myersj

> MRI machines are extremely common here

Which says nothing about whether they ought to be, or whether our healthcare is better for having them. Needless imaging is a massive cost drain in the industry.

Let's please stop using healthcare examples when we don't understand healthcare.

You're misunderstanding, probably intentionally. GP is not upset on behalf of the cold lunch or the person receiving it. They're saying this is a stupid way to protest. Until she was arrested (which was not an expected or anticipated consequence), it was utterly irrelevant and meaningless. It had no benefit to anyone, brought no attention to what she was upset about (which is moronic anwyays - being mad that robots are taking the "jobs" of DD/UE "workers" is completely misunderstanding the issue), and had no chance of changing anything. It was an idiotic way to "protest".

But go off about guillotines and cold lunches or whatever.

> We could remove these weird constraints by making health care a government service rather than a highly contorted pseudo-market, but that would not be the American way. It has to at least look like a market, even if it’s an ineffective, inefficient, opaque, corrupt one.

It is still a market (and a single-payer one, ultimately) in these places, but it is not a government service. It is the best solution: the government funds the appropriate cost of care, the provider group is financially responsible for meeting it, and they are incentivized directly to get it right.

The left needs to stop shrieking about Medicare-for-all and the right needs to stop pretending like it can even spell healthcare. There are good solutions.

> but also encourages just refusing to treat people.

It categorically does not. It would be foolish to do so.

> There's a paradigm shift needed in how health insurance works: optimize for total cost of care.

Value-based care, e.g. Medicare Advantage.

The idea is that the government gives you $X for the care of a patient, with multipliers on risk factors. The government's goal is for that to be basically exactly what care costs. The provider is incentivized to treat you for less. Which sounds perverse, but if they, for instance, deny all care, a patient will end up in the hospital and cost exponentially more than they would have through proper preventive care. It is not perfect, and it should be broader, but it is a strong optimizer for providing the right care to keep a patient healthy, without providing hundreds of unnecessary tests (and especially imaging) that are medically unnecessary.

It is absolutely a system that should be rolling out to more and more patients.

"Why not just skip the HbA1c tests? After all, you know they'll give you insulin. Just start taking it."

Do you think everyone with poor blood test indicators is aware of how unhealthy they are? How quickly they need to reverse course? Or do think there might be some possible validity to discussing your results with an actual doctor and understanding how acute your symptoms actually are? Do you think there are no side effects to statins and everyone should just be on one at all times, forever? Do you think there might be some value, for those patients, in discussing GLP-1s? Or nah, everyone can just like, go run 10 miles tomorrow because some 20 year old in SV said so?

I'm always deeply confused by people who think all medicine is "just repeat whatever ChatGPT said as if it's profound, like, duh - I'm smart and invincible and can't quite figure out that other people aren't me", in spite of them not knowing anything about medicine in the first place.

"I can imagine none of this will matter and I'm already mad about it" is sort of an intellectually lazy, self-fulfilling prophecy. But do you.

You mean the dot com bubble, which was in fact a major bubble that caused a lot of huge financial issues in the country? You'd think someone on a tech forum would have heard of it, but I suppose some of us would rather make asinine clapback comments than think about what we're saying.

> Any measures we can take to ensure that we don't fall into a situation where there is only one choice is sensible.

Amen. Prepare for a disaster tomorrow by planning for it today. The specific implementation might be mediocre, but we should be pushing for more, especially vis-a-vis pushing for anyone in the company who knowingly was involved in fraud to go to prison.

> Amazing what people spend time writing about.

I need to know that you recognize the irony, here.

Just stop clicking things you're not interested in. It's a self-solving problem if you're not intentionally going out of your way to be a jerk about things for meaningless internet validation.

Of course it is. It's the start of conversations like this very one. Or it's a personal blog that other people find and like to read. I don't understand why the author's motivation for writing something matters literally at all, except for a small group of people who really, really get off on X-style judging/hating everything for some reason.

Perhaps some introspection would be more useful/valuable than the sneering bullshit.

One person with a weird schedule has absolutely nothing, at all, to do with how the vast, overwhelming number of people in the world work. Come on.

If I need to go to the bank, or the gym, or do basically anything involving other people, I can't just like, do whatever, man. I'm sort of beholden to the rest of the world's scheduling. How is that hard to understand?

How, specifically, would you solve for "just show up like, whenever you want" for kids in school?

> I’m not sure how this causes an identity crisis.

It doesn't - author outright states his title and premise were complete clickbait.