Musings Report #47 11-23-13 The Decentralization & Democratization of Healthcare
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The Decentralization and Democratization of Healthcare
Back in Musings Report 33 I posted a link to a 2-minute video, Advice from Elon Musk: How to Be a Giant Killer. Many find Mr. Musk too self-promotional for their taste, but regardless of one's opinion of him, he has certainly challenged the Status Quo in a number of industries that were presumed too capital-intensive and too heavily moated to ever be breached by smaller competitors, i.e. space travel and autos.
In Musk's view, industries that are stagnant and dependent on government subsidies are absolutely ripe for creatively destructive competition.
The ultimate example of such a system is U.S. healthcare, a.k.a. Sickcare/ObamaCare (and the Pentagon, but that's another Musings). It turns out a number of small companies are on the verge of disrupting enormous chunks of the bloated, corrupt, fraud-ridden, inefficient, perverse-incentives Sickcare system.
Correspondent Cheryl A. submitted a healthcare story with multiple long-term ramifications: The Breakthrough of Instant Diagnosis: A Stanford dropout is bidding to make tests more accurate, less painful—and at a fraction of the current price.
"The secret that hundreds of employees are now refining involves devices that automate and miniaturize more than 1,000 laboratory tests, from routine blood work to advanced genetic analyses. Theranos's processes are faster, cheaper and more accurate than the conventional methods and require only microscopic blood volumes, not vial after vial of the stuff. The experience will be revelatory to anyone familiar with current practices, which often seem like medicine by Bram Stoker.
It's the kind of modern, painless service that consumers rarely receive in U.S. health care, though Ms. Holmes makes the point the other way around: "We're here in Silicon Valley inside the consumer technology world . . . and what we think we're building is the first consumer health-care technology company. Patients are empowered by having better access to their own health information, and then by owning their own data."
Lew summarized the potentially revolutionary impact of crowdsourcing on the testing of new medications:
"The cost (of developing new drugs) is in the clinical trials. That process is nonsense, hugely expensive and complex, a big waste of money and it can't deliver safety for the larger population. The old way was to take a drug through animal tests, then test it on the people who had the most to gain, the least to lose -- those near death. If it worked there ...
The entire process could be replaced by an open database, or 'patientslikeme.com' That group did a test of a treatment far faster and cheaper than the FDA could do."
It's not too hard to stitch together the main ideas presented in these articles--faster, better, cheaper testing, patient ownership of test results and data, a legal overhaul of the system (or new decentralized alternatives that simply bypass the broken legal system), and crowdsourced testing and data-sharing.
It's also not too hard to imagine a system that delivers better results for far less than half the current costs--if only the Central State would stop subsidizing cartels and quasi-monopolies. But even if that continues (as it must, due to regulatory capture), new technologies and systems are arising that enable people to completely bypass the current Sickcare status quo. Eventually the status quo will collapse under its own bankrupt, sclerotic weight as creative destruction clears away the deadwood.
Summary of the Blog This Past Week
A week of themes I have often explored: stock market euphoria, overbuilding of commercial space, DeGrowth as a new model of Progress, Sickcare/ObamaCare and the ontological dangers of centralization of power.
Best Thing That Happened To Me This Week
Longtime correspondent Michael M. mailed me a CD of Yuja Wang's live performance early this year of two ferociously difficult and wide-ranging piano concertos, Rachmaninov's #3 and Prokofiev's #2. Though no expert on the piano repertoire (the blog and Musings have an extremely talented concert-level pianist among our readers--lucky me!), I have heard both Martha Argerich and Emanuel Ax perform with the SF Symphony and have an amateur's appreciation of the art, skill and emotional content of such performances. Thank you, Michael, for the thoughtful, inspiring gift.
Market Musings
The following scenario seems likely to me, though by no means guaranteed: seasonal euphoria plus the near-extinction of both volatility and Bears lofts the markets higher until Thanksgiving.
Renewed fiscal-cliff worries plus tepid holiday retail sales cause market to sag until the Fed meeting of Dec. 17, when the Fed issues its umpteenth reassurance that QE will last as long as necessary, i.e. forever. The market erupts in a Santa Claus Rally that extends as the fiscal-cliff can is kicked down the road for the umpteenth time.
But the happy story that Bull markets driven by QE last forever suddenly collapses due to an unforeseen "credit event" that makes participants realize the Fed is all-in and additional QE has hit the diminishing-returns wall.
Here's what few participants seem to ponder: volatility and thus risk appear to have been vanquished, while the fragility of the global credit bubble has increased dramatically beneath the surface. That disconnect is unlikely to last.
From Left Field
Blame Rich, Overeducated Elites as Our Society Frays (via Maoxian) "Of about 30 detailed indicators I developed for tracing these historical cycles (well-being, inequality, social cooperation and its inverse, polarization and conflict), almost all have been moving in the wrong direction in the last three decades. And because complex societies are much more fragile than we assume, there is a chance of a catastrophic failure of some kind." A must-read--not too long.
The Year the Monarch Didn’t Appear (via Joel M.) The precipitous loss of native vegetation across the United States has led to a dramatic decline of insect populations. Chemically green lawns are deserts for bees and butterflies, ditto Federally subsidized biofuel mono-crops (corn)
The 5 kinds of boredom (via John D.) Maybe add a sixth-- social media-induced zombie-boredom?
Software Is Reorganizing the World (via Lew G.) "We may begin to see cloud towns, then cloud cities, and ultimately cloud countries materialize out of thin air. People are meeting like minds in the cloud and traveling to meet each other offline, in the process building community — and tools for community — where none existed before." Wow--this is a must-read....
"The liberties of a people never were, nor ever will be, secure, when the transactions of their rulers may be concealed from them." Patrick Henry
Thanks for reading--
charles
