Hacker News Reader

Comment by astrange | Hacker News Reader

If you want better healthcare you don't need to invent anything new or "disrupt systems of oppression". Just pick another country where it's working and do what they do.

Largely, they have a lot more doctors, hospitals and MRI machines per capita than we do, and they pay their doctors less and require less education from them.

This is particularly safer in America because the #1 thing voters hate is anyone doing anything new. If you ever try doing anything new you'll immediately get voted out. That's what happened after the ACA passed.

View on HN

The United States is #2 in the OECD for MRI machines per capita [1], with double that of France and nearly four times as many as Canada. Of the 38 nations of the OECD, only Japan has more MRI machines per person.

[1]: https://www.statista.com/statistics/282401/density-of-magnet...

I was indeed thinking of Japan but didn't go look up any other countries.

There is additional nuance here. Not all of the MRI machines are the same.

The USA typically uses machines with higher magnetic field strength, which are more expensive but produce higher spatial resolution. These machines are based on large superconducting solenoid magnets.

In Japan, there are many MRI machines with lower magnetic field, which makes them much more affordable while still quite useful. Some of such machines even use ordinary permanent magnets, which have much lower upkeep costs compared to the large superconducting devices.

Unfortunately we have the AMA which won’t let us import or bulk train doctors to the point of depressing their salaries

> If you want better healthcare you don't need to invent anything new or "disrupt systems of oppression". Just pick another country where it's working and do what they do.

Sure. That's like telling me that if I want to win an Olympic gold medal, I should just do what Phelps does. It'll work, right?

Even those countries may only have metastable healthcare economics, and while it looks as if it works now it could fail in the future. In the short term.

> Largely, they have a lot more doctors, hospitals and MRI machines per capita than we do,

So you're saying that all we need to do is have more resources that we don't have more of?

The AMA artificially caps the number of doctors and hospitals we have to increase salaries and costs. So no it doesn't necessarily take more resources to do these things

They've backed off on that and I think support more residency slots for training doctors now, but it actually is a funding issue because Medicare pays for a lot of that.

We also have very high to impossible standards for training doctors, and our residency rotation program requires you to not sleep because it was designed by a literal coke addict.

Which is dumb because there’s plenty of money to pay the residents otherwise.

The AMA has reversed position from their 1990s lobby to limit residency slots (which got enacted under the Republican "Contract with America"). At this point, increasing funding for residency slots would be seen as increasing government spending and is politically unpalatable.

medical school admissions is such a zero sum pissing contest of schmoozing profs for research positions, building houses for free in africa, grinding academics far past the point where the knowledge is beneficial, sheer perseverence, and sometimes being the right skin colour. the US could 10x the number of residency spots (and therefore med school spots) without significantly diminishing the capability of the incoming class to be good doctors.

You can simply buy more MRI machines and open more hospitals, yes.

The US has "certificate of need" laws saying you can't open a hospital unless all the nearby competitors allow it first. We could just not do that.

> Sure. That's like telling me that if I want to win an Olympic gold medal, I should just do what Phelps does. It'll work, right?

America is the #1 country at a lot of things. Surely you're not going to let Australia, Japan, the Netherlands etc beat you on this.

>If you want better healthcare you don't need to invent anything new or "disrupt systems of oppression". Just pick another country where it's working and do what they do.

This is completely impossible. We're talking about America here: it's utterly impossible for America to look at other countries and just copy them. It doesn't matter how much sense it would make; if America has a choice between sticking with some brain-dead system (perhaps, a measurement system for instance), or adopting a very logical and sensible alternative that America didn't invent, America will stick with its own brain-dead system, and claim that the alternative somehow can't possibly work in America because America is "different" and "exceptional". The only way America will adopt something new and better is if it's invented in America.

I've seen enough of American politics to consider that copying a better system and lying your ass off that it's American made would work (tbh this would work for most modern democracies).

Just expand Medicaid.. simple.

I think someone could sneak in Medicare for children if they tried.

Reply on news.ycombinator.com