I've had to use the CDC lab to figure out a drug-resistant Trichomonas infection. Lots of very skilled people at that facility and this is a bad one to lose; it was the only lab that did those sorts of tests. There's not enough money in it for commercial labs.
How is there not enough money in it? Do only poor people get these sorts of issues? Serious question, no shade on poor people.
The article mentions something about resistant strains; that's going to be low volume, so high upfront investments for a one time result. In theory, I'm not an expert.
But this is the problem with capitalism and health care, the providers just stop if there's not enough money in it for them.
> But this is the problem with capitalism and health care, the providers just stop if there's not enough money in it for them.
Is this supposed to be a flaw?
If the cost of a lab is $500/patient then the patient (or their insurance) pays the $500 and the lab exists. If the cost of the lab is $50,000,000/patient, the lab probably shouldn't be funded, because its cost/benefit ratio is very bad and the same money could have saved more lives by putting it somewhere else.
What would you do in the alternative? Have the government provide unlimited funding for things that cost more than they're worth?
Who determines "worth"? What's the RoE on the military or poetry, for example?
> But this is the problem with capitalism and health care, the providers just stop if there's not enough money in it for them.
That's precisely the question, isn't it? In the case of medical treatment, you decide. Do you want to run a test if it costs you $500? What if it's $50,000,000? Or, in practice, you decide ahead of time by choosing how much insurance to carry, and then it's the premiums on insurance that would cover $50M tests that probably isn't worth it to you.
You might then have concerns about people who can't afford a reasonable amount of insurance, but that's a question of whether the government should provide insurance subsidies to the poor, not a question of who decides how much is worth having. Do you even want someone other than yourself deciding the most that can be spent on saving your life?
> What's the RoE on the military or poetry, for example?
Defense and copyright are tragedy of the commons. Everybody wants there to be a military force to fend off invaders but the benefits redound to everyone, including people who don't pay. People have the incentive not to pay as long as someone else is covering the cost, but then since everyone has that incentive it would end up under-funded. As a result there is a law requiring everyone to pay.
The way things like that ought to work is that there should have to be a separate vote by the general public in order to increase the budget for that specific department. Then bloated budgets get voted down because the public can see when they're excessive.
Medical facilities aren't a tragedy of the commons. You pay for one if you need it and if there are enough people who need one to pay for it to exist, it does. If there aren't, by what reasoning should it? The people paying are the same people using it and they don't value it by as much as it costs.
> Medical facilities aren't a tragedy of the commons. You pay for one if you need it and if there are enough people who need one to pay for it to exist, it does. If there aren't, by what reasoning should it? The people paying are the same people using it and they don't value it by as much as it costs.
So if you have a very rare disease which might cost a lot more to treat because there's no economies of scale you are... Not worth it? Your life is unworthy because it's unprofitable to save you? Or your mom, dad, sibling, loved one?
You need to be very, very deep into pure inhumane financial thinking to even consider this as a good outcome for a society. Please die if it's too expensive to care for you, it's economical eugenics.
> So if you have a very rare disease which might cost a lot more to treat because there's no economies of scale you are... Not worth it? Your life is unworthy because it's unprofitable to save you? Or your mom, dad, sibling, loved one?
How could it possibly be otherwise?
Never mind $50M, suppose it would cost twenty trillion dollars to save you. The large majority of the entire US GDP. The majority of everyone in the whole country, ignoring all other problems and lives to dedicate all of their time to saving you. And if they did that, they could; but not otherwise.
Is that worth it? No, it can't be, because a million other people would die instead. There exist things that are possible but not reasonable and some of those things are in medicine.
> Never mind $50M, suppose it would cost twenty trillion dollars to save you. The large majority of the entire US GDP. The majority of everyone in the whole country, ignoring all other problems and lives to dedicate all of their time to saving you. And if they did that, they could; but not otherwise.
> Is that worth it? No, it can't be, because a million other people would die instead. There exist things that are possible but not reasonable and some of those things are in medicine.
We are talking about reality here, not some made-up fantasy to justify your outlook on it. I don't think I needed to preface my argument with that since I'd expect to discuss with rational and reasonable beings. Considering reality, where we live and touch grass, it's better that some rare diseases with high costs for treatment get subsidised by the whole pool of money society gathers for healthcare, within reasonable bounds of what the aforementioned system can bear.
I really thought I didn't need to guard myself against some bizarre outworldly conjecture with no basis in reality. You can toy with models and inflated situations to be pedantically argumentative but I'd much rather try for us to base this in more-or-less real situations. Paying for the US$ 5 million treatment of one kid with a very, very rare disease which is treatable can be afforded if a society is wealthy enough.
Or isn't the USA wealthy enough to care for its population?
You're acting as though there's only one kid. The case where the cost is very, very expensive is a demonstration that there must be some limit. You then have to answer the question of where the limit should be.
Meanwhile there are charities that can save a life for on the order of $3000-$5000. Spending millions of dollars on one person is saying that person's life is worth more than the thousand others who could have been saved with the same money.
People have a hard time understanding this because the consequences are indirect. You spend millions of dollars to save a kid, but you took it from a company that would have hired a hundred people. Three of those people really needed the money. One of them needed it to pay someone to get the mold out of their house, so instead that family of five ended up in the hospital and two of them died. Another would have used it to repair the brakes on their car and because they couldn't, they died in a car crash along with the person they hit. The third simply couldn't afford to make rent without a job and then froze to death in the street.
On top of this you have the other 97 people who wouldn't have died, but certainly didn't enjoy being unemployed.
Should we care about one person more than all of these others put together, or does it matter how much something costs because it's always a trade off against something else?