Deporting Disabled Children?

[bernie14]

Well, partially. Anybody who pulls 'eugenics' from that should probably get snipped.

People acting on uterine diagnostics is part of the solution space however. I don't bemoan the damage done to the spina bifida community caused by folic acid pills. Nor the reduction of PKU complications due to simple testing and dietary changes.

Once a medical condition has a viable intervention, medical demand stops being infinite

So, as in trisomy 21, would it be easier (cheaper) to design a fetal genetic test to identify a few genes that significantly increase the risk of schizophrenia or treat that person later on in life?

 

[El_Machinae]

There is no amount of Disney+ bingeing or tipping your Starbucks barrista that can invent viable interventions for schizophrenia. Treating every single person with schizophrenia is unaffordable, especially given how few DALYs are purchased with that effort.

The only long run solution is the creation of a viable alternative.

This has nothing to do with eugenics. Or at least, the base message doesn't. Medical demand is infinite until it isn't, because there's an s-curve.

 

[bernie14]

So fetal testing, yes?

 

[TheMeInTeam]

What possible ethics are there in a system of distributing finite resources?

optimizing usage of resources to fit whatever utility you most consider "ethical". if you don't optimize for that, it implies choices being made that result in worse outcomes, per your ethical framework. aka, some choices under a "finite resources" constraint (aka literally everywhere humans live) are necessarily more ethical than others, for any coherent framework of ethics.

not only are ethics possible under finite resources, they are necessarily present/mandatory if you have any sort of preference for outcomes whatsoever.

nz is at the forefront of economic development, and is really wealthy. practically, you can afford this.

if your hospitals are strained, it's not because of some disabled migrants

it's kind of funny how the logic of the first sentence leads to the outcome in the second sentence. i wonder how many people noticed.

countries can afford most things, taken in isolation. countries cannot afford all things, "practically" or otherwise.

 

[Senethro]

it's kind of funny how the logic of the first sentence leads to the outcome in the second sentence. i wonder how many people noticed.

countries can afford most things, taken in isolation. countries cannot afford all things, "practically" or otherwise.

Just a whole bunch of unsupported claims. Look at them all!

 

[TheMeInTeam]

Just a whole bunch of unsupported claims. Look at them all!

yeah, imagine things that cost money can be prohibitive because they cost money1 what an outlandish claim1

 

[bernie14]

There is no amount of Disney+ bingeing or tipping your Starbucks barrista that can invent viable interventions for schizophrenia. Treating every single person with schizophrenia is unaffordable, especially given how few DALYs are purchased with that effort.

The only long run solution is the creation of a viable alternative.

This has nothing to do with eugenics. Or at least, the base message doesn't. Medical demand is infinite until it isn't, because there's an s-curve.

Wow, what a dodge!

 

[innonimatu]

nz is at the forefront of economic development, and is really wealthy. practically, you can afford this.

if your hospitals are strained, it's not because of some disabled migrants

NZ is very much not at the forefront of economic development. It has a good standard of living, or had until recent years, I think that is a different thing.

It was a backwater of the British Empire, did manage to modernize and urbanize in recent decades but it's not some high-tech exporter country, not does it have any particularly valuable raw resource in massive quantities. It arguably improved standards of living and could sustain its current acount in trading with th rest of the world because it had a low population to natural resources ratio. Allowing in many immigrants looks great in therms of " growing GDP" (more people means more money in circulation) but seriously screws up the quality of living in the country by undermine that very advantage of low population to resources.

 

[Zardnaar]

NZ is very much not at the forefront of economic development. It has a good standard of living, or had until recent years, I think that is a different thing.

It was a backwater of the British Empire, did manage to modernize and urbanize in recent decades but it's not some high-tech exporter country, not does it have any particularly valuable raw resource in massive quantities. It arguably improved standards of living and could sustain its current acount in trading with th rest of the world because it had a low population to natural resources ratio. Allowing in many immigrants looks great in therms of " growing GDP" (more people means more money in circulation) but seriously screws up the quality of living in the country by undermine that very advantage of low population to resources.

Pretty much what happened. Highest per Capita growth rate in OECD now all sorts of skill shortages, housing prices going bonkers then popping.

Really screwed over the younger crowd aka anyone who couldn't buy property 7-10+ years ago.

For an agricultural economy we're doing comparatively great but geographic isolation and small population means expensive imports and disadvantages on exports compared with EU for example.

California cost of living, Alabama wages.

NZ products often cheaper in UK than here. If we were in Europe probably comparable to your country or something like Czech republic.

 

[Perfection]

Once again, the actual solution is viable diagnostics and therapeutics. R&D. Medical technology is heavily an information technology, and therefore can go through an s-curve and eventual deflation. Obviously, we cannot afford infinite medical demand. But medical demand does not infinite.

Once a solution to a medical problem is invented, it's available to undergo innovation until it's affordable. Everything before that is stop gap.

In the long run of future history, solving the problems will create more human well-being than rearranging the deck chairs.

I disagree with this notion. Technology can definitely improve patient outcomes but the biggest cost driver in medical services is the need for medical professionals. And I don't see technology doing away with that need anytime soon. Sure there can be some improvements and efficiency but this isn't something that's going to see the dramatic cost reductions you so desire. And the fact that more and better services can be offered has and will likely to continue to increase the share of cost that medical care has on public coffers.

Don't get me wrong, I'm all for these technologies and believe they are strongly worth public investment. They can have profound positive effects on millions. But we cannot pretend that technology alone will provide access to all those who need it.

 

[Valka D'Ur]

I disagree with this notion. Technology can definitely improve patient outcomes but the biggest cost driver in medical services is the need for medical professionals. And I don't see technology doing away with that need anytime soon. Sure there can be some improvements and efficiency but this isn't something that's going to see the dramatic cost reductions you so desire. And the fact that more and better services can be offered has and will likely to continue to increase the share of cost that medical care has on public coffers.

Don't get me wrong, I'm all for these technologies and believe they are strongly worth public investment. They can have profound positive effects on millions. But we cannot pretend that technology alone will provide access to all those who need it.

Exactly. You can have the world's most advanced ambulance, but what good is it if the province has either laid off or driven away (no pun intended) the personnel to drive and staff it? And that's not even getting to the problem of there being no room at the hospital.

 

[Zardnaar]

Exactly. You can have the world's most advanced ambulance, but what good is it if the province has either laid off or driven away (no pun intended) the personnel to drive and staff it? And that's not even getting to the problem of there being no room at the hospital.

So you've visited NZ lately?

 

[Senethro]

yeah, imagine things that cost money can be prohibitive because they cost money1 what an outlandish claim1

That things cost money is not outlandish, but that they are prohibitive is always implied with poor support by the soft eugenics crowd.
(That is, those who are functionally making the same choices as eugenicists. Those who would fire you from your position as a living being due to a downturn in the economy.)

 

[Valka D'Ur]

So you've visited NZ lately?

I don't have to; that's how it is here, in my city.

People are dying for lack of timely ambulances, or just ambulances, period. People who do get one are likely to be sent to either Edmonton or Calgary (90 minutes north or south, respectively).

 

[Zardnaar]

I don't have to; that's how it is here, in my city.

People are dying for lack of timely ambulances, or just ambulances, period. People who do get one are likely to be sent to either Edmonton or Calgary (90 minutes north or south, respectively).

I've heard stories here about driver shortages. It's not to bad locally but those horror stories from elsewhere are cropping up here.

 

[Farm Boy]

California cost of living, Alabama wages.

NZ products often cheaper in UK than here.

Welcome to agricultural economies. Food deserts all in the "bad parts" of big cities, and also where you grow the food, where the badpolitics people live. Because that's just how economies naturally work or something. Def def definitely not political.

 

[El_Machinae]

I disagree with this notion. Technology can definitely improve patient outcomes but the biggest cost driver in medical services is the need for medical professionals. And I don't see technology doing away with that need anytime soon. Sure there can be some improvements and efficiency but this isn't something that's going to see the dramatic cost reductions you so desire. And the fact that more and better services can be offered has and will likely to continue to increase the share of cost that medical care has on public coffers.

Don't get me wrong, I'm all for these technologies and believe they are strongly worth public investment. They can have profound positive effects on millions. But we cannot pretend that technology alone will provide access to all those who need it.

The only long run solution is a solution. Everything before that will require rationing. And eventually the rationing will result in requiring people's unwilling labor, so there's also a practical ceiling.

It has been a while since I've run the graphs, but Medical Services tended to compound in costs at about 8% annually. Anybody can calculate for their own region pretty easily, especially if they use the rule of 72. Obviously, there's an actual ceiling that we're willing to spend, but even the United States hasn't discovered it at 18% of GDP.

But the demand isn't actually infinite. Medicine is a series of individual technologies, each capable of going through an s-curve. And every innovation that leads to a price drop allows a reapportioning of the budget. Until a problem is solved, it's all deck chairs

Wow, what a dodge!

Not really. You're trying to have a different conversation. If, after my direct feedback, you cannot go back and reread my post without thinking I'm talking about eugenics, then I don't know what to say other than you're wrong. Not all whistles are dog whistles.

 

[bernie14]

The only long run solution is a solution. Everything before that will require rationing. And eventually the rationing will result in requiring people's unwilling labor, so there's also a practical ceiling.

It has been a while since I've run the graphs, but Medical Services tended to compound in costs at about 8% annually. Anybody can calculate for their own region pretty easily, especially if they use the rule of 72. Obviously, there's an actual ceiling that we're willing to spend, but even the United States hasn't discovered it at 18% of GDP.

But the demand isn't actually infinite. Medicine is a series of individual technologies, each capable of going through an s-curve. And every innovation that leads to a price drop allows a reapportioning of the budget. Until a problem is solved, it's all deck chairs



Not really. You're trying to have a different conversation. If, after my direct feedback, you cannot go back and reread my post without thinking I'm talking about eugenics, then I don't know what to say other than you're wrong. Not all whistles are dog whistles.

I didn't address the entirely of your "message" to try to keep on topic. My gist of your original post is "best bang for your buck", no?

 

[El_Machinae]

No, it's not really about 'best bang for your buck'. It's 'the problem is expensive until a viable solution is created'.

We don't have a raging debate about Universal Iron Lung coverage because we have a $25 vaccine available for polio. Diabetes was killing people until insulin was made mass-producable. And the more conditions you can put onto the 'easily solved' pile, the more resources are available to help those with the unsolved conditions. It's R&D that makes the future.

 

[bernie14]

Yep, and right now, the  easily solved conditions are going to be solved by gene therapy.