Phi for All Posted November 22, 2013 Posted November 22, 2013 Ideally, nothing changes militarily if every country makes fair cuts; they will only gain by advancing medicine for human beings. Unfortunately, medicine in general is handled poorly in a capitalist approach using modern business models. The ideal of business is growth. The ideal of medicine is to reduce sickness, suffering and disease. The two aren't really compatible unless we can figure a way to pay doctors for spreading health instead of reducing illness. That could be a big stumbling block to this plan. I wonder too about how much governments looks at us the way a restaurant manager looks at patrons on a busy Saturday night. "It's great that you're here, you help keep things running with your consumerism and we love you, but could you please hurry up and leave so we can stop wasting resources on you and make way for the next customer?" I still say it would be smarter to focus extra funding on education. It would make medicine and medical knowledge more available and thus more efficiently applied worldwide, as well as all the other great things history tells us happens in an informed, mature and well-educated society.
Tridimity Posted November 22, 2013 Posted November 22, 2013 (edited) The ideal of business is growth. The ideal of medicine is to reduce sickness, suffering and disease. The two aren't really compatible unless we can figure a way to pay doctors for spreading health instead of reducing illness. That could be a big stumbling block to this plan. Perhaps it would be possible to incentivise reductions in mortality rate; medical researchers compete for funding from charities and research councils just as they do at present except the parameter that is used as a basis for determining who wins grants is reduction in morbidity/mortality rather than the number of research publications/h index. This would necessitate research projects that operate on a far larger scale than at present and with timescales of 5-10 years or so. I think that this would work best in the context of an open research institute for which the recruitment policy is strictly meritocratic with a strong emphasis on creativity and problem-solving skills. As I envisage it, all researchers would be free to work anywhere within the institute and to collaborate freely or work independently as they choose. Subject specialisations and titles would be ignored in order to create an effective and co-operative (not competitive) environment. The only two rules would be: i. To strive to achieve the set objective (e.g. reducing mortality rates associated with a particular type of cancer within a certain time period, in animal models and in clinical trials) ii. To acknowledge the contributions of any and all people who have contributed to the project Edited November 22, 2013 by Tridimity
iNow Posted November 22, 2013 Posted November 22, 2013 Along similar lines, in many instances doctors are paid for performance and well-being outcomes instead of fee per service provided. http://en.wikipedia.org/wiki/Pay_for_performance_(healthcare) 1
Science Student Posted November 23, 2013 Author Posted November 23, 2013 Unfortunately, medicine in general is handled poorly in a capitalist approach using modern business models. The ideal of business is growth. The ideal of medicine is to reduce sickness, suffering and disease. The two aren't really compatible unless we can figure a way to pay doctors for spreading health instead of reducing illness. That could be a big stumbling block to this plan. Why would the money have to go to private businesses? Why can't it keep going to universities or government funded medical research organizations? I still say it would be smarter to focus extra funding on education. It would make medicine and medical knowledge more available and thus more efficiently applied worldwide, as well as all the other great things history tells us happens in an informed, mature and well-educated society. If more money went to education for medical research, then I would consider that a way to support medical research.
iNow Posted November 23, 2013 Posted November 23, 2013 (edited) Why would the money have to go to private businesses? Why can't it keep going to universities or government funded medical research organizations?I believe Phi is referring to private health insurance, such as that we have in the United States. People purchase insurance through corporations and those corporations agree to pay claims for doctors visits and other medical expenses. The problem is with those agreements, and the fact that corporations (and private businesses) core mission is to make money. Think for a moment how businesses make money. They want to maximize revenues and minimize costs. In the case of healthcare, the insurance premiums we pay are their revenues. They have an interest in making those as high as they possibly can without losing too many customers. The problem comes in on the cost side. Remember that businesses are very incentivized to minimize their costs, and payment of medical claims is pure cost. Each time you go to the doctor, it costs them money. Each time you fill a prescription, it costs them money. Each time you get hurt and go to the hospital, each time you have bloodwork done, each time you get new glasses or your teeth cleaned... It costs them money. The more costs a business has, the less successful it is. In it's purest form, health insurance offered through private businesses and corporations would never pay a single claim and would charge the most amount of money possible. It's the exact opposite of focusing the well-being of the patient. It's anathema to good health. If we were focused on good health, we'd not care how much it cost. We'd focus on effectiveness of the treatment. We don't do that, and it's made worse by the way we pay the doctors themselves. We pay doctors for the number of patients seen, the number of tests run, the number of visits... Regardless of whether or not the patient benefited from the treatment or if the right treatment was given. Basically, we're doing this wrong on two different fronts. We're paying our doctors for the wrong things, and we're asking for businesses to make those payments even though they care more about lowering their costs than increasing our health. I think that is what Phi was referring to in his post... The broken nature of that approach. Edited November 23, 2013 by iNow 2
Science Student Posted November 23, 2013 Author Posted November 23, 2013 I believe Phi is referring to private health insurance, such as that we have in the United States. People purchase insurance through corporations and those corporations agree to pay claims for doctors visits and other medical expenses. The problem is with those agreements, and the fact that corporations (and private businesses) core mission is to make money. Think for a moment how businesses make money. They want to maximize revenues and minimize costs. In the case of healthcare, the insurance premiums we pay are their revenues. They have an interest in making those as high as they possibly can without losing too many customers. The problem comes in on the cost side. Remember that businesses are very incentivized to minimize their costs, and payment of medical claims is pure cost. Each time you go to the doctor, it costs them money. Each time you fill a prescription, it costs them money. Each time you get hurt and go to the hospital, each time you have bloodwork done, each time you get new glasses or your teeth cleaned... It costs them money. The more costs a business has, the less successful it is. In it's purest form, health insurance offered through private businesses and corporations would never pay a single claim and would charge the most amount of money possible. It's the exact opposite of focusing the well-being of the patient. It's anathema to good health. If we were focused on good health, we'd not care how much it cost. We'd focus on effectiveness of the treatment. We don't do that, and it's made worse by the way we pay the doctors themselves. We pay doctors for the number of patients seen, the number of tests run, the number of visits... Regardless of whether or not the patient benefited from the treatment or if the right treatment was given. Basically, we're doing this wrong on two different fronts. We're paying our doctors for the wrong things, and we're asking for businesses to make those payments even though they care more about lowering their costs than increasing our health. I think that is what Phi was referring to in his post... The broken nature of that approach. That could be what Phi meant. Or maybe Phi meant pharmaceutical companies. If Phi meant that, then I can see the point. In Canada the process is that the universities first discover something, and then bid pharma buys patenting for it and then invests money into it for further research and development like clinical trails, marketing etc. But a huge and interesting problem is that they are not interested in one-time cures as much as they would be interested in something that requires indefinite usage. They also need it to be patentable. An example of this is http://www.cancer.ca/en/about-us/news/national/2013/canadian-cancer-societys-perspective-on-dca/?region=on DCA is not patentable, so big pharma has no interest in it, which makes sense from a business perspective.
Tridimity Posted November 23, 2013 Posted November 23, 2013 (edited) We pay doctors for the number of patients seen, the number of tests run, the number of visits... Regardless of whether or not the patient benefited from the treatment or if the right treatment was given. Absolutely, this is the main problem, financial wellbeing is prioritised over patient wellbeing. In the UK this has also resulted in target-setting activity which, although done with the best of intentions (e.g. to reduce waiting times for appointments and treatments) has had negative consequences such as forcibly limiting the duration of consultation appointments and, regrettably, fudging of the data by healthcare workers under pressure. Of course we need our healthcare programmes to be affordable - but this may well be achieved more efficiently by incentivising reduction in morbidity/mortality - if you tally Doctors' pay to resolution of disease and to mortality figures (and do not allow them to pick and choose which patients they treat!) then I think a lot of people would be quite surprised at how cost-effective their practise becomes. Putting people's daily bread on the line quickly makes them re-assess their own priorities! It is also much more difficult to fudge morbidity/mortality outcome data - just enforce random spot checks on patients to ask about their condition and to check if they are still alive. Doctors who fail to perform to high standards ought to be given extra support and those performing adequately or better ought to be rewarded. Edited November 23, 2013 by Tridimity
ralfy Posted November 23, 2013 Posted November 23, 2013 That doesn't make any sense to me. This is a gain for China and every other country. Ideally, nothing changes militarily if every country makes fair cuts; they will only gain by advancing medicine for human beings. It makes sense because its unlikely that "every country" will make "fair cuts."
Tridimity Posted November 23, 2013 Posted November 23, 2013 It makes sense because its unlikely that "every country" will make "fair cuts." Perhaps all of the nations involved could come to a joint agreement as to what is fair for each of them to cut - and to impose sanctions on those who step out of line
Phi for All Posted November 23, 2013 Posted November 23, 2013 I believe Phi is referring to private health insurance, such as that we have in the United States. People purchase insurance through corporations and those corporations agree to pay claims for doctors visits and other medical expenses. The problem is with those agreements, and the fact that corporations (and private businesses) core mission is to make money. Think for a moment how businesses make money. They want to maximize revenues and minimize costs. In the case of healthcare, the insurance premiums we pay are their revenues. They have an interest in making those as high as they possibly can without losing too many customers. The problem comes in on the cost side. Remember that businesses are very incentivized to minimize their costs, and payment of medical claims is pure cost. Each time you go to the doctor, it costs them money. Each time you fill a prescription, it costs them money. Each time you get hurt and go to the hospital, each time you have bloodwork done, each time you get new glasses or your teeth cleaned... It costs them money. The more costs a business has, the less successful it is. In it's purest form, health insurance offered through private businesses and corporations would never pay a single claim and would charge the most amount of money possible. It's the exact opposite of focusing the well-being of the patient. It's anathema to good health. If we were focused on good health, we'd not care how much it cost. We'd focus on effectiveness of the treatment. We don't do that, and it's made worse by the way we pay the doctors themselves. We pay doctors for the number of patients seen, the number of tests run, the number of visits... Regardless of whether or not the patient benefited from the treatment or if the right treatment was given. Basically, we're doing this wrong on two different fronts. We're paying our doctors for the wrong things, and we're asking for businesses to make those payments even though they care more about lowering their costs than increasing our health. I think that is what Phi was referring to in his post... The broken nature of that approach. I wanted to quote this whole post again from iNow. If I'd had the time to go into more detail, I couldn't have said it any better than this. Some things are better funded publicly. Medicine is one. Prisons are another. If you don't want more prisons and more prisoners, don't apply a growth model to the situation. That could be what Phi meant. Or maybe Phi meant pharmaceutical companies. If Phi meant that, then I can see the point. In Canada the process is that the universities first discover something, and then bid pharma buys patenting for it and then invests money into it for further research and development like clinical trails, marketing etc. But a huge and interesting problem is that they are not interested in one-time cures as much as they would be interested in something that requires indefinite usage. They also need it to be patentable. An example of this is http://www.cancer.ca/en/about-us/news/national/2013/canadian-cancer-societys-perspective-on-dca/?region=on DCA is not patentable, so big pharma has no interest in it, which makes sense from a business perspective. The US is a bit different, but the pharmas are part of the problem here too. Like too many others, they have the money to buy political clout, then get regulations relaxed or work some sweet deals like Bush's Medicare reform in 2003. We can regulate the pharmas better. Few for-profit companies would spend the initial research money that ends up being so critical to any discovery, so public funding through universities and government makes sense even though it's heavily criticized. We can extract a fairer price for that research by requiring them to test for medicines for less-profitable diseases. Far too many industries have forgotten how much financial help our citizens provide through publicly funded programs. They don't do much to give back, they hide their profits from taxation and they send jobs to foreign countries while enjoying US protections. In fact, if we could plug the leaks in our state and federal budgets that spew tax dollars out to big business and get little in return, we might not need to reduce anything else. 1
Science Student Posted November 23, 2013 Author Posted November 23, 2013 (edited) It makes sense because its unlikely that "every country" will make "fair cuts." Can you give me a reason or reasons why a country wouldn't want to participate in such an agreement? What I feel that I have designed is a win-win proposal where no country loses in such an agreement but only gains. Imagine you square off with somebody in a street fight because of an argument or whatever. But before you fight, someone offers you both $1000.00 each to simply move the fight closer to a crowd where the guy can raise the money. So, you both are going to beat each other up, but you will both gain/win in a different way. So one person loses the fight but receives money, and the other person wins and receives money. This is a synergy of benefit - if you will. It is a win-win proposition to move the fight. We can regulate the pharmas better. Few for-profit companies would spend the initial research money that ends up being so critical to any discovery, so public funding through universities and government makes sense even though it's heavily criticized. We can extract a fairer price for that research by requiring them to test for medicines for less-profitable diseases. That seems like a good idea. The fact that big pharma won't touch DCA (a good cancer curing prospect) tells me that your idea needs to be implemented. And if it is already implemented to some degree, then the current model is not good enough. And, I agree with everything else that you said. Edited November 23, 2013 by Science Student
ralfy Posted November 24, 2013 Posted November 24, 2013 Can you give me a reason or reasons why a country wouldn't want to participate in such an agreement? What I feel that I have designed is a win-win proposal where no country loses in such an agreement but only gains. Imagine you square off with somebody in a street fight because of an argument or whatever. But before you fight, someone offers you both $1000.00 each to simply move the fight closer to a crowd where the guy can raise the money. So, you both are going to beat each other up, but you will both gain/win in a different way. So one person loses the fight but receives money, and the other person wins and receives money. This is a synergy of benefit - if you will. It is a win-win proposition to move the fight. You can look back and see many reasons why agreements or attempts at such failed, from the years before the start of WW2 to the Cold War years to the present. I am not sure how the future will be any different, especially given increased arms production, profits from the same, etc., not to mention predicaments such as peak oil, global warming, and financial crisis. About the example, the fight continues, which means both sides still have to beef up on military spending, and the costs are passed on to citizens. Worse, it's moved elsewhere, which means citizens of those places become collateral damage. The winners are the two armies that get their armaments and any financial elite that will profit from arms sales and from the effects of the war, such as control of various natural resources and deals struck with the government and elite in that area.
iNow Posted November 24, 2013 Posted November 24, 2013 Can you give me a reason or reasons why a country wouldn't want to participate in such an agreement? What I feel that I have designed is a win-win proposal where no country loses in such an agreement but only gains. I think the flaw in your reasoning here is the assumption that countries will always act in the best interest of everyone, and often not even in their own best interest. This challenge is magnified when you recall that governments of these nations are generally made up of many different people with many different ideologies and many different agendas that most often do not align.
Science Student Posted November 24, 2013 Author Posted November 24, 2013 You can look back and see many reasons why agreements or attempts at such failed, from the years before the start of WW2 to the Cold War years to the present. I am not sure how the future will be any different, especially given increased arms production, profits from the same, etc., not to mention predicaments such as peak oil, global warming, and financial crisis. I strongly disagree. The U.S.A. and the U.S.S.R. agreed to curtail the production of nuclear arms and reduce their stockpiles, http://en.wikipedia.org/wiki/SALT_II#SALT_II . About the example, the fight continues, which means both sides still have to beef up on military spending, and the costs are passed on to citizens. Worse, it's moved elsewhere, which means citizens of those places become collateral damage. The winners are the two armies that get their armaments and any financial elite that will profit from arms sales and from the effects of the war, such as control of various natural resources and deals struck with the government and elite in that area. My example is way too vague. I meant something else. I think the flaw in your reasoning here is the assumption that countries will always act in the best interest of everyone, and often not even in their own best interest. This challenge is magnified when you recall that governments of these nations are generally made up of many different people with many different ideologies and many different agendas that most often do not align. There are many things that many people want and don't want. But we can all agree on two things that we want at least for ourselves; the two things are health and life.
ralfy Posted November 25, 2013 Posted November 25, 2013 (edited) I strongly disagree. The U.S.A. and the U.S.S.R. agreed to curtail the production of nuclear arms and reduce their stockpiles, http://en.wikipedia.org/wiki/SALT_II#SALT_II . But the number of nuclear powerss grew, and the threat of nuclear war today may be as great as it was during the Cold War. Add to that proliferation of more advanced weapons, predicaments mentioned earlier, and more. Hence, "Nuclear Attack a Ticking Time Bomb, Experts Warn" http://www.cbsnews.com/news/nuclear-attack-a-ticking-time-bomb-experts-warn/ Don't forget to look at militarization in general worldwide. My example is way too vague. I meant something else. Feel free to explain what you meant. There are many things that many people want and don't want. But we can all agree on two things that we want at least for ourselves; the two things are health and life. I am not referring to what people want. I am referring to the manner by which nations have been behaving the last six decades or so, and that puts to question the claim that they will suddenly decrease military budgets and cooperate with each other. Edited November 25, 2013 by ralfy
Science Student Posted November 25, 2013 Author Posted November 25, 2013 But the number of nuclear powerss grew, and the threat of nuclear war today may be as great as it was during the Cold War. Add to that proliferation of more advanced weapons, predicaments mentioned earlier, and more. Hence, "Nuclear Attack a Ticking Time Bomb, Experts Warn" http://www.cbsnews.com/news/nuclear-attack-a-ticking-time-bomb-experts-warn/ Don't forget to look at militarization in general worldwide. My point was that there has been a collaboration that involved nations agreeing to weaken military capabilities. Feel free to explain what you meant. No, it was too stupid for words. I am not referring to what people want. I am referring to the manner by which nations have been behaving the last six decades or so, and that puts to question the claim that they will suddenly decrease military budgets and cooperate with each other. My post was responding to iNow's post.
ralfy Posted November 26, 2013 Posted November 26, 2013 My point was that there has been a collaboration that involved nations agreeing to weaken military capabilities. That was between only two countries (not many nations) and focused on nuclear weapons (not "military capabilities" as a whole). Even then, both countries continued to use military forces to engage in proxy wars. Today, we see the same plus more nuclear powers. My post was responding to iNow's post. My argument is based on what iNow said, that countries operate based on their own interest.
iNow Posted November 26, 2013 Posted November 26, 2013 My argument is based on what iNow said, that countries operate based on their own interest.Just to clarify, what I said is that sometimes they cannot even be counted on to do that.
Science Student Posted November 26, 2013 Author Posted November 26, 2013 That was between only two countries (not many nations) and focused on nuclear weapons (not "military capabilities" as a whole). Even then, both countries continued to use military forces to engage in proxy wars. Today, we see the same plus more nuclear powers. You are arguing about things that I didn't even say, such as "many nations". And then you added "as a whole" when I was not referring to military capabilities as a whole. So I am going to stop this conversation with you.
ralfy Posted November 27, 2013 Posted November 27, 2013 You are arguing about things that I didn't even say, such as "many nations". And then you added "as a whole" when I was not referring to military capabilities as a whole. So I am going to stop this conversation with you. From what you wrote previously: That doesn't make any sense to me. This is a gain for China and every other country. Ideally, nothing changes militarily if every country makes fair cuts; they will only gain by advancing medicine for human beings. Note "every country." Just to clarify, what I said is that sometimes they cannot even be counted on to do that. I think it's the default, i.e., realpolitik. The same should apply to acting in favor of everyone, from which the government and Big Business always get something in return.
Science Student Posted November 27, 2013 Author Posted November 27, 2013 From what you wrote previously: Note "every country." It was just an example to show that my idea might be possible.
ralfy Posted November 28, 2013 Posted November 28, 2013 It was just an example to show that my idea might be possible. That's not a problem, but I would look at what has been taking place during the last few decades and see if there is any trend towards de-militarization. From what I've read, it has been the opposite.
iNow Posted November 28, 2013 Posted November 28, 2013 Ralfy - The past is not always the best predictor of the future.
Science Student Posted November 29, 2013 Author Posted November 29, 2013 That's not a problem, but I would look at what has been taking place during the last few decades and see if there is any trend towards de-militarization. From what I've read, it has been the opposite. I am mostly interested in what may be the result if my idea in the OP actually happened.
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