The main problem is that it's often impossible for a consumer to know whether a test or other medical intervention is necessary, appropriate or cost efficient.
For a standard automated series of 20 blood tests, in a federally regulated lab, you have something close to a generic product and you can quote a standard price, which I think runs $50-100.
For other services -- the most expensive ones -- you may not have a standard price. How much is an ambulance ride? If you need oxygen, that's another $50. If you need a pint of blood, that's another $200.
A nurse told me that she broke her leg and stayed in a hospital. She asked the hospital for an itemized bill. It was a hundred page printout. She said, "I couldn't figure it out -- and I have a PhD in health care finance."
I don't know what kind of blood test you had, but at $1,670 it doesn't sound like a standard test. If you don't know what it is, the doctor will have to explain it to you. I'm familiar with a lot of these tests. There are some tests that could take an hour to explain, if you've never studied immunology for example. Are you going to pay the doctor for his time explaining it to you? You're asking the doctor to sell you on every procedure. It's too complicated, and the risks of error are too great. It's not like buying a car.
That's one of the advantages they have in the U.K. and most other countries where the government health service decides what interventions are important based on the best scientific evidence.
I agree that in principle everybody should know what procedures he's getting and give informed consent. But in the real world when you've got 5 or 10 minutes with a busy doctor, it may not be possible to press that issue.
(There are other industries that operate that way. There are law firms that handle corporate clients that send the client the bill and expect him to pay for it. "For fighting off a hostile takeover . . . . . $1 million.")
There are lots of pharmaceutical chemists who would love to develop new drugs, if you just give them $80-100,000 a year so they can live a comfortable life with their families and send their children to school.
In fact there are chemists who would do it for less.
The problem is, you don't know whether it's end of life care until they're dead.
You spend $50,000 on one patient, and as a result, the patient lives another 10 years. You spend $50,000 on a similar patient, but the treatment doesn't work and the patient dies. How do you avoid end of life care? By denying the $50,000 treatment to both patients?
Oddly enough Lasik surgeries haven't gone up in price. It isn't covered by insurance.
Oddly enough cataract surgeries have gone down in price. Most of them are covered by Medicare.
The reason is that all eye surgery has become more efficient in the last 30 years. Surgery that used to take an hour takes 15 minutes. So doctors charge/get paid less.
Lasik is not an example of free-market competition driving prices down. It's an example of technology driving prices down.
P.S. You wouldn't want to have Lasik performed by the cheapest doctor.
I don't know that that's true. People in undeveloped countries go to first world countries, but the health care in Switzerland, France, Germany or Sweden is just as good as the care here.
Some experts said that Iraq had the best health care system in the (non-Israeli) mideast. Saddam used to send his medical students to the UK for training, and people from all over the mideast used to go to Iraq for treatment.
There are stories about Canadians coming to the U.S., but that's only for exotic diseases or new procedures for which there are only a few specialists in the world. (There are other stories about Canadians coming to the U.S. for medical treatment that have been debunked.) People have looked at the outcome data. and there's no significant difference between the U.S. and Canada.
When I go to a doctor sometimes I will opt not to get a test or take a medication because I don't think it's worth it.
I don't understand how that works. The doctor says, "You may have cancer, we have to do this test to rule it out." How do you say no?
The reason we have overtesting in the U.S. is because doctors get paid by procedure, not because patients don't have to pay for it.
If the test or medication is necessary, you have no choice. If it's not necessary, they shouldn't be giving it.
In the UK, NICE decides what tests and medications are necessary under what circumstances. Doctors are government employees, so they're expected to follow guidelines unless they have a good reason for doing otherwise. They give a lot fewer PSA tests in the UK. The death rate for prostate cancer is about the same.
Three weeks later, I get the bill, for over $1,670 for the "labs." If I had known, that was how much they were going to charge, I would have never allowed them to draw my blood.
That depends on what the test is for. If he says, "You might have X. This blood test can tell. If you do, and we catch it in time, it can save your life." (Or, "Then you can put your affairs in order.")
$1,670 is much higher than the standard panel of automated blood tests, the SMA-20, which I'd guess is $100, so it must have been some specialized test.
I agree that he should have explained to you what it was for, and how much it was going to cost. But if he did that for every patient, he'd have to raise his rates.
The bottom line is that we don't and can't have a free market in health care, because the amount of information a consumer would need to make a decision is too great.
If you can't find a doctor that you can trust, you're screwed.
And it's harder to find a doctor you can trust when doctors are motivated by profit, than it is when doctors are on salary and required to follow the guidelines.
Oh, that's reassuring. If I visit that website, Homeland Security will merely record my name and file it away in case I visit any other suspicious websites.
Best story I heard about that: The Taliban drove up to this woman's house in an SUV and said, "Sister, in the times of the Prophet, they didn't have televisions."
She said to them: "In the times of the Prophet they didn't have automobiles either. Come back on a camel."
The presumption of innocence under U.S. law is pretty limited. All it means is that the prosecution has the burden of proof in order to convict you.
For example, if you can't pay bail, there's no presumption of innocence. The judge can keep you in jail even though you've never been convicted of anything.
The issue here is that the cops weren't seriously investigating Zimmerman, and that they've failed to prosecute people in the past who killed black victims.
It didn't look like Zimmerman and his accusers would ever have their day in court -- until they went to the media. That's an appropriate role of the media.
BTW there's nothing about "presumption of innocence in the Constitution.
Damn good question. I did a Google search for "site:.edu Easy Voice Biometrics Voice Biometrics Software" and came up with more results than I had time to plough through.
I would think that if they had good studies, they would be touting them on their web site, but maybe not.
We'll find out if it ever goes to trial and Zimmerman's lawyer puts their expert on the witness stand.
I think there are a lot of people out there who want to know what's happening behind the screen when they swipe colorful icons around.
There are a lot of people out there who want to get a better idea of how computers work.
It can be done. Learning Python or Java is a reasonable place to start.
I remember a special issue of Scientific American on computers, which had an article that walked you through how a simple, Turing-style computer worked on the logic circuit level -- reading from memory, adding binaries, storing the answer, etc. I spent an hour figuring out the illustration, and I had a pretty good conceptual understanding of how a computer worked. Any reasonably intelligent person who was willing to work at it could have read that article and understood it. A lot of people did. They understood the future a lot better.
I'm a non-computer geek but in the 1990s I learned HTML well enough to put up a quick web site, because it was fun and it was useful. I also learned how to put together a few databases and spreadsheets, and automated my word processing programs. I know about as much FORTRAN and BASIC as you would get in an introductory 101 course. I used to read Forrest Mims' notebooks and build digital circuits. I like it. I like flashing lights. I like programming f=1/r^2 fields. I like to open up the case and figure out what the parts do. It helps me understand what's going on in the world around me. So sue me.
I think any intellectually curious person wants to learn a lot of things, just because they're fun. I took my car apart and put it together. I learned the basics of a few foreign languages, a lot of math, chemistry, history, art, filmmaking, poetry, and other things I'll never use professionally. I could place respectably in a contest for the world's worst piano player.
I realize how offended people get when a novice, an amateur, presumes to learn something that they are an expert in. How could they affront your wisdom by suggesting that they are basking in the same sun? However, their target is different. As somebody in TFA mentioned, he learned enough to appreciate what real programmers are doing, so maybe you will get the respect you deserve.
Slashdot Mirror
http://tech.mit.edu/V127/N40/simpson.html
It wasn't the flight crew that freaked out. It was the cleanup crew.
The flight crew knows what electrical wires do.
The main problem is that it's often impossible for a consumer to know whether a test or other medical intervention is necessary, appropriate or cost efficient.
For a standard automated series of 20 blood tests, in a federally regulated lab, you have something close to a generic product and you can quote a standard price, which I think runs $50-100.
For other services -- the most expensive ones -- you may not have a standard price. How much is an ambulance ride? If you need oxygen, that's another $50. If you need a pint of blood, that's another $200.
A nurse told me that she broke her leg and stayed in a hospital. She asked the hospital for an itemized bill. It was a hundred page printout. She said, "I couldn't figure it out -- and I have a PhD in health care finance."
I don't know what kind of blood test you had, but at $1,670 it doesn't sound like a standard test. If you don't know what it is, the doctor will have to explain it to you. I'm familiar with a lot of these tests. There are some tests that could take an hour to explain, if you've never studied immunology for example. Are you going to pay the doctor for his time explaining it to you? You're asking the doctor to sell you on every procedure. It's too complicated, and the risks of error are too great. It's not like buying a car.
That's one of the advantages they have in the U.K. and most other countries where the government health service decides what interventions are important based on the best scientific evidence.
I agree that in principle everybody should know what procedures he's getting and give informed consent. But in the real world when you've got 5 or 10 minutes with a busy doctor, it may not be possible to press that issue.
(There are other industries that operate that way. There are law firms that handle corporate clients that send the client the bill and expect him to pay for it. "For fighting off a hostile takeover . . . . . $1 million.")
That's right.
Caduceus (Hermes, god of thieves)=2 snakes.
Rod of Aesculapius (Apollo, god of medicine)=1 snake.
Alexander Flemming refused to patent penicillin.
There are lots of pharmaceutical chemists who would love to develop new drugs, if you just give them $80-100,000 a year so they can live a comfortable life with their families and send their children to school.
In fact there are chemists who would do it for less.
The problem is, you don't know whether it's end of life care until they're dead.
You spend $50,000 on one patient, and as a result, the patient lives another 10 years. You spend $50,000 on a similar patient, but the treatment doesn't work and the patient dies. How do you avoid end of life care? By denying the $50,000 treatment to both patients?
Oddly enough Lasik surgeries haven't gone up in price. It isn't covered by insurance.
Oddly enough cataract surgeries have gone down in price. Most of them are covered by Medicare.
The reason is that all eye surgery has become more efficient in the last 30 years. Surgery that used to take an hour takes 15 minutes. So doctors charge/get paid less.
Lasik is not an example of free-market competition driving prices down. It's an example of technology driving prices down.
P.S. You wouldn't want to have Lasik performed by the cheapest doctor.
I don't know that that's true. People in undeveloped countries go to first world countries, but the health care in Switzerland, France, Germany or Sweden is just as good as the care here.
Some experts said that Iraq had the best health care system in the (non-Israeli) mideast. Saddam used to send his medical students to the UK for training, and people from all over the mideast used to go to Iraq for treatment.
There are stories about Canadians coming to the U.S., but that's only for exotic diseases or new procedures for which there are only a few specialists in the world. (There are other stories about Canadians coming to the U.S. for medical treatment that have been debunked.) People have looked at the outcome data. and there's no significant difference between the U.S. and Canada.
When I go to a doctor sometimes I will opt not to get a test or take a medication because I don't think it's worth it.
I don't understand how that works. The doctor says, "You may have cancer, we have to do this test to rule it out." How do you say no?
The reason we have overtesting in the U.S. is because doctors get paid by procedure, not because patients don't have to pay for it.
If the test or medication is necessary, you have no choice. If it's not necessary, they shouldn't be giving it.
In the UK, NICE decides what tests and medications are necessary under what circumstances. Doctors are government employees, so they're expected to follow guidelines unless they have a good reason for doing otherwise. They give a lot fewer PSA tests in the UK. The death rate for prostate cancer is about the same.
Can you give an example of a country where there exists a genuine free market in health care, that achieves better health results than the USA does?
Mod parent up.
I've been asking that question for a long time and never got an answer.
The only free-market health care systems I know of are in third world countries that don't have much of a health care system at all.
I believe South Africa had a free-market system under apartheid, but I could be wrong.
Three weeks later, I get the bill, for over $1,670 for the "labs." If I had known, that was how much they were going to charge, I would have never allowed them to draw my blood.
That depends on what the test is for. If he says, "You might have X. This blood test can tell. If you do, and we catch it in time, it can save your life." (Or, "Then you can put your affairs in order.")
$1,670 is much higher than the standard panel of automated blood tests, the SMA-20, which I'd guess is $100, so it must have been some specialized test.
I agree that he should have explained to you what it was for, and how much it was going to cost. But if he did that for every patient, he'd have to raise his rates.
The bottom line is that we don't and can't have a free market in health care, because the amount of information a consumer would need to make a decision is too great.
If you can't find a doctor that you can trust, you're screwed.
And it's harder to find a doctor you can trust when doctors are motivated by profit, than it is when doctors are on salary and required to follow the guidelines.
I don't care how the jury decides. We'll see how good a scientific case the experts can make for the voice technology on the witness stand.
Have you been to Afghanistan?
Or do you just depend on stereotypes you get from tv, radio and newspapers?
That was supposed to be a real story. I think I read it in the Wall Street Journal.
I can believe that Pashtun women say things like that.
Oh, that's reassuring. If I visit that website, Homeland Security will merely record my name and file it away in case I visit any other suspicious websites.
Doesn't Google Translate do Pashto?
Best story I heard about that: The Taliban drove up to this woman's house in an SUV and said, "Sister, in the times of the Prophet, they didn't have televisions."
She said to them: "In the times of the Prophet they didn't have automobiles either. Come back on a camel."
Yes, but the problem is that every time a white guy kills a black guy in Florida, the district attorney decides he can't win the case.
The presumption of innocence under U.S. law is pretty limited. All it means is that the prosecution has the burden of proof in order to convict you.
For example, if you can't pay bail, there's no presumption of innocence. The judge can keep you in jail even though you've never been convicted of anything.
The issue here is that the cops weren't seriously investigating Zimmerman, and that they've failed to prosecute people in the past who killed black victims.
It didn't look like Zimmerman and his accusers would ever have their day in court -- until they went to the media. That's an appropriate role of the media.
BTW there's nothing about "presumption of innocence in the Constitution.
Good question. I couldn't find anything quickly, but maybe there is something.
A Google search for "site:.edu Easy Voice Biometrics Voice Biometrics Software" gave me more hits than I had time to get through.
"Speaker recognition" on Wikipedia, discusses the subject but doesn't clearly answer the question.
They say on their web site that the software is $5,000.
It looks like police departments have a lot of Homeland Security money to throw around.
Damn good question. I did a Google search for "site:.edu Easy Voice Biometrics Voice Biometrics Software" and came up with more results than I had time to plough through.
I would think that if they had good studies, they would be touting them on their web site, but maybe not.
We'll find out if it ever goes to trial and Zimmerman's lawyer puts their expert on the witness stand.
I think there are a lot of people out there who want to know what's happening behind the screen when they swipe colorful icons around.
There are a lot of people out there who want to get a better idea of how computers work.
It can be done. Learning Python or Java is a reasonable place to start.
I remember a special issue of Scientific American on computers, which had an article that walked you through how a simple, Turing-style computer worked on the logic circuit level -- reading from memory, adding binaries, storing the answer, etc. I spent an hour figuring out the illustration, and I had a pretty good conceptual understanding of how a computer worked. Any reasonably intelligent person who was willing to work at it could have read that article and understood it. A lot of people did. They understood the future a lot better.
I'm a non-computer geek but in the 1990s I learned HTML well enough to put up a quick web site, because it was fun and it was useful. I also learned how to put together a few databases and spreadsheets, and automated my word processing programs. I know about as much FORTRAN and BASIC as you would get in an introductory 101 course. I used to read Forrest Mims' notebooks and build digital circuits. I like it. I like flashing lights. I like programming f=1/r^2 fields. I like to open up the case and figure out what the parts do. It helps me understand what's going on in the world around me. So sue me.
I think any intellectually curious person wants to learn a lot of things, just because they're fun. I took my car apart and put it together. I learned the basics of a few foreign languages, a lot of math, chemistry, history, art, filmmaking, poetry, and other things I'll never use professionally. I could place respectably in a contest for the world's worst piano player.
I realize how offended people get when a novice, an amateur, presumes to learn something that they are an expert in. How could they affront your wisdom by suggesting that they are basking in the same sun? However, their target is different. As somebody in TFA mentioned, he learned enough to appreciate what real programmers are doing, so maybe you will get the respect you deserve.
http://books.google.com/ngrams/
Don't spend the whole day on it.
It's like judging teachers by their students' results on standardized tests.