Hacker News Reader

Comment by houseabsolute | Hacker News Reader

I can't take an article seriously that claims we'd be better off without doctors and hospitals. Whatever fallacy that's called, I'm definitely guilty.

View on HN

He's showing that things are screwed up. We're spending too much on education for what we are getting in return. He's claiming that the system is wholly inefficient. He's just extending that to the health care system in that one-liner.

More generally: "For the amount of money that we are putting into <blank>, we should be getting more value out of it."

That is not what the article _says_, though.

It's just phrased differently. Stating that investing the money in the stock market or in developing nations would have a greater return on investment is just another way of stating that we're doing something wrong that is wasting significant amounts of money.

First of all, that's not the assertion I was talking about in the comment you originally replied to. I was talking about his stated position on doctors and hospitals. But anyway, the rest of the article is crock too, and if you're curious why you can read my other top-level comment.

The article is basically claiming that if a doctor earns $100k a year, and costs, say, $1m in funds to be able to complete his or her extended studies (that take many years), then creating that doctor is not a worthwhile investment for parents or for society.

That's wrong on so many levels that I won't even bother to argue with it.

Maybe there are some highly specialized occupations (e.g. theoretical scientist) where the high cost of education is justified. But the point is that most people don't go into those fields.

> The article is basically claiming that if a {knowledge} earns ${number} year, and costs, say, ${bigger_number} in funds to be able to complete his or her extended studies (that take many years), then creating that notfunh is not a worthwhile investment for parents or for society.

For a given value of {knowledge}, there are values of {number} and {bigger number} for which that statement is true. There are other values for which it is false.

Suppose, for example, it cost $1b to train a straw basketweaver and society was only willing to pay $10k for said basketweaver's output. That's not a worthwhile investment. And substituting doctor for basketweaver doesn't much change things.

Absent force, salary/compensation doesn't capture all of the value that society places on an occupation, but it isn't hugely wrong either.

> For a given value of {knowledge}, there are values of {number} and {bigger number} for which that statement is true. There are other values for which it is false.

Actually, there are values of {number} and {bigger number} for which that statement is true regardless of the value of {knowledge}.

I suspect that there are values for which it is always false as well.

How many doctors are unemployed and living with their parents?

Don't take the statement about hospitals and doctors and try to combine it with the statements about the education system. The former was just a jab at the healthcare system, the later is a jab at spending gobs of money just to end up with people that aren't doing much of anything with their education. Doctors that go out and do something with their education (i.e. work as a doctor) aren't included in that.

That's not quite what it says.

It says that we're paying too much for the service we get in return.

> Just as we’ve produced a health care system so expensive that we’d be better off without doctors and hospitals

This is what it says.

No one seriously believe we don't need doctors and hospitals, and probably not the author.

But when you say "it's so bad we would be better without", you imply - through exaggeration - that the system is very bad.

It's like when you say "I'd rather die than watch that movie".

It reads to me like he is embracing a belief in a fact, not a rhetorical exaggeration. YMMV. I think the whole article is idiotic so I am perfectly ready to believe that the author has other stupid beliefs as well.

Did you read the other article it was referencing?

The basis of the argument was Mexicans have a life expectancy of 2 years less than Americans, but massively smaller health care bills. The stipulation is that the return we get (2 years more life) is actually smaller than the cost (in terms of time worked, stress, etc) to bring it about. In other words, you give up 4 years of your life to your work so you can live 2 years longer. So, by giving up the 2 years greater life expectancy (cutting out/back/down hospitals and doctors) we'd get more back.

Not necessarily saying I agree, but I did want to point out that the argument isn't QUITE as fanciful as the reference might make it sound.

edit: it's all cool if you know the argument. Just wanted to make sure nobody was going solely off the sensationalist reference.

I did not read that article but I have read enough like it to know the general thrust of the argument. The ones I've read so far have hinged

- on life-expectancy data that is measured differently -- sometimes substantially differently -- from country to country and

- the probably false belief that Americans could continue to lead the same lifestyles they do now and still live about as long under a much smaller healthcare regime.

> the probably false belief that Americans could continue to lead the same lifestyles they do now and still live about as long under a much smaller healthcare regime.

yes, leading the same lifestyles is the rub. Which is kind of annoying now that I think about it. The lifestyles of the masses essentially determines the kind of healthcare everybody else has to pay for. If my gaunt, ever-grumbling stomach is any kind of a sign, I'm going to spend my life resenting that our healthcare system doesn't fit me in the slightest.

I've always been a 'what you do on your own time is your own choice' sort of guy, but I learn more and more that other people make decisions that should be purely their own choice, but in reality impact me all the time, which is confusing my ethical system. You should be allowed to eat what and how you want, for example, but it's becoming clearer and clearer that can have a very real and measurable impact on everybody else.

I don't see any reason to be upset that a civilized society spends a large portion of its output on living longer. It seems to make sense that as the material goods and experiences we want become less expensive that we should start spending more of our money on increasing the time and comfort in which we can enjoy them.

With respect to people living bad lifestyles, you have three unappetizing options.

- Let them die.

- Force them to stop living bad lifestyles.

- Pay the price yourself for the bad lifestyles that others lead.

There isn't really a fourth way. Unless you believe that most people's bad lifestyle choices can be fixed through education or non-forceful conditioning. Which, if you do, I have a bridge to sell you.

Bad behaviors often have a reason behind them: stress. Stress is often created by poorly run, evil, cruel, egotistic societies. Improve social capital - the problems will decrease by themself.

Why you think US is the country with highest incarceration rate? And let's say Norway - much smaller?

I think if you took away drug related arrests, the U.S. incarceration rate would be dramatically lower. So that's a case of stupid, fundamentalist laws more than stress causing crime.

Not sure. Incarceration rate is almost directly tied to rhe level of inequality in the society, so even if USA takes away these laws, will change, but dramatically.

There is compelling evidence that even within the US, we could cut a lot of medicine without any adverse health effects.

http://hanson.gmu.edu/CutMed.htm

He makes that argument in several other blog posts, and the argument is that the cost of doctors and hospitals is so high that the entire thing could be allocated to other initiatives with better overall outcomes.

I think its actually a better argument than this one.

Reply on news.ycombinator.com