isaacyes

Atul Gawande - Better or Being Mortal

Non-technical but very interesting and emotive to most people.

Healthcare analytics

The British Medical Journal (BMJ) have been doing this for a while - publishing both the peer-review comments and author responses. I have published a paper in the BMJ and thought the process worked well and tempered the responses on both sides.

the joys of a fee for service model! What approach are you taking? As a payer, is capitation better? Outcomes based payments?

What a feeling it must be for the researchers involved in this, if it turns into a method of improving pancreatic cancer survival. I am glad their are so many medical researchers driven in this way.

My mother passed away from pancreatic cancer last year; she had no symptoms until two months before she passed, when she got a diagnosis from a scan. There are a lot of trials ongoing looking at how the area around the pancreas impacts how well different therapies work in treating it.

This is really interesting as it suggests a new avenue to improve treatment, as well as a potential tool for easier diagnosis.

Google Deepmind x The Royal Free hospital didn't quite go as planned, Information Governance wise.

Chiming in as someone who works at an insurer in clinical analytics.

There's a few ways we can pay less for a compound where there are generics/biosimilars. We could contract with a hospital group saying we will pay a small % markup on the cheapest drug to treat each condition - i.e. they can use the cheapest generic/biosimilar and make profit, or use a more expensive one and make a loss. They naturally shift all volume to the cheaper one. That then makes demand very elastic to price, and so encourages a lower price from manufacturers. We do see some compounds all sit at the same lowest price and not shift - that does suggest collusion - potentially tacit collusion though. An alternative is to contract with one pharma company to get a rebate if we push volume to their drug. We could then mandate to providers that we'll only pay for that drug.

In the UK, since WW2, ROI for buying a house and renting it out has on average kept pace with the stock market, albeit with far less volatility. This is including the house price growth and income from renting it out exceeding the debt.

This shouldn't happen - there should be a premium return for investing in something risky. The reason it has happened is because of policies such as being able to discount mortgage costs from rent before you pay tax on the rent (the government is phasing this out).

What has been the result of this? People who can borrow a lot (the rich) have hoovered up houses, reducing home ownership, raising house prices & rents, and making lots of money in a not very productive way. This is bad - a few decades ago average house prices were about 4x average salary, now it is 10+. Incentives to work hard are becoming out of touch. Also, all the money people are investing in housing could have been invested in starting a new company, or something risky but rewarding.

Why We Get the Wrong Politicians - Isabel Hardman

A very real world and practical look at UK politics. When it costs £100,000 from your own pocket to stand, and councillor jobs (that are the training ground for MPs) are part-time but spread throughout working hours, we aren't really selecting politicians from a diverse pool.