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Comment by moistoreos | Hacker News Reader

You could literally eliminate homelessness, world hunger, and fully pay health care costs in that same timeframe with much less cash.

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Homelessness and world hunger are not bottlenecked by money. There's a stronger case for healthcare, but that's also substantially a political issue.

There's a stronger case for world hunger being bottlenecked than healthcare. World hunger is a logistics problem now, but no amount of money lets you print doctors.

Actually funding education via wealth distribution is a great way of ”printing doctors”.

I don't know what wealth distribution means in this context, or why it's relevant at all, but food grows fast and doctors take like 20 years to grow no matter how much money you throw at it or where you get the money. And the context above was more specifically "fully pay health care costs" which is a comical fantasy the moment you try to actually define what that means, because the limit is not the price.

simply, we have a scarcity of healthcare because we don’t invest the wealth we collectively produce in healthcare.

Or most people, really. We are letting it accrete around more of itself and don't clean up and redistribute.

Changing the entire paradigm of medical care would be possible with enough money. There's no logical reason it takes 20 years to become a doctor. The fact that it does severely hampers both the quantity and quality of doctors. Becoming a doctor is much less about knowledge and intelligence than it is about attrition resistance. Loads of capable students disregard medical careers each year for more rapidly attainable positions. In many cases these are the MOST capable students because they recognize the problems with pursuing medical degrees.

Certainly the most skilled and advanced in the medical field will need significant schooling but there needs to be a major reform in healthcare training. One that produces more knowledgeable and skilled professionals and not a glut of questionably competent nurse practitioners.

With a little bit of lag time (school) we could have a metric fuckton of doctors. We have a metric fuckton of shitty lawyers. Doctors are artificially gated in the US

What’s the joke? “What do you call the person who graduated last in their class from med school? A doctor.”

Sure, I think that helps my point. You can't create "good" doctors out of thin air with money, just "more" doctors, and it takes forever.

Do we really need "good" doctors all of the time? I think the industry is overregulated to restrict the supply of healthcare.

When a simple easy to make mistake will kill me, I'm pretty sure I want to have a good doctor all the time.

Isn't that gap being filled nowadays with roles like nurse practitioners?

The optimal amount of bad doctors is not zero. But there is a point of "ChatGPT does a better job than this man does, and we're talking GPT-4o, not GPT-5 Pro". In which case we have a problem.

It’s funny how some people think shitty lawyers are good and some people think good lawyers are shitty, huh?

You can't just throw money at the world hunger problem, it will end up in some warlord's coffers. Hunger still exists because it is politically useful to keep people hungry.

A logistics problem is just a money problem, throw enough cash at it and you can get anything moved to anywhere

Fully pay health care costs for _who_ for four years with 1 trillion dollars?

Doesn't America alone already spend 2 or 3 trillion a year on healthcare?

> Doesn't America alone already spend 2 or 3 trillion a year on healthcare?

There's a huge difference between "paying for healthcare" and "paying a healthcare provider" here in the United States. Oftentimes the latter has 2 or 3 additional zeroes attached.

Sure, but Congress invariably pretend to say the former but mean the latter. You're asking for single-payer instead of privatized health insurance, they will sooner bankrupt the country than switch to sanity. Congress and its funding sources are now captured by privatized health insurance:

In 2023-4, Health came #7 in total political donations, #8 is Lawyers & Lobbyists; the combined "Finance/Insur/RealEst" is #1; would be useful to see "Insurance" broken out by health insurers vs non-health (can anyone cite a more granular breakdown?). [https://www.opensecrets.org/elections-overview/sectors]

It's not single payer vs privatized insurance. Why is this myth so persistent in US?? There are many different options for public healthcare, of which single payer is but one, and it's not even the most popular worldwide. Many European countries are not single payer, including e.g. Germany.

That would just be just reopening decades of debate in the US.

For whatever reasons, the consensus in the US after decades of talking comes down to single payer vs privatized insurance. Congress isn't going to implement single-payer, so the menu reduces to either we choose good or bad regulation of privatized insurance.

We don't have time for yet another decade of debate, since health insurance premiums (net, post-tax-credit) in the US are about to jump this November open enrollment by median 18% overall, or 114% for people on ACA due to the expiration of enhanced premium tax credits [0]. Expect that to feature prominently in the news cycle by Thanksgiving.

(Germany's multi-payer system (government + mandatory statutory contributory insurance + optional private insurance) would in theory be fine if US Congress was ever incentivized to implement such a thing. But it very clearly isn't, since the 1950s - look at the lobbying money trails. Let the good not be the enemy of the perfect. The ACA was the closest the US (briefly) came to mandatory statutory contributory insurance, but the federal mandate was abolished back in calendar 2019 by the "Tax Cuts and Jobs Act of 2017").

[0]: https://www.kff.org/affordable-care-act/aca-marketplace-prem...

Have you considered that those decades of debate haven't resulted in a public healthcare system precisely because single payer is what was pushed by the pro side, and many people in US (rightly or wrongly) have a problem with the notion of government telling them that they can't pay money for better healthcare?

America spends $5T on healthcare per year.

That is twice as much per capita as our "peer" nations (UK, France, Canada, Germany, etc) and we have poorer outcomes.

We have poorer outcomes because we’ve normalized obesity not because our healthcare is worse.

I have done a lot of research into this area. Obesity and other self inflicted health issues are definitely a factor, but not, by far, the whole picture.

Our cost per service is 2-4x or more, and the larger reliance on specialists creates significant complexity and even more costs. So, we do spend 2x, but we get 1/3 to 1/4 of "care" per dollar. In other words, we get less actual care. And the care is biased to fixing things as opposed to preventing things. And it is also biased to those who are wealthier.

Some of the cost drivers: - Administration is 25% of costs, far less in other countries. Insurance company profits and complex administration with confusing and overlapping methodologies that obfuscate costs and comparisons.

- Capital costs are 25% of costs, far less in other countries. Multiple, private, and overlapping hospitals demand more capital and private capital with its expected returns

- Doctor compensation is 2x to 4x more, nursers 2x. Specialists here get truly rich, not true in other countries.

So, quite a lot of the extra spend is not efficient, and goes to insurers, owners of hospitals, and doctors.

I also have personal experience. To get a simple ultrasound, you are talking about $450 for a primary care visit to get a referral for a $650 specialist to get a $1000 ultrasound ($800 scan plus $200 reading), to get a $650 follow-up visit with the specialist to discuss the results. That is almost $3,000 of actual out of pocket costs to me, with a good insurance plan ($2K per month for a couple), the "claimed" costs were significantly higher. MRI and CT are even higher. Similar for a broken ankle, which cost me over $4000 out of pocket.

I am, relatively speaking, well off compared to average, and was able to do this, but that hurt, and significantly disincentivizes me in the future.

Our health system is broken, and pumping more money into only makes it worse.

It's neither, your outcomes are poorer because access is not uniform. If you can afford it, US healthcare is the best in the world, but if you can't you basically don't get it (or at least, you don't get it until the problems are bad enough it's an emergency and you get saddled with life-crushing debt for the bare minimum to stabilise you from the ER)

If that's true, all you have to do is convince other people that it's true and they can just vote for someone to deploy that money. Don't need to wait for someone else to do it.

Cash is just paper. You can't eat paper.

You can't eat AI, either.

Yet another hidden benefit of a human workforce, that AI can't match.

It seems to me that you're suggesting cannablism, but maybe I'm reading you wrong?

It does seem like a rather modest proposal.

You mean like, at least we can eat the human workforce?

It’s more recyclable than old gpus and out of date models

Soylent Green is people!

Money Can Be Exchanged For Goods and Services

Time is money. the investment of time and resources spent on AI could be spent producing food or healing people.

Not that I think we should, but the "Cash is just paper" attitude makes no sense. If it's just paper, how is OpenAI training AI using just paper?

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