the profit motive in medicine

Abortion, euthanasia, genetic engineering, Just War theory and other such hot topics.

Moderators: AMod, iMod

Skepdick
Posts: 8041
Joined: Fri Jun 14, 2019 11:16 am

Re: the profit motive in medicine

Post by Skepdick »

commonsense wrote: Fri Feb 19, 2021 11:29 pm There are preventive measures for all of the conditions mentioned, and while they may have some effect on the incidence of diseases, the measures are not effective enough to move any off the top 10 list.
How do you know the measures are "preventive" if they aren't lowering incidence?
Skip
Posts: 2734
Joined: Tue Aug 09, 2011 1:34 pm

Re: the profit motive in medicine

Post by Skip »

Skepdick wrote: Fri Feb 19, 2021 11:26 pm [Skip -- Which "we" are already doing any of that? Where? How effectively?]
We - society.
Chinese society? Nigerian society? Israeli society? They're not all doing the same thing, or having the same results.
Some parts do some stuff better, other parts do other stuff better. On average they all progress in most aspects.
Nice thought.
What's your yardstick for "effectiveness" ?
https://photius.com/rankings/healthranks.html
Interesting, too, is the standing of the USA in relative efficiency: 37th in overall health care system performance; 1st in per capita spending on health care. You'd almost think expenditures were out of balance with outcomes. https://photius.com/rankings/world_heal ... ranks.html
How effective do you want it?
100% You?
In respect of this regulatory framework, the key services associated with primary and secondary prevention, such as immunisation, perinatal care and national screening programmes, appear to be well organised in a mixed network of public and private services. The system provides universal coverage based on residence, through public health insurance and universal medical coverage.
https://www.biomedicineandprevention.co ... ion-france
commonsense
Posts: 3514
Joined: Sun Mar 26, 2017 6:38 pm

Re: the profit motive in medicine

Post by commonsense »

Skepdick wrote: Fri Feb 19, 2021 11:36 pm
commonsense wrote: Fri Feb 19, 2021 11:29 pm There are preventive measures for all of the conditions mentioned, and while they may have some effect on the incidence of diseases, the measures are not effective enough to move any off the top 10 list.
How do you know the measures are "preventive" if they aren't lowering incidence?
As I said, not effective.
Age
Posts: 7045
Joined: Sun Aug 05, 2018 8:17 am

Re: the profit motive in medicine

Post by Age »

Advocate wrote: Fri Feb 19, 2021 4:07 am Making money off other people's misery is abhorrent.
Yet here 'you' are, "advocate", doing the EXACT SAME 'thing'.
Advocate wrote: Fri Feb 19, 2021 4:07 am The only thing an ethical doctor can be doing is trying to lose their job by making themselves irrelevant. Focusing on either profit or status, esteem or credentials is a direct opportunity cost to your oath to save lives or whatever.

As a society we need to focus our energy almost exclusively on prevention and stop rewarding/perpetuating people who exhaustively create prettier and more expensive Band-Aids.
What 'we' could also be focusing on is CHANGING 'adult', human beings, so they rid themselves of being VERY GREEDY. That would make a GREAT DEAL of difference to the down hill spiral, which 'you' people are CREATING for ALL of 'us'.
Skepdick
Posts: 8041
Joined: Fri Jun 14, 2019 11:16 am

Re: the profit motive in medicine

Post by Skepdick »

Skip wrote: Sat Feb 20, 2021 12:38 am Chinese society? Nigerian society? Israeli society? They're not all doing the same thing, or having the same results.
Yeah, they are. Chinese, Nigerian and Israeli society have all added at least 20 years to human life expectancy in the last 60 years alone.
Some have added more, but they are all progressing in the same direction.

https://ourworldindata.org/life-expectancy
Skip wrote: Sat Feb 20, 2021 12:38 am https://photius.com/rankings/healthranks.html
Yeah, and? When you frame everything as a race there's always winners and losers.

The fact that the losers of 2021 are doing much better than the winners of 1821 is of no concern to you.
Skip wrote: Sat Feb 20, 2021 12:38 am Interesting, too, is the standing of the USA in relative efficiency: 37th in overall health care system performance; 1st in per capita spending on health care. You'd almost think expenditures were out of balance with outcomes. https://photius.com/rankings/world_heal ... ranks.html
I think the same when people buy $500+ cars - it still gets them from A to B.

But then again, we didn't even have cars 200 years ago.
Skip wrote: Sat Feb 20, 2021 12:38 am 100% You?
Since you've dragged us away from the realm of possibilities and into the realm of dick-measuring then...

I want more than you want. Whether 101% or 100000000000000000000000000000000000000000000000000001%

When you find the magic wand which lets you efficiently turn the inefficient into efficient - do let me know.

Skip wrote: Sat Feb 20, 2021 12:38 am
In respect of this regulatory framework, the key services associated with primary and secondary prevention, such as immunisation, perinatal care and national screening programmes, appear to be well organised in a mixed network of public and private services. The system provides universal coverage based on residence, through public health insurance and universal medical coverage.
https://www.biomedicineandprevention.co ... ion-france
I am talking about the system of systems. Society.

You are talking about the countries that make up society.
Skip
Posts: 2734
Joined: Tue Aug 09, 2011 1:34 pm

Re: the profit motive in medicine

Post by Skip »

Skepdick wrote: Sat Feb 20, 2021 5:59 am Chinese, Nigerian and Israeli society have all added at least 20 years to human life expectancy in the last 60 years alone.
No, they have not. Technology, medical and food production science have. Of course, the gains are not evenly distributed. But then, nothing ever was.
Yeah, and? When you frame everything as a race there's always winners and losers.
There are. BTW there was no race and I didn't do the framing. Nobody was competing; every nation was making its own policy decisions without reference to the others.
Fact remains: the US system is inefficient.
The fact that the losers of 2021 are doing much better than the winners of 1821 is of no concern to you.
1821 is entirely irrelevant to what can and should be done in 2021, so, that is correct.
I think the same when people buy $500+ cars - it still gets them from A to B.
The same as what?
But then again, we didn't even have cars 200 years ago.
And the possession of cars has something to do with .... ?
I want more than you want. Whether 101% or 100000000000000000000000000000000000000000000000000001%

When you find the magic wand which lets you efficiently turn the inefficient into efficient - do let me know.
It doesn't require a magic wand to improve a system. It takes intelligent policies and practical application of those policies. Some countries manage that better than others. We may therefore conclude that humans could manage it better than they generally do. I would like all of them to strive for 100% effectiveness.

I am talking about the system of systems. Society.
You are talking about the countries that make up society.
Oh, I see. Society means the entire human race.
In that case, society is doing a really, really crappy job of delivering health-care to all of the human race.
Last edited by Skip on Sat Feb 20, 2021 7:31 am, edited 1 time in total.
Skepdick
Posts: 8041
Joined: Fri Jun 14, 2019 11:16 am

Re: the profit motive in medicine

Post by Skepdick »

Skip wrote: Sat Feb 20, 2021 7:15 am No, they have not. Technology, medical and food production science have.
That's sure is anthropomorphising technology and science...

Those are things that humans do. They don't do anything in and of themselves.
Skip wrote: Sat Feb 20, 2021 7:15 am
It's entirely irrelevant to what can and should be done in 2021, so, yes.
That's entirely irrelevant to what SHOULD vs COULD be done in 2021, yes? Illusion of control.

For starters, if your ranked list were to magically invert itself and the "losers" became the "winners" you would instantly switch your narrative
and insist that the new losers do like the new winners, no?
Skip wrote: Sat Feb 20, 2021 7:15 am
The same as what?
As your WHO report. The inputs (cost of car) don't match up to the outputs (travel from A to B).
Skip wrote: Sat Feb 20, 2021 7:15 am
And the possession of cars hase something to do with .... ?
Your bitching over the cost of health, when we didn't have the option to live to 75 at any cost 200 years ago.
Skip wrote: Sat Feb 20, 2021 7:15 am
It doesn'5t require a magic wand to improve a crappy system.
To 100% efficiency it does.
Skip wrote: Sat Feb 20, 2021 7:15 am
It takes intelligent policies and practical application of those policies.
First and foremost - it takes culture and mindset to develop and execute on any such plan.
Skip wrote: Sat Feb 20, 2021 7:15 am
Some countries manage that better than others. From that, we may conclude that humans can manage it better than they generally do.
Humans, eh? Is that Chinese, Nigerian or Israeli humans?
Skip wrote: Sat Feb 20, 2021 7:15 am I would like all of them to strive for 100% effectiveness.
So how have you determined what they strive for, given that none of them achieve 100%?
Skip wrote: Sat Feb 20, 2021 7:15 am In that case, society is doing a really, really crappy job of delivering health-care to all the human race.
France is doing a really, really crappy job of delivering health-care to all French people.

And they are Number on your list!
Skip
Posts: 2734
Joined: Tue Aug 09, 2011 1:34 pm

Re: the profit motive in medicine

Post by Skip »

Skepdick wrote: Sat Feb 20, 2021 7:26 am That's sure is anthropomorphising technology and science...
Whereas, pretending that 'society' which encompasses all nations, can act as a conscious agent isn't.

[1821 is irrelevant to now, so it's no concern to me]
That's entirely irrelevant to what SHOULD vs COULD be done in 2021, yes? Illusion of control.
You mean society can't do anything, after all?
For starters, if your ranked list
Not mine. Just a citation.
were to magically invert itself and the "losers" became the "winners" you would instantly switch your narrative
and insist that the new losers do like the new winners, no?
If anything happened by magic, we'd all have to change our narratives.
The purpose of the list was simply to illustrate that different societies - nationally designated and identified sections of the great big all-inclusive Society - manage health care differently; that there are more and less effective systems existing in the world at the same time.

As your WHO report. The inputs (cost of car) don't match up to the outputs (travel from A to B).
You think the same of a cheap car as of the WHO report on health-care? Ho-kay.


Your bitching over the cost of health,
No. I'm pointing out that spending more money doesn't necessarily get better results: there are other factors.
when we didn't have the option to live to 75 at any cost 200 years ago.
I don't understand why you're harping on 200 years ago.

[It doesn'5t require a magic wand to improve a crappy system.]
To 100% efficiency it does.
You asked what I want, not what's possible. If you're not aiming for 100%, you're not really trying.
Humans, eh? Is that Chinese, Nigerian or Israeli humans?
Yes.
So how have you determined what they strive for, given that none of them achieve 100%?
They? Variously.
France is doing a really, really crappy job of delivering health-care to all French people.
No, that little nationally designated and identified segment of Society called France is doing a pretty good job of delivering health care to that little nationally designated segment of Humanity called the French people. They're not delivering it to all the other billions of people in the great big all-encompassing Society. They're just showing an example of how, if they were paying attention and wanted to do better, all those segments might improve their performance.
Which I think would be worth doing.
That's all.
Skepdick
Posts: 8041
Joined: Fri Jun 14, 2019 11:16 am

Re: the profit motive in medicine

Post by Skepdick »

Skip wrote: Sat Feb 20, 2021 7:53 am Whereas, pretending that 'society' which encompasses all nations, can act as a conscious agent isn't.
Society IS all conscious agents. Self-organization.

Nothing to do with nations. That's your misunderstanding. Nations are emergent phenomena.
Skip wrote: Sat Feb 20, 2021 7:53 am You mean society can't do anything, after all?
The scale sure seems to confuse you.

YOU can't do much (if anything) to influence society. You can't move the needle!

Your level of influence goes no further than a handful of people at once.

That's a few hundred thousand short of having actual control over any given province/city.
That's a few million short of having actual control over any given country.
That's a few billion short of having actual control over society as a whole.

Even if you find yourself in a position of power/influence you'll figure out how easy it is to plan things and how difficult it is to make this plan come to fruition.

Ideas are easy. Policy-setting is easy. Writing laws is easy. Execution and reification of what has been written is hard for various human reasons.
Skip wrote: Sat Feb 20, 2021 7:53 am Not mine. Just a citation.
A citation chosen/endorsed by you.
Skip wrote: Sat Feb 20, 2021 7:53 am If anything happened by magic, we'd all have to change our narratives.
In so far as anything happens outside of any individual's awareness/control/narrative - it's all magic.

There's no narrative that can capture the complexity of individual decision-making that produces the outcomes that you are observing.

All narratives of HOW anything happens in society are naive over-simplifications. You would do best to avoid the narrative fallacy
Skip wrote: Sat Feb 20, 2021 7:53 am The purpose of the list was simply to illustrate that different societies - nationally designated and identified sections of the great big all-inclusive Society - manage health care differently; that there are more and less effective systems existing in the world at the same time.
And the purpose of my point was to indicate that the difference is relative. You could shuffle or invert that list and you'd still object just same.

Because you are holding a normative view of "It's never good enough".
Skip wrote: Sat Feb 20, 2021 7:53 am You think the same of a cheap car as of the WHO report on health-care? Ho-kay.
You are working double over-time to strawman me, aren't ya? I explicitly used a NON-cheap car in my example.

For precisely the same reason. You are measuring efficiency (inputs vs outputs). I am pointing that that there wasn't even an output 200 years ago.
Skip wrote: Sat Feb 20, 2021 7:53 am No. I'm pointing out that spending more money doesn't necessarily get better results: there are other factors.
Which is precisely the point I made re: using a very expensive car for traveling from A to B.
Skip wrote: Sat Feb 20, 2021 7:53 am I don't understand why you're harping on 200 years ago.
Because you don't exist in a contemporary vacuum. The past causes the present.
Skip wrote: Sat Feb 20, 2021 7:53 am You asked what I want, not what's possible. If you're not aiming for 100%, you're not really trying.
Ah well, if we are back to dick-measuring, then let me point out that your standards are abhorrent!

If you aren't aiming for 1000000000000000000000000000% you aren't really trying...
Skip wrote: Sat Feb 20, 2021 7:53 am Yes.
So which of those are aiming for 100% (but not for 1000000000000000000000000000%) ?
Skip wrote: Sat Feb 20, 2021 7:53 am They? Variously.
So where's China at on your 0-to-100% scale?
Where's Nigeria?
Where's France?
Where's Israel?

Skip wrote: Sat Feb 20, 2021 7:53 am No, that little nationally designated and identified segment of Society called France is doing a pretty good job of delivering health care to that little nationally designated segment of Humanity called the French people.
Yes! And they are doing a piss-poor job of delivering it to the French people! Relative to the 100% or 1000000000000000000000000000% goal we have established.
Skip wrote: Sat Feb 20, 2021 7:53 am They're not delivering it to all the other billions of people in the great big all-encompassing Society.
Nobody is saying they are. We are criticising them on their own merits now.

Failing to strive for 100% or 1000000000000000000000000000%
Skip wrote: Sat Feb 20, 2021 7:53 am They're just showing an example of how, if they were paying attention and wanted to do better, all those segments might improve their performance.
Which I think would be worth doing.
That's all.
Medice, cura te ipsum!

Till they get to 100% or 1000000000000000000000000000% I don't think they should be showing anybody anything.
Skip
Posts: 2734
Joined: Tue Aug 09, 2011 1:34 pm

Re: the profit motive in medicine

Post by Skip »

Everything is honky-dory because it's not 1821.
No conscious or deliberate action required; society will just keep on improving.
Cool.
commonsense
Posts: 3514
Joined: Sun Mar 26, 2017 6:38 pm

Re: the profit motive in medicine

Post by commonsense »

Skip wrote: Sat Feb 20, 2021 12:38 am Interesting, too, is the standing of the USA in relative efficiency: 37th in overall health care system performance; 1st in per capita spending on health care. You'd almost think expenditures were out of balance with outcomes.
Do you think that the profit motive has anything to do with the US being in 37th place?

What do you suppose is responsible for the terrible ROI (Return on Investment)?
Skip
Posts: 2734
Joined: Tue Aug 09, 2011 1:34 pm

Re: the profit motive in medicine

Post by Skip »

commonsense wrote: Sat Feb 20, 2021 5:35 pm Do you think that the profit motive has anything to do with the US being in 37th place?
Ay-yup! Also politics.
What do you suppose is responsible for the terrible ROI (Return on Investment)?
That depends. Which investments are yielding terrible returns? And what's "terrible" in this context?
Skepdick
Posts: 8041
Joined: Fri Jun 14, 2019 11:16 am

Re: the profit motive in medicine

Post by Skepdick »

Skip wrote: Sat Feb 20, 2021 3:06 pm Everything is honky-dory because it's not 1821.
No conscious or deliberate action required; society will just keep on improving.
Cool.
Somewhere in between your cynicism you completely missed the point about moving needles.

In so far as conscious and deliberate action is required - it's required towards directly solving the problems, not towards virtue-signaling the need for conscious and deliberate action on a Philosophy forum.

You've confused slacktivism with activism.

And if you got off your ass and actually attempted to tackle the problems you are so passionate about, the scale of the problem and the impotence of your influence will humble you.
commonsense
Posts: 3514
Joined: Sun Mar 26, 2017 6:38 pm

Re: the profit motive in medicine

Post by commonsense »

Skepdick wrote: Sat Feb 20, 2021 5:46 pm
Skip wrote: Sat Feb 20, 2021 3:06 pm Everything is honky-dory because it's not 1821.
No conscious or deliberate action required; society will just keep on improving.
Cool.
Somewhere in between your cynicism you completely missed the point about moving needles.

In so far as conscious and deliberate action is required - it's required towards directly solving the problems, not towards virtue-signaling the need for conscious and deliberate action on a Philosophy forum.

You've confused slacktivism with activism.

And if you got off your ass and actually attempted to tackle the problems you are so passionate about, the scale of the problem and the impotence of your influence will humble you.
What are the problems we ought to be solving? Please school me.
Skepdick
Posts: 8041
Joined: Fri Jun 14, 2019 11:16 am

Re: the profit motive in medicine

Post by Skepdick »

commonsense wrote: Sat Feb 20, 2021 6:03 pm What are the problems we ought to be solving? Please school me.
There's a very long list of problems that are important.

To point you at the "most important" ones just because it's important is to neglect any knowledge about your strengths and weaknesses.

I am not a believer in stoicism/grit and "bite down and do it" - if a problem is too hard it will demotivate you. You have some level of expertise and some affinity to some area that you are passionate about, you know what your support structure is like (experts, mentors, people you can work with and learn with).

You should know what the important problems are and you should know what the chain-reaction of solving them will look like when it ripples through society.
Post Reply