With regard to medical costs, you neglect to include the influence of the FDA, which is essentially controlled by the pharma industry. There have been improvements in medicine, but many so-called improvements are nothing of the sort. I will give one example. Blood pressure medicines in use 50 years ago were quite effective and had minimal side effects, but they went off-patent and quit generating significant revenues, so new ones were developed. The FDA required that they test the new medications against a placebo, to prove that they were better than doing nothing, but carefully did NOT require that they be tested against the previous standard of care, against which they would almost certainly have fallen short. But the new medications solved a huge problem for the pharma companies because they were under patent and thus MUCH more expensive, and padded their bottom line nicely. Multiply this by thousands of other medicines, some of which may be real improvements, but when only tested against placebos, how can we know?
In any case, I realized decades ago that the pharma companies don't want to cure anyone. They want medicines that they hold the patent on that treat the SYMPTOMS of chronic conditions, such that a patient becomes a lifetime client. If such medications also have side effects that require other prescriptions, so much the better. It is in their best interest to keep people sick but alive, and the FDA totally supports them in this racket.
The vast majority of people on blood pressure medicine take generic statins that cost almost nothing per script. Only a small minority takes brand statins, though this used to be a bit more common before atorvastatin went off patent.
Most of the people taking brand drugs when there is a rough generic equivalent are low income. The state pays nearly all the cost for drugs (you can get a $100,000 brand for $10 on Medicare if your LIS) so people take it because why not.
Pharma cured Hepatitis Part C but when you sell a cure it needs to have a super high sticker price because its a one off and then people complain about the big scary number.
Statins treat high blood cholesterol; blood pressure medicines are diuretics, calcium channel blockers or ACE inhibitors. It’s always possible for a patient to use an old cheaper drug, doctors prescribe the newer ones for various reasons, some not in the patient (or insurers) economic interest.
Look at the explosion of chronic illness, mental illness, and excess deaths - this is the result of better quality healthcare? The idea that Big Pharma is making healthcare great again is ludicrous.
"Despite the veneer of technical sophistication, they casually smuggle in the assumption that better health care is the prime or sole cause of better health, despite strong experimental evidence to the contrary."
Is the assumption really that health care is the prime cause of better health or that consumers believe that health care is prime cause of better health? I suspect that it is the latter. If you ask more people if access to more health care, more up to date technology in health care, or access to new drugs results in better health, I suspect that the overwhelming majority will say yes (comparable to the fraction of people who say the earth is round).
Back in hte ACA debates, there were charts circulating comparing the cost of health care, higher ed, and other service intensive industries and then compared these to inflation and things like housing and food. As I recall, the cost of veterinary care rose much more sharply than health care and was comparable to higher education (as measured by tuition and fees). As far as I know, the federal subsidies for veterinary care is near 0. This strikes me as a useful control and indicates that the story that higher-ed has exploded in cost because of federal subsidies is missing something important.
STEM majors (can) have plenty of free time too. I studied physics at a selective school (albeit a couple decades ago), but my physics classmates and I had roughly the same amount of free time as most of our classmates.
Higher iq and less ChatGPT-esque work. More specifically, higher iq due to self selection rather than weeding out. Math/physics usually has less weeding out compared to engineering.
Ha , I appreciate the incredulity, but it wasn’t *that* hard. It helps that I really liked physics and was good (enough) at it that it wasn’t that much work to keep up on. That said, I wasn’t gunning for medical school or a top PhD program or anything, so I was cool with Bs and the occasional C.
With regard to medical costs, you neglect to include the influence of the FDA, which is essentially controlled by the pharma industry. There have been improvements in medicine, but many so-called improvements are nothing of the sort. I will give one example. Blood pressure medicines in use 50 years ago were quite effective and had minimal side effects, but they went off-patent and quit generating significant revenues, so new ones were developed. The FDA required that they test the new medications against a placebo, to prove that they were better than doing nothing, but carefully did NOT require that they be tested against the previous standard of care, against which they would almost certainly have fallen short. But the new medications solved a huge problem for the pharma companies because they were under patent and thus MUCH more expensive, and padded their bottom line nicely. Multiply this by thousands of other medicines, some of which may be real improvements, but when only tested against placebos, how can we know?
In any case, I realized decades ago that the pharma companies don't want to cure anyone. They want medicines that they hold the patent on that treat the SYMPTOMS of chronic conditions, such that a patient becomes a lifetime client. If such medications also have side effects that require other prescriptions, so much the better. It is in their best interest to keep people sick but alive, and the FDA totally supports them in this racket.
The vast majority of people on blood pressure medicine take generic statins that cost almost nothing per script. Only a small minority takes brand statins, though this used to be a bit more common before atorvastatin went off patent.
Most of the people taking brand drugs when there is a rough generic equivalent are low income. The state pays nearly all the cost for drugs (you can get a $100,000 brand for $10 on Medicare if your LIS) so people take it because why not.
Pharma cured Hepatitis Part C but when you sell a cure it needs to have a super high sticker price because its a one off and then people complain about the big scary number.
Statins treat high blood cholesterol; blood pressure medicines are diuretics, calcium channel blockers or ACE inhibitors. It’s always possible for a patient to use an old cheaper drug, doctors prescribe the newer ones for various reasons, some not in the patient (or insurers) economic interest.
Look at the explosion of chronic illness, mental illness, and excess deaths - this is the result of better quality healthcare? The idea that Big Pharma is making healthcare great again is ludicrous.
"Despite the veneer of technical sophistication, they casually smuggle in the assumption that better health care is the prime or sole cause of better health, despite strong experimental evidence to the contrary."
Is the assumption really that health care is the prime cause of better health or that consumers believe that health care is prime cause of better health? I suspect that it is the latter. If you ask more people if access to more health care, more up to date technology in health care, or access to new drugs results in better health, I suspect that the overwhelming majority will say yes (comparable to the fraction of people who say the earth is round).
Back in hte ACA debates, there were charts circulating comparing the cost of health care, higher ed, and other service intensive industries and then compared these to inflation and things like housing and food. As I recall, the cost of veterinary care rose much more sharply than health care and was comparable to higher education (as measured by tuition and fees). As far as I know, the federal subsidies for veterinary care is near 0. This strikes me as a useful control and indicates that the story that higher-ed has exploded in cost because of federal subsidies is missing something important.
STEM majors (can) have plenty of free time too. I studied physics at a selective school (albeit a couple decades ago), but my physics classmates and I had roughly the same amount of free time as most of our classmates.
How???
Higher iq and less ChatGPT-esque work. More specifically, higher iq due to self selection rather than weeding out. Math/physics usually has less weeding out compared to engineering.
Ha , I appreciate the incredulity, but it wasn’t *that* hard. It helps that I really liked physics and was good (enough) at it that it wasn’t that much work to keep up on. That said, I wasn’t gunning for medical school or a top PhD program or anything, so I was cool with Bs and the occasional C.