These solutions are often proposed as easy fixes but I'm skeptical that they actually will do much to reduce healthcare costs. Healthcare is fundamentally expensive. Not-for-profit hospitals and for-profit hospitals don't really substantively differ in terms of out-of-pocket expenditures for patients; I find it difficult to imagine that forcing insurance companies to be nonprofit would do much to reduce costs.
> large insurance pools that must span age groups and risk groups.
What you describe (community rating) has been tried and it works. But it requires that a lot of young, healthy people enroll, and seniors receive most of the care. In an inverted demographic pyramid like most Western economies have, this is a ticking time bomb, so costs will continue to rise.
> Mandate at least decent minimal coverage standards
I think a better solution is to allow the government to threaten in negotiating prices with companies as Canada does; it greatly reduces rent-seeking behavior by pharmaceutical companies while allowing them to continue earning profits and innovating. (I understand a lot of the complaints against big pharma but they are actually one of the few sectors of the economy that doesn't park their wealth and actually uses it for substantive R&D, despite what the media will tell you, and countless lives have been saved because of pharma company profits)
Essentially the gist of what I'm saying, as someone who has been involved with and studied this industry for the better part of five years, is that it's much more complex than what meets the eye.
There are a lot of not-for-profit insurance companies and they aren't noticably cheaper, though I'm not in HR and they may well be cheaper for the employer.
Agreed. I'd also argue that there will always be the issue of adverse selection, which in any system that doesn't mandate that all individuals be covered for healthcare regardless of risk profile, will continue to raise costs regardless of whether or not margins are good or bad. That dream died with the individual mandate, and if the nation moves even further away from universal healthcare, we will only see costs rise and not fall as companies shoulder more and more of the relative risk.
Disruption, yes, in the sense that the current system needs to be overhauled. But this is a space that's frequented by the SV and VC space and "disruption" has very different connotations, usually in the realm of thought that suggests some SV-brained solution to an existing problem. In some edge cases like Uber/Lyft, this upending of an existing market can yield substantial positive externalities for users. Other "heavy industry" adjacent sectors, not so much. Healthcare and aviation, not so much.
Even SpaceX's vaunted "disruption" is just clever resource allocation; despite their iterative approach to building rockets being truly novel they're not market disruptors in the same way SV usually talks about them. And their approach has some very obvious flaws relative to more traditional companies like BO, which as of now has a lower failure-to-success ratio.
I don't think you'll find many providers clamoring for an AI-assisted app that hallucinates nonexistent diseases, there are plenty of those already out there that draw the ire of many physicians. Where the industry needs to innovate is in the insurance space, which is responsible for the majority of costs, and the captive market and cartel behavior thereof means that this is a policy and government issue, not something that can be solved with rote Silicon Valley style startup-initiated disruption; that I would predict would quickly turn into dysfunction and eventual failure.
Enshittification has done a lot of damage to the concept of "disrupting" markets. It's DOA in risk-averse fields.
Interests are not inherently gender-specific. I know many women who gravitate towards wargames, sports, and the like, typically male-dominated hobbies. We need to stop pursuing this notion that an activity is inherently male or inherently female.
Most trans women I know are the exact opposite, they gravitate towards extremely feminine interests, like makeup, fashion, design, etc. Inherent attraction towards a particular interest only dictates your personality type, I don't think it's meaningful insofar as it relates to gender dysphoria -- I think that stems from a much deeper, much more subconscious phenomenon which is adjacent to body dysmorphia. But I digress.
I proffer a question to those skeptical about gender transition: with the rise of GLP-1 blockers, many have found holes in the body positivity movement, in that a lot of formerly obese people who found solace in Ozempic and lost a lot of weight -- this accounts for a body transformation. Many report their symptoms of body dysmorphia disappeared entirely. Is this not the same for HRT and trans people? The other issue is that many are quick to compare the plight of a trans person to that of an anorexic -- but it's already established that anorexia nervosa is a special class of eating disorder that is multifactorial in origin and etiology.
If you're content with GLP-1 blockers and Ozempic being used to combat obesity, then you should have no issue with HRT. It's essentially the same thing, being used to treat a very similar condition. A lot of obese people don't necessarily want to be skinny, they just want to feel comfy in their own skin, and that's a trait they share with trans people.
There's one particular variable in all of these examples and videos that is conveniently elided by the authors, which is that most of these seem like inner-city schools. Children born into poverty with lackluster parenting are more likely to act out, the presence of social media notwithstanding.
I'm having a hard time reading this as a reasonable suggestion, so I apologize in advance if I'm being closed-minded.
Do you not believe that this would lead to further bad outcomes? Children need something to do during the day, and with neither the ability to work, nor other obligations (not to mention their brains are not fully developed) it seems like they would end up far worse off than they would otherwise, even if the school was under-performing.
The initial batches of F-35 rusted to pieces in 3 months of service. The Sikorsky MH-53E has a kapton defect and has been dropping out of the sky for decades. Commercial aircraft aren’t filled with well paid people who signed a waiver saying they’re OK with the risk of dying. It’s a completely different space. A fighter pilot crashing isn’t anything compared with a plane going down with a hundred souls aboard
> Commercial aircraft aren’t filled with well paid people who signed a waiver saying they’re OK with the risk of dying.
Neither are military aircraft (especially ones that carry more than just a pilot and navigator/RIO), generally, unless “well-paid” is defined broadly enough to be equivalent to just “paid”.
Doesn't seem like that far of a stretch given that Accutane (another acne medication) has been linked to IBD as well. There are a lot of drugs that interfere with the gut microbiota, of which its dysbiosis is often linked to the development of IBD. We're still in the infancy of understanding the pharmacokinetics of drugs as far as they relate to the gut and the ability of drugs to modulate the microbiome.
Isotretinoin and benzoyl peroxide are not remotely similar drugs. They have completely different mechanisms of action. That they both treat acne is essentially a coincidence.
This is irresponsible advice. Some people find that meat alleviates their symptoms while other people find more relief from going vegetarian. Recommending a single type of diet (especially a "fad" diet like the carnivore diet, rather than one with some type of scientific basis like low-fodmap or specific carbohydrate diets) as a panacea is not going to work for most people. People can and should try elimination diets instead, where you eliminate all but the most basic of foods and slowly reintroduce foods over time to see which ones are triggers.
It's entirely possible you or someone you know saw great success with a carnivore diet, but others trying it might not see the same results and need one tailored to their specific gut microbiome.
Beef-only is the ultimate elimination diet. You literally eliminate absolutely everything except beef.
And beef contains 100% of the nutrients you need in order to thrive in life.
There are people who have literally eaten nothing but ribeye steaks for over ten years now.
Also, consider the fact that agriculture is only about 12,000 years old, but human beings have been living on Earth for about 200,000 years (in our current form -- a couple million if you include Homo Erectus and the other variations). We were basically 99% meat-eaters for the vast vast majority of human history.
I follow a diet that is basically 100% beef, eggs, salmon, and milk (planning to cut out the milk) and I can assure you that it is the easiest possible diet for your digestive system. (For one thing, you completely stop farting.). You have never known poops so small, easy, and quick (because 99% of what you eat is simply absorbed - this diet has no fiber).
Note that there is no truly satisfactory "literature" on ANY diet, because double-blind randomized controlled trials that are of a long enough duration and over a large enough sample size are basically impossible to conduct. The human body is the most complex thing that we know of in the universe.
However, you can follow the work of Dr. Ken Berry or Dr. Shawn Baker to learn more about the carnivore diet -- they've been neck deep in it for years. And the anecdotal evidence is becoming overwhelming -- check ou the success stories at the carnivore.diet website.
Both of those doctors have had their medical licenses revoked, and are the exact type of guru-grifters I was referring to in another comment.
> Also, consider the fact that agriculture is only about 12,000 years old, but human beings have been living on Earth for about 200,000 years (in our current form)
Classic "appeal to nature" fallacy, with no real evidence to back up. If humans were healthier before 12,000 years ago, surely it'd be easy to prove that they had lower mortality rates and longer life expectancy?
First, Dr. Ken Berry has not had his medical license revoked.
Second, Dr. Shawn Baker got involved in a dispute with a hospital system because he began curing people through the carnivore diet rather than through extremely expensive surgery (he is an orthopedic surgeon). This led to the hospital system losing a lot of money. They insisted that he stop curing people, but Dr. Baker refused. They retaliated against him by getting a fraudulent fellow to badmouth his work and get his license revoked. He then went to court and won and his name was cleared completely.
As for your claim that there is no evidence to back up the fact that humans were healthier before 12,000 years ago, what about the fact that they were taller and had fewer dental caries and larger brains? Also, my point was not that humans were healthier then (although they were) but that the carnivore diet was the diet that human beings literally evolved on.
It's better to attempt elimination diets rather than a single type (low-fodmap, specific carb, carnivore, etc.) What works for one person may not work for everybody.
The carnivore diet is the ultimate elimination diet. The strict version (in which you eat nothing but ribeye steak) is nutritionally 100% complete and there are people who have been thriving on this diet for over a decade now. Meat is the food that human beings evolved on. Just try it and see for yourself.
> large insurance pools that must span age groups and risk groups.
What you describe (community rating) has been tried and it works. But it requires that a lot of young, healthy people enroll, and seniors receive most of the care. In an inverted demographic pyramid like most Western economies have, this is a ticking time bomb, so costs will continue to rise.
> Mandate at least decent minimal coverage standards
I think a better solution is to allow the government to threaten in negotiating prices with companies as Canada does; it greatly reduces rent-seeking behavior by pharmaceutical companies while allowing them to continue earning profits and innovating. (I understand a lot of the complaints against big pharma but they are actually one of the few sectors of the economy that doesn't park their wealth and actually uses it for substantive R&D, despite what the media will tell you, and countless lives have been saved because of pharma company profits)
Essentially the gist of what I'm saying, as someone who has been involved with and studied this industry for the better part of five years, is that it's much more complex than what meets the eye.