DIYbio: the free market's answer to health care pricing

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sophie
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DIYbio: the free market's answer to health care pricing

Post by sophie » Wed Apr 17, 2019 8:09 am

I don't know about you guys, but it's awesome to see how in many ways artificially high health care pricing is ripe for arbitrage, and the regulatory system propping it all up simply won't be able to respond fast enough to these new trends:

https://www.cell.com/trends/biotechnolo ... 18)30200-2
New innovation ecosystems for drug discovery and development are emerging.
Members of the ‘do-it-yourself biology’ community, sometimes called ‘biohackers,’ are contributing to this new frontier by experimenting with the development of medical treatments and devices.
An initiative known as the Open Insulin Project is working to develop a protocol for insulin production in order to sidestep intellectual property.
Follow-on work could contribute to a number of different insulin distribution structures, including ‘home-brewed’ insulin for personal use.
The current regulatory system is incongruous with emerging innovation ecosystems such as the Open Insulin Project.
The Open Insulin Project http://openinsulin.org/

I guess we'll have to see how the FDA will react to this. Not well, I imagine. Ditto the AMA. They've already been fighting hard against in-store "mini-clinics" like CVS's, which handled 40 million visits last year according the CVS CEO. They'd probably push against the new "virtual visit" companies that can handle primary care duties over the internet for far less than a typical PMD followup appointment fee, except they may not have noticed them yet.
boglerdude
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Re: DIYbio: the free market's answer to health care pricing

Post by boglerdude » Wed Apr 17, 2019 10:43 pm

Youre an MD? Is the AMA restricting the number of doctors to keep salaries high?

https://www.washingtonexaminer.com/than ... gh-doctors
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sophie
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Re: DIYbio: the free market's answer to health care pricing

Post by sophie » Thu Apr 18, 2019 6:15 am

Amazingly enough, you can't blame this on the AMA.

Residency slots are fixed via the Medicaid program, but that's not the the biggest limitation right now. When they say "doctor shortage" they mean primary care doctor shortage. The residency slots in that specialty don't fill up, because being a primary care doctor just plain sucks - worse than being a doctor in general, which is bad enough. Seriously no one wants that job, not even the nurse practitioners who are supposed to fill the gap. The rate at which doctors are quitting the field is increasing, by a lot, though I can't tell you how much or in which specialties because it's not being measured.

Check out this site: https://www.docjobs.com/. A good friend of mine is a member. And I know a few people who have already quit.

So yes I guess you could say it's the doctors' fault for not wanting to go into primary care and not wanting to be sacrificial lambs. Sorry, but I didn't get the memo where it said I had to do that.
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Re: DIYbio: the free market's answer to health care pricing

Post by pugchief » Thu Apr 18, 2019 7:50 am

sophie wrote:
Thu Apr 18, 2019 6:15 am
When they say "doctor shortage" they mean primary care doctor shortage. The residency slots in that specialty don't fill up, because being a primary care doctor just plain sucks - worse than being a doctor in general, which is bad enough. Seriously no one wants that job, not even the nurse practitioners who are supposed to fill the gap. The rate at which doctors are quitting the field is increasing, by a lot, though I can't tell you how much or in which specialties because it's not being measured.
Let's examine why no one wants to go into primary care:
  • 1. electronic medical records
    2. low insurance and medicare reimbursement, particularly compared to higher paying specialties, but in general
    3. ridiculous debt to complete education, without traditional high pay
Now which of those things is not directly or indirectly the fault of the government?
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sophie
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Re: DIYbio: the free market's answer to health care pricing

Post by sophie » Fri Apr 19, 2019 8:02 am

pugchief wrote:
Thu Apr 18, 2019 7:50 am
sophie wrote:
Thu Apr 18, 2019 6:15 am
When they say "doctor shortage" they mean primary care doctor shortage. The residency slots in that specialty don't fill up, because being a primary care doctor just plain sucks - worse than being a doctor in general, which is bad enough. Seriously no one wants that job, not even the nurse practitioners who are supposed to fill the gap. The rate at which doctors are quitting the field is increasing, by a lot, though I can't tell you how much or in which specialties because it's not being measured.
Let's examine why no one wants to go into primary care:
  • 1. electronic medical records
    2. low insurance and medicare reimbursement, particularly compared to higher paying specialties, but in general
    3. ridiculous debt to complete education, without traditional high pay
Now which of those things is not directly or indirectly the fault of the government?
All three, definitely. A lot of the blame for #2 can be laid at the feet of private insurance though. And #3 is about mostly private university tuition being ridiculously high. Debt isn't so bad if you go to a state school (which is a benefit of government).

Still, my post was a response to the earlier one blaming "the doctors" when in fact doctors are the victims. So is anyone in need of health care. Good news is that I'm detecting the creation of a free-market layer over the existing medical system that is rapidly taking hold. This is not unlike the economy in the Soviet Union, before the breakup. I visited there in late 1980s. The government stores were empty most of the time, and when they got supplies people would instantly form long lines (up to several blocks long) to grab whatever they could, because the prices were artificially low. On top of that was a "black market" layer that was unregulated and with prices determined by supply & demand. People set up outdoor shops on sidewalks, and that's where 95% of commerce took place. The government didn't do anything about this because I guess they recognized that people & the economy would starve if they tried to stop it. It would be awesome if the same thing is now happening for routine medical care.
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