Comments on: Fixing Health Care III: Hospitals http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/ ...explorations in complex adaptive systems... Thu, 09 Sep 2010 12:29:42 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: kevindick http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/#comment-3989 kevindick Thu, 22 Oct 2009 18:14:32 +0000 http://emergentfool.com/?p=2268#comment-3989 The leukemia point is a bit of a red herring. First, I wouldn't call childhood leukemia definitely "terminal" in most cases. Second, people are free to write whatever contract they want. If kids are that important, the contracts will except them. But there are undoubtedly a lot of cases where there is very little percentage in continuing treatment. By specifying those up front, you save. The leukemia point is a bit of a red herring. First, I wouldn’t call childhood leukemia definitely “terminal” in most cases. Second, people are free to write whatever contract they want. If kids are that important, the contracts will except them. But there are undoubtedly a lot of cases where there is very little percentage in continuing treatment. By specifying those up front, you save.

]]> By: Alex Golubev http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/ ...explorations in complex adaptive systems... Thu, 09 Sep 2010 12:29:42 +0000 http://wordpress.org/?v=2.9.2 hourly 1 Comments on: Fixing Health Care III: Hospitals http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/ ...explorations in complex adaptive systems... Thu, 09 Sep 2010 12:29:42 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: kevindick http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/#comment-3989 kevindick Thu, 22 Oct 2009 18:14:32 +0000 http://emergentfool.com/?p=2268#comment-3989 The leukemia point is a bit of a red herring. First, I wouldn't call childhood leukemia definitely "terminal" in most cases. Second, people are free to write whatever contract they want. If kids are that important, the contracts will except them. But there are undoubtedly a lot of cases where there is very little percentage in continuing treatment. By specifying those up front, you save. The leukemia point is a bit of a red herring. First, I wouldn’t call childhood leukemia definitely “terminal” in most cases. Second, people are free to write whatever contract they want. If kids are that important, the contracts will except them. But there are undoubtedly a lot of cases where there is very little percentage in continuing treatment. By specifying those up front, you save.

]]> By: Alex Golubev http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/#comment-3989 kevindick Thu, 22 Oct 2009 18:14:32 +0000 http://emergentfool.com/?p=2268#comment-3989 The leukemia point is a bit of a red herring. First, I wouldn't call childhood leukemia definitely "terminal" in most cases. Second, people are free to write whatever contract they want. If kids are that important, the contracts will except them. But there are undoubtedly a lot of cases where there is very little percentage in continuing treatment. By specifying those up front, you save. The leukemia point is a bit of a red herring. First, I wouldn’t call childhood leukemia definitely “terminal” in most cases. Second, people are free to write whatever contract they want. If kids are that important, the contracts will except them. But there are undoubtedly a lot of cases where there is very little percentage in continuing treatment. By specifying those up front, you save.

]]> Comments on: Fixing Health Care III: Hospitals http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/ ...explorations in complex adaptive systems... Thu, 09 Sep 2010 12:29:42 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: kevindick http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/#comment-3989 kevindick Thu, 22 Oct 2009 18:14:32 +0000 http://emergentfool.com/?p=2268#comment-3989 The leukemia point is a bit of a red herring. First, I wouldn't call childhood leukemia definitely "terminal" in most cases. Second, people are free to write whatever contract they want. If kids are that important, the contracts will except them. But there are undoubtedly a lot of cases where there is very little percentage in continuing treatment. By specifying those up front, you save. The leukemia point is a bit of a red herring. First, I wouldn’t call childhood leukemia definitely “terminal” in most cases. Second, people are free to write whatever contract they want. If kids are that important, the contracts will except them. But there are undoubtedly a lot of cases where there is very little percentage in continuing treatment. By specifying those up front, you save.

]]> By: Alex Golubev http://emergentfool.com/2009/10/17/fixing-health-care-iii-hospitals/#comment-3920 Alex Golubev Mon, 19 Oct 2009 21:51:20 +0000 http://emergentfool.com/?p=2268#comment-3920 "Studies have shown that the 5% of Medicare patients who die each year account for 30% of Medicare's costs, with 78% of last-year-of-life expenses occurring in the month before death. A March 9 Archives of Internal Medicine study of 603 dying cancer patients at seven hospitals, oncology clinics and hospices found that care for patients who had end-of-life discussions with their physicians cost $1,295, compared with $2,780 for patients who did not have such talks." i think the end of life debate is the crux of the moral issues. I like you approach, but: 1. i wonder if 30% price difference is close to what it would be or if its materially higher/lower. 2. some may argue that a 30% difference means that two kids born to different families have very different options for battling their leukemia. I don't really know where i land on this issue. The willies are quite disturbing one way or another. On the one hand, it's such an inelastic service - last year or month of life (in a drug induced coma possibly). On the other hand, this is precisely the voting mechanism that is needed to extend those moments. if everyone's indifferent to how it gets paid for, then innovation won't focus on it. “Studies have shown that the 5% of Medicare patients who die each year account for 30% of Medicare’s costs, with 78% of last-year-of-life expenses occurring in the month before death. A March 9 Archives of Internal Medicine study of 603 dying cancer patients at seven hospitals, oncology clinics and hospices found that care for patients who had end-of-life discussions with their physicians cost $1,295, compared with $2,780 for patients who did not have such talks.”

i think the end of life debate is the crux of the moral issues. I like you approach, but:
1. i wonder if 30% price difference is close to what it would be or if its materially higher/lower.
2. some may argue that a 30% difference means that two kids born to different families have very different options for battling their leukemia.

I don’t really know where i land on this issue. The willies are quite disturbing one way or another. On the one hand, it’s such an inelastic service – last year or month of life (in a drug induced coma possibly). On the other hand, this is precisely the voting mechanism that is needed to extend those moments. if everyone’s indifferent to how it gets paid for, then innovation won’t focus on it.

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