-urgent cases to doctors’ offices and urgent care centers, but clinicians face profound challenges in making this decision based on what patients tell them about their condition.”

Study Sheds Light On Non-Urgent Visits To Emergency Departments

Perhaps Tele-health interactions may cut down on emergency visits if they are utilized and staffed by those with adequate knowledge. I have seen a few blurbs where AI will be doing a lot of Tele-Doc virtual visits going forward. Maybe it will work. IDK

 

[bobcat]

I personally know several people who go, or have been, to Emergency Rooms because it is the fastest way to access healthcare in the US. At least in their circumstances. It's a symptom of a broken system.

Very true. If it takes you a month to get a doctor appointment and you are feeling very ill, you don't have a lot of choices.
You're right. It is a symptom of a broken system. As I mentioned, maybe virtual visits will change things a bit, but that remains to be seen.

 

[RambleTamble]

I agree in part. But no one would ever invent new drugs or new medical devices without the promise of a potential commercial payoff.

I don't think that's true. People do things all the time just for the sake of discovery or for the challenge.

People who do things only for monetary reward usually just look to capitalize on other people's discoveries. Bill Gates is a good example of that. Most innovation at Microsoft came from exploiting other people's work. Same with Elon Musk and PayPal and Tesla. Those weren't his inventions. His innovations came from the business end of it -- not the technological discoveries.

 

[VaughanJB]

Very true. If it takes you a month to get a doctor appointment and you are feeling very ill, you don't have a lot of choices.
You're right. It is a symptom of a broken system. As I mentioned, maybe virtual visits will change things a bit, but that remains to be seen.

The problem with any idea, ever, is that once we work out what is needed, those delivering the system/service start to look for ways to deliver it at an increasingly lower cost. This eventually, inevitably, degrades the offering.

Look at manufacturing in the US. It's held up today as a patriotic call to action. But the reason manufacturing moved abroad wasn't because of geo-politics, it was pure economics. Essentially, decreasing the most expensive component - labor. What business leader is saying we should pay more for goods and services? The reason these things went abroad was pure economics. It was capitalism. Hence a lot of big companies are moving operations out of China, but not back to the US, but to other Asian nations.

Getting back on topic, if I were looking into implementing a virtual doctor system, my main concern would be the quality of the doctors, and the maintenance of that quality over time (a year, five years, and ten years). Too often promises are made, and we don't track ultimate results.

 

[VaughanJB]

I don't think that's true. People do things all the time just for the sake of discovery or for the challenge.

Some the greatest research and developments were done without a financial motive. Did Einstein worry about the money he could make from having his theories accepted? Penicillin wasn't discovered for profit motives. Think about insulin. Think about the Polio vaccine.

Today we seem only to be able to think in terms on return on investment in dollar terms.......

 

[bobcat]

I don't think that's true. People do things all the time just for the sake of discovery or for the challenge.

People who do things only for monetary reward usually just look to capitalize on other people's discoveries. Bill Gates is a good example of that. Most innovation at Microsoft came from exploiting other people's work. Same with Elon Musk and PayPal and Tesla. Those weren't his inventions. His innovations came from the business end of it -- not the technological discoveries.

I'm not here to defend Elon Musk, but to his credit, he does have a strong background in science and engineering, and has a degree in physics, so I wouldn't exactly say he had little input on his ideas. No doubt he is surrounded by brilliant minds that he depends on, but I still think he is instrumental in a lot of it. JMO

 

[RambleTamble]

Some the greatest research and developments were done without a financial motive. Did Einstein worry about the money he could make from having his theories accepted? Penicillin wasn't discovered for profit motives. Think about insulin. Think about the Polio vaccine.

Today we seem only to be able to think in terms on return on investment in dollar terms.......

Yep, the only thing that seems to matter any more is money. That's why almost everything sucks. Music sucks, movies suck, modern art and architecture suck...

 

[Irishdude]

I don't think that's true. People do things all the time just for the sake of discovery or for the challenge.

People who do things only for monetary reward usually just look to capitalize on other people's discoveries. Bill Gates is a good example of that. Most innovation at Microsoft came from exploiting other people's work. Same with Elon Musk and PayPal and Tesla. Those weren't his inventions. His innovations came from the business end of it -- not the technological discoveries.

It takes hundreds of millions of dollars to bring a commercial drug to market. A university or a government can fund discovery but they can't foot the bill for development, trials and distribution, let alone manufacturing. Alexander Fleming and Oxford University discovered penicillin and proved its efficacy, but Merck manufactured and sold it.

 

[Irishdude]

Simply tying healthcare to your employment is a huge problem in my mind.

That's a relic of WWII labor shortages, when companies added health care benefits to lure employees.

The US needs to start over with a clean sheet of paper and take guidance from best practices around the world.

 

[Irishdude]

Some the greatest research and developments were done without a financial motive. Did Einstein worry about the money he could make from having his theories accepted? Penicillin wasn't discovered for profit motives. Think about insulin. Think about the Polio vaccine.

Today we seem only to be able to think in terms on return on investment in dollar terms.......

Insulin was discovered by Banting and McLeod, but it took Eli Lilly & Co. to bring it to market.

Let me ask you, how many wonder drugs have come out of non-capitalist countries?

 

[VaughanJB]

Insulin was discovered by Banting and McLeod, but it took Eli Lilly & Co. to bring it to market.

Let me ask you, how many wonder drugs have come out of non-capitalist countries?

Hmmmmm sort of.

The inventor (discoverer) of insulin famously said, "Insulin does not belong to me, it belongs to the world". He thought selling it for profit was unethical. He sold the patent for $1 to a university, and that university cooperated with Big Pharma to produce it, but without profit.
Then capitalism kicked in, and Big Pharma did more research, enough to get their own patent. Once they had it - profit motive kicked in.
Non-capitalist? Anti malaria drugs (Artemisinin). Meningitis vaccine. There's a vaccine for use in Lung Cancer treatment.

But it stands to reason that capitalist countries would have the mechanisms in place to exploit research and development.

 

[Irishdude]

I don't think that's true. People do things all the time just for the sake of discovery or for the challenge.

People who do things only for monetary reward usually just look to capitalize on other people's discoveries. Bill Gates is a good example of that. Most innovation at Microsoft came from exploiting other people's work. Same with Elon Musk and PayPal and Tesla. Those weren't his inventions. His innovations came from the business end of it -- not the technological discoveries.

That's been true throughout the history of the Industrial Age. It takes a genius to discover something, but it takes another kind of genius to bring it to market.

 

[VaughanJB]

That's been true throughout the history of the Industrial Age. It takes a genius to discover something, but it takes another kind of genius to bring it to market.

Which is where we are with AI. Right NOW. Those who understand how to use it to add value, will survive.

 

[Irishdude]

Hmmmmm sort of.

The inventor (discoverer) of insulin famously said, "Insulin does not belong to me, it belongs to the world". He thought selling it for profit was unethical. He sold the patent for $1 to a university, and that university cooperated with Big Pharma to produce it, but without profit.
Then capitalism kicked in, and Big Pharma did more research, enough to get their own patent. Once they had it - profit motive kicked in.
Non-capitalist? Anti malaria drugs (Artemisinin). Meningitis vaccine. There's a vaccine for use in Lung Cancer treatment.

But it stands to reason that capitalist countries would have the mechanisms in place to exploit research and development.

Manufacturing good quality insulin is a pretty complex process. It stands to reason that someone making it would expect to be compensated.

Everybody needs food, but we don't ask farmers or anyone else in the food supply chain to work for free. Why should drugs be different?

But sure, let's remove the profit motive from pharma and biotech and medical engineering and see how much innovation that produces.

 

[Brookswood]

Deleted. I need to study the issue more.

 

[Trade]

Australia has heard the outsourcing mantra repeated ad nauseum. How can you do something at cost and outsource it for cost plus a margin without compromising something?

You can't. Medicare Advantage is just a scam designed to allow private insurance companies to feed at the public trough.

 

[VaughanJB]

Manufacturing good quality insulin is a pretty complex process. It stands to reason that someone making it would expect to be compensated.

I don't recall the part where they were asked to manufacture insulin at a loss to themselves. The person who discovered the method to make insulin wanted it to be "free", but I'm sure he wouldn't have insisted companies made it at a total loss.

Everybody needs food, but we don't ask farmers or anyone else in the food supply chain to work for free. Why should drugs be different?

It's not, and I don't see any indication here that is to the contrary.

But sure, let's remove the profit motive from pharma and biotech and medical engineering and see how much innovation that produces.

In this case, the innovation had nothing to do with Pharma, or biotech. In fact, it appears this innovation occurred outside of it.

 

[Irishdude]

I don't recall the part where they were asked to manufacture insulin at a loss to themselves. The person who discovered the method to make insulin wanted it to be "free", but I'm sure he wouldn't have insisted companies made it at a total loss.



It's not, and I don't see any indication here that is to the contrary.



In this case, the innovation had nothing to do with Pharma, or biotech. In fact, it appears this innovation occurred outside of it.

Good points and counter points. I should note that I used to do PR for big pharma companies and probably got caught up in some of their BS. They have a role to play although they wield too much pricing power.

 

[OneEyedDiva]

We're spending over a trillion dollars a year now on the military with much of that going to military contractors who are getting filthy rich off government contracts. But we can't spend $35 billion a year to help people pay for health insurance. That just shows how f*cked up the priorities are in this country.

I wholeheartedly agree and it makes me so disgusted and frustrated!

 

[gruntlabor]

We're spending over a trillion dollars a year now on the military with much of that going to military contractors who are getting filthy rich off government contracts. But we can't spend $35 billion a year to help people pay for health insurance. That just shows how f*cked up the priorities are in this country.

People will die, they should be taught to take better care of themselves and those they are responsible for. And churches and charities should earn their keep.
In my opinion, the role of the federal government is first and foremost to protect and defend the nation.
It's only an opinion, so ...

 

[VaughanJB]

People will die, they should be taught to take better care of themselves and those they are responsible for. And churches and charities should earn their keep.
In my opinion, the role of the federal government is first and foremost to protect and defend the nation.
It's only an opinion, so ...

Not sure how someone can "better care of themselves" when it comes to infectious disease, car wrecks where someone hits you, hereditary illness, and accidents at work or elsewhere. Some people don't live healthy lifestyles, sure. But that extends to a poor diet, and other risky behaviors like playing contact sports, skiing. and so on. Risk is risk.

The role of a Federal Government is up for debate, but I'd say it certainly extends far beyond simple defense. From monetary policies, the debate and passing of countrywide laws, infrastructure, and yes - for me - healthcare.

There is a group of people, of whom you may be one, who believes we are all personally responsible for everything, and no-one has any right to act otherwise. This doesn't work for me, since the world is far more complex than that. The forces which affect our lives aren't simply in the neighborhood you happen to be, and we don't all want the same things.

IMO YMMV. And whatever declarations steer us toward reasonable debate.