Ep. 65: "Most Drugs Are Bad for You" - Robin Hanson & Sebastian Brunemeier Return, The Crisis of Health Outcomes, Sclerosis of Science and Special Jurisdictions as Solutions
Sep 14, 2023
auto_awesome
Sebastian Brunemeier and Robin Hanson discuss the disappointing outcomes of the healthcare market and the hidden motives behind it. They explore the misallocation of capital in the pharma-industrial complex and regulatory monopoly. The podcast also highlights the potential of special jurisdictions and medical tourism. They propose implementing groundbreaking ideas such as life insurance coupled with healthcare. The chapters cover topics like the limitations of medicine, misaligned incentives in healthcare, trust in doctors, starting a new insurance company, putting control in the hands of the patient, and advancements in society, healthcare, and longevity biotech.
Merging health and life insurance can create a system where insurance companies are incentivized to provide quality care.
Separating the roles of diagnosis and treatment empowers patients and promotes competition in the healthcare system.
Encouraging diversity and patient decision-making can lead to increased innovation and better outcomes in healthcare.
Deep dives
Merging Health and Life Insurance: A Solution for Incentivizing Quality Care
By merging health and life insurance, we can create a system where insurance companies have a renewed risk incentive to care for patients. The idea is that when bad things happen to patients, it also affects the financial well-being of the insurance companies. Life insurance, disability insurance, and pain insurance can all be bundled together to align the incentives of the insurance company with the health outcomes of the patient. This would allow the insurance company to make cost-benefit decisions when it comes to treatments, ensuring that the treatment choices are in the best interest of the patient. There are challenges such as regulatory obstacles and getting insurance companies to adopt this new approach, but by starting with a group of willing customers and advocating for change in the insurance industry, we can work towards a healthcare system where the incentives are aligned with providing quality care.
Separating Diagnosis and Treatment for Patient Empowerment
To empower patients and introduce competition in the healthcare system, there should be a separation between the roles of diagnosis and treatment. Currently, doctors who diagnose a problem also recommend treatment, making it difficult for patients to seek alternative options or second opinions. By separating these roles, patients can have a doctor diagnose their problem and then decide how to proceed with treatment, giving them more control and the ability to evaluate different options. This separation also allows for better competition in the healthcare market as patients have the freedom to choose their treatment based on their own preferences and research. By encouraging this separation and empowering patients, we can foster a system where patients have more say in their healthcare decisions and better access to a range of treatments.
The Problem of Concentration and the Need for Diverse Approaches in Medicine
The issue of concentration in medicine, where certain approaches and theories dominate while alternative hypotheses are suppressed, is a significant problem. This concentration can lead to stagnation in research and limited progress in finding effective treatments. One potential solution is to encourage diversity and openness in medical approaches, allowing for a wider range of therapies and ideas to be explored. Rather than relying solely on the FDA or insurance companies to dictate which treatments are approved or reimbursed, giving more power to patients and their families to decide which treatments they prefer can lead to increased innovation and better outcomes. By valuing individual decision-making and avoiding monopolistic control, we can promote a healthcare system that fosters a multitude of approaches and encourages a more patient-centric approach.
Overcoming Regulatory and Institutional Challenges for Innovative Healthcare Solutions
Implementing innovative healthcare solutions, such as merging health and life insurance or separating diagnosis and treatment, may face various regulatory and institutional obstacles. The existing regulations in the insurance industry and healthcare sector can inhibit the adoption of new approaches. Startups and new ventures face high barriers to entry due to capital requirements and licensing regulations. However, there are opportunities to explore other jurisdictions or special economic zones where new regulations can be established to support these innovative solutions. Working with existing insurance companies and advocating for change within the industry can also be a strategy to overcome these challenges. By seeking alternative solutions and promoting a more adaptable and patient-focused healthcare system, we can strive for better outcomes and advancements in the field.
Medical tourism and regulatory restrictions
One of the main ideas discussed in the podcast is the phenomenon of medical tourism and the restrictive regulations that limit certain treatments in the United States. The podcast highlights how people are traveling abroad to access alternative or non-orthodox medical approaches that are not yet approved in the US. Stem cell therapy, such as mesenchymal stem cell injections, is cited as an example. The podcast argues that prohibitive regulations and the lack of a certificatory approach in the US hinder medical innovation and prevent patients from accessing potentially effective treatments.
Issues with government-funded research and academia
Another key point discussed is the criticism of government-funded research and academia. The podcast mentions the work of Terence Keeley, who argues that government funding restricts progress and innovation through crowding out and the prevalence of dogma in academia. The podcast suggests that private-sector innovation, experimentation, and the startup society approach may be more effective in advancing various fields, including healthcare. The goal is to find solutions and encourage individuals to engage in experimentation and alternative ideas that can lead to tangible improvements and advancements in different areas of human activity.
Two of the most popular previous guests are back: Sebastian Brunemeier, the General Partner of Healthspan Capital and CEO of ImmuneAGE Pharma, and Robin Hanson, Professor of Economics at George Mason University and iconic thinker.
In this episode, we talk about the surprising science of health outcomes. Equipped with vast amounts of money and talent (18% of GDP), the healthcare market disappoints egregiously when it comes to making us living longer and healthy.
Robin explains why that is: it's hidden motives in human behavior. We defer rational decision-making to authorities with the incentive to overmedicate us.
Increased spending and more drugs make us worse.
Sebastian can confirm as a practicing scientist how the pharma-industrial complex and regulatory monopoly are drivers of a massive misallocation of capital.
However, we have now learned much about the potential of special jurisdictions, medical tourism, and regulatory flexibility.
Niklas and Sebastian have worked together over the past year to implement some groundbreaking ideas in practice: life insurance coupled with healthcare, for example, is an idea that is waiting for the right jurisdiction to make it possible.
At the following events, we'll gather renegade life scientists, biotechnology engineers, and crypto hackers to build the healthcare system of the future: