Thanks for this, Vinay. As you may know one of the Drs coming to DC is Richard Pan, the former CA state politician who championed one of your favorite policies, “Toddler Masking”, at daycares during the COVID times. He is a mandate lover through and through, and is one who thinks that “ experts “ , himself included of course, know what’s better for children than any parent does. He’s a real winner! Yippee! ( Insert a huge amount of sarcasm here!)
Government involvement beyond a moderate level, especially when funding endeavors, is almost always bad. Everything thing costs more than it otherwise would.
I have been a fan of yours for many years, but your bias is becoming so pronounced it affects everything you say. I have to respectfully disagree with you.
You blame government and insurance for the problems of "Access, cost, and value" but those are not solved by free market non-insurance health care. Re value, From your time at FDA you know how easy it into bamboozle doctors and ordinary people about what works and what doesn't. re access, I agree AI may answer some questions, and that may be enough for some, but it remains unproven that it reduces the demands for access to doctors etc. The problem of medical care acess for the poor is best solved at government level, and insurance is how we spread the costs of expensive unforseen events. The French health care system does a good job at providing high qualitiy health care to all (the accessissue) at relatively low cost to the patient; though like all health care systems it is held hostage by the high charges of companies making pharmaceuticals and medical devices (there's the cost issue that requires some sort of regulation).
Sorry Dr Prasad, I have to disagree with you. The NHS system in the UK is a great example of what can work in healthcare. Everyone has access, everyone has a GP. There is no hunting around for a doctor. Consultants are the specialists. They are fully capable of knowing their specialty. Ai is a fallacy. Garbage in garbage out. Okay AI can crunch numbers quickly if fed the right numbers, study results, outcomes.
Yes the USA has some lovely hospitals, operating theatres etc, but if so many have no health insurance they will never see the inside of these buildings. For the richest country in the world, the USA health system is one big disgrace! I didn’t even mention litigation and how the legal profession got their piece of the action! Causing all docs to practice defensively and test, test, test.
Oh and by the way, yes healthcare is rationed. The newest RA drug will not be available on the NHS, or possibly anywhere in the UK. I think Humira was only allowed in recently because it went genetic.
Britain waits a long time to get the latest and greatest oncology drugs, which often aren’t so great. I trust my healthcare providers here and have had some magnificent levels of care when needed to rule out GCA recently. I truly believe I would have never had such speedy treatment in the USA. And I was never asked once for payment. Nor did I ever receive a medical bill for services rendered.
Speaking of American healthcare, anyone been to an “urgent care” facility lately. From the reception all the way down, not a good experience. And you even get to pay for it.
I was with you 100% until number five , Vinay. I believe Better doctors do generate better outcomes. An example is the orthopedist that my wife saw for her distal radius fracture. He only had two options in his armamentarium. Surgery and no surgery. What he should’ve done was a closed reduction after either a hematoma block or an axillary block. After three weeks he offered surgery for the crooked healing. Better doctors definitely result in better outcomes.
Do you think that AI well-trained in honest critical appraisal could rapidly create a repository of its evaluation of the harms vs benefits of pharmaceuticals and devices on a website that would allow public input and qualified human oversight to “separate the wheat from the chaff”? I imagine that such a domain could compete with the pharmaceutical-biased FDA to eventually lead to more evidence-based medicine…but perhaps this is only a fantasy.
Thanks for this, Vinay. As you may know one of the Drs coming to DC is Richard Pan, the former CA state politician who championed one of your favorite policies, “Toddler Masking”, at daycares during the COVID times. He is a mandate lover through and through, and is one who thinks that “ experts “ , himself included of course, know what’s better for children than any parent does. He’s a real winner! Yippee! ( Insert a huge amount of sarcasm here!)
Government involvement beyond a moderate level, especially when funding endeavors, is almost always bad. Everything thing costs more than it otherwise would.
Vinay
I have been a fan of yours for many years, but your bias is becoming so pronounced it affects everything you say. I have to respectfully disagree with you.
You blame government and insurance for the problems of "Access, cost, and value" but those are not solved by free market non-insurance health care. Re value, From your time at FDA you know how easy it into bamboozle doctors and ordinary people about what works and what doesn't. re access, I agree AI may answer some questions, and that may be enough for some, but it remains unproven that it reduces the demands for access to doctors etc. The problem of medical care acess for the poor is best solved at government level, and insurance is how we spread the costs of expensive unforseen events. The French health care system does a good job at providing high qualitiy health care to all (the accessissue) at relatively low cost to the patient; though like all health care systems it is held hostage by the high charges of companies making pharmaceuticals and medical devices (there's the cost issue that requires some sort of regulation).
Sorry Dr Prasad, I have to disagree with you. The NHS system in the UK is a great example of what can work in healthcare. Everyone has access, everyone has a GP. There is no hunting around for a doctor. Consultants are the specialists. They are fully capable of knowing their specialty. Ai is a fallacy. Garbage in garbage out. Okay AI can crunch numbers quickly if fed the right numbers, study results, outcomes.
Yes the USA has some lovely hospitals, operating theatres etc, but if so many have no health insurance they will never see the inside of these buildings. For the richest country in the world, the USA health system is one big disgrace! I didn’t even mention litigation and how the legal profession got their piece of the action! Causing all docs to practice defensively and test, test, test.
Oh and by the way, yes healthcare is rationed. The newest RA drug will not be available on the NHS, or possibly anywhere in the UK. I think Humira was only allowed in recently because it went genetic.
Britain waits a long time to get the latest and greatest oncology drugs, which often aren’t so great. I trust my healthcare providers here and have had some magnificent levels of care when needed to rule out GCA recently. I truly believe I would have never had such speedy treatment in the USA. And I was never asked once for payment. Nor did I ever receive a medical bill for services rendered.
Speaking of American healthcare, anyone been to an “urgent care” facility lately. From the reception all the way down, not a good experience. And you even get to pay for it.
I was with you 100% until number five , Vinay. I believe Better doctors do generate better outcomes. An example is the orthopedist that my wife saw for her distal radius fracture. He only had two options in his armamentarium. Surgery and no surgery. What he should’ve done was a closed reduction after either a hematoma block or an axillary block. After three weeks he offered surgery for the crooked healing. Better doctors definitely result in better outcomes.
Respectively, we are not the UK.
Do you think that AI well-trained in honest critical appraisal could rapidly create a repository of its evaluation of the harms vs benefits of pharmaceuticals and devices on a website that would allow public input and qualified human oversight to “separate the wheat from the chaff”? I imagine that such a domain could compete with the pharmaceutical-biased FDA to eventually lead to more evidence-based medicine…but perhaps this is only a fantasy.