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Comment by ctdonath | Hacker News Reader

The key:

His department was able to obtain some older laparoscopic equipment inexpensively.

Thanks to high-cost health care systems elsewhere spending enormous sums on the latest & best equipment on a regular basis, older equipment capable of facilitating very good (albeit not best possible) results becomes inexpensive.

In all the sneering at the high cost of healthcare in some areas, the consequential benefits to others gets overlooked. If you want the very best, yes it will cost a lot; if you're willing to settle for good instead of best, you can leverage what those buying the best paid for. If you cut the high cost options, the good low cost options may very well become infeasible.

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Is your claim that the existence of excellent high-cost treatment options drive down the price of moderate good ones in the present, or that the moderate-cost good ones were at one point paid for by being the excellent high-cost ones? The two claims have very different policy implications.

Overall, though, we should be skeptical of device manufacturers' claims that dumping more money into expensive equipment leads to better health. Most money sloshing around in the healthcare system is wasted (see, for instance, the recent counterintuitive Medicaid study results: increased health care spending doesn't necessarily equate to improved outcomes). If we could spend 50% of the money for 80% of the results, that'd be an amazing improvement. And that money could be spent on other quality-of-life improvers, which very well might improve overall population health more than that last 20% coming from complicated medical treatments.

I think his claim is both those things. The R&D of the goods was paid for when they were originally sold as high-cost excellent equipment. Now, the existence of even better high-cost treatment options drives down the price of the older originally-high-cost equipment.

Is this the magical trickle-down healthcare plan? :-)

Sounds like the opposite of trickle-down. It's rich health care systems basically subsidizing equipment for poor ones.

How is this the key? All that thinking for years, mulling over the problem is off course rubbish and unimportant

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