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PaperclipPerfector  6d ago (text post)   26154 thread views

Culture War Roundup for the week of November 18, 2024

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Urgent Cares exist because people these days refuse to use the system how its designed (and it's because of incentives, I get it and have committed this crime also) but they aren't really designed for the care people ask of them.

Sounds like a design problem.

This has a number of important effects one of which is: most of the shit that annoys you most about doctors is not their fault, they are required to do it because they aren't in charge anymore (most people in most specialties are employed now and not in independent private practice).

Sounds like a design problem.

Doctors no longer work for themselves and are now required by law and by their employer to do things that annoy the hell out of patients and we hate it but its not our fault please dont blame us thank you.

Sounds like a design problem. I'm not blaming them, definitely not individual doctors.

But doctors are theoretically in the best position to raise the issue and demand or impart adjustments. Seems like there's a large... incentive problem, who profits from keeping things as they are, and why don't they suffer consequences for failure?

Another Eliezer Yudkowsky tweet that lives rent free in my head on top of the other one is his almost certainly correct argument that completely removing all regulations currently effecting the healthcare industry would create immediate improvements compared to the status quo.

So, hope that Trump takes a chainsaw to the healthcare regs?

He also has interesting ideas on addressing the status quo.

Sounds like a design problem.

It's designed well, people just refuse to use it correctly and we can't force them. No amount of civil engineering is going to make up for disaffected young males who insist on driving around at 40 miles over the speed limit.

Society has mostly decided we can't force patients to use the systems correctly or take care of themselves. And I'm okay with that. Although this was a big part of what the ACA was about - health insurance only really works if everyone has it so you needed to force people to get.

I'm not saying all the regulations are good, many are emphatically not - physician salaries have been dropping for forever, so what's causing increased costs? Well a bunch of it is admin and other horseshit like that.

Think about how complex some of this system is, a huge percentage of costs, maybe even worth as much of 50% of doctors salaries, is healthcare workers and systems protecting themselves from getting sued. You want to drop healthcare costs and make access easier? Great make it so we can't get sued. I promise you that you will mostly get better quality care faster and for cheaper. But no, people don't want that, they want to be able to sue.

So healthcare is more expensive.

So much of what goes on is like that.

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