9/ Today, public health and epidemiology connect a healthcare "market" to a healthcare "innovation" sector via a set of prioritization choices that reflect profit-making potential rather than incidence rates. Again, just an observation, not a judgment.
-
Show this thread
-
10/ Ie, the health conditions that get prioritized are efficiently privatizable ones. Healthcare evolves by corporations deciding for instance that "diabetes" is a better market, and more worth privatizing, than some other condition which offers weaker margins.
1 reply 2 retweets 4 likesShow this thread -
11/ Goes without saying that the efficiently privatizable conditions may not be the ones that represent the greatest societal burden. Social and moral of course, but in the US, we mean primarily economic burden.
1 reply 1 retweet 4 likesShow this thread -
12/ Condition A that represents say a -1% drag on the GDP (ie fixing it would add 1% to growth) goes unaddressed because there is no way to privately make a sweet profit off it.
1 reply 0 retweets 3 likesShow this thread -
13/ While Condition B, that is a 10th place rounding error in GDP terms gets a huge amount of attention/resources because it has efficient private market development potential. Call these "charismatic diseases."
1 reply 0 retweets 6 likesShow this thread -
14/ A charismatic disease/condition is 3 things: a) Easy to market (strong "brands" in symptom terms) b) Easy to dramatize via relateable life narratives ("the American dream, but with diabetes") c) Most importantly: good for drive-by interventions instead of open-ended care
3 replies 2 retweets 14 likesShow this thread -
15/ Charismatic diseases are (Carsean) finite-game diseases where there is such a thing as a clear win condition (or escalation sequence thereof) marketable as a "cure narrative." This does not mean the condition is necessarily curable, just that there's an tree of things to try
1 reply 1 retweet 7 likesShow this thread -
16/ By contrast, infinite game diseases/conditions that require open-ended care relationships are a systemic blindspot. They are hard to privatize, and a system that only targets what is privatizable tends to just give up and let sufferers just live awful lives till they die
2 replies 2 retweets 6 likesShow this thread -
17/ Again, just an observation. Draw your own conclusions about whether tradeoffs made by other countries are better or worse. The point is, "the US has the best healthcare" is a very narrow claim: "best healthcare that a system based on privatizing diseases can deliver"
3 replies 1 retweet 4 likesShow this thread -
Replying to @vgr
Great thread. Irrelevant to your point but at least within pharmaceutical the “free loading” narrative doesn’t hold up to an examination of the facts in terms of $$ spent on pure R&D or origin of discoveries
1 reply 1 retweet 1 like
Yeah Pharma is just hard to attribute to national economies anyway, whether it is US, UK, German or Swiss HQ companies. In-patient care is probably a much stronger correlate of the structure of national system tradeoffs.
Loading seems to be taking a while.
Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.