I think the way uber is revolutionising taxi services is a really good model and a really good story for how health care and health insurance might also be revolutionized for years and years a taxi service has been awful just think of trying to hail a cab at five o'clock on a rainy afternoon now why well the supply was really badly restricted taxis were extensively regulated cities don't allow more than a certain number of taxis and there's a the idea was that the regulation was there to protect the consumer and over came along and undermined that whole business from the outside with both the technological innovation and a business innovation and now what do you get you get all of a sudden much better quality much cleaner cars much nicer drivers and prices going down like crazy you know if there's the standard story that hospitals won't post prices they won't tell you how much things will cost that is a prime sign of a business that doesn't have anywhere near enough competition I know no airline would dream of trying to say well just show up at the airport and then we'll tell you after the fact how much you're going to pay right the big thing that gives us quality improvements cost control all the great stuff we see in other industries is supply there's just this huge spider web of regulations in the way of competition not just federal state and local or as much of the problem in our own state of Illinois if there's still a certificate of need law so you want to open up a new hospital or a clinic or even expand or buy a piece of machinery you got to go down to the State Board of Equalization and get a certificate of need and your competitors can show up and all they have to say is this will hurt my profits and they can stop you from doing it I mean imagine United Airlines joy if they could get the federal government to stop anybody from flying in and out of O'Hare if they would endanger United Airlines profits that's the way it used to be back when air fares were really expensive another lesson of uber is is people tried to undermine the taxi monopoly for years and years and the taxi companies were very good at getting the city regulators to enforce their monopolies uber came in all at once and quickly got through technology a base of people who really love their service and that became then politically difficult for cities to put the genie back in the bottle because now there's a whole bunch of people who have sampled what the world can be like in a competitive market we don't have to just hope for free market economists like me to rant and rave about deregulation and hope it comes from the top I think there's a there's good hope that the same kind of technical innovation will undermine the the forces strangling supply of healthcare there's all sorts of new apps that can can diagnose your diseases and take your blood tests you know send you radiology to China that sort of thing otherwise we have to sit around and wait for our regulators to decide to deregulate which could be an awful long wait but as in uber the disruptive forces can work around the existing regulations and undermine them you

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Methew Wade

8 thoughts on “We need an Uber for health care”

  1. My understanding is that Uber drivers don't profit and in some cases operate at a loss. Can you address this concern? If it's true, how might an Uber-like model of health care be different and not self-destructive to doctors?

  2. I like the concept, but one of the problems we know is that the more a hospital does a specific surgery the fewer the complications and the better the outcome for the patient. Thus more hospitals doing fewer procedures equals worse outcomes.

  3. NIce to see my ex-Prof on this – I just found his blog via Capital Ideas.  I had been mentioning about an Uber for health care and my colleague/friend is doing a mobile app that I christened it to the same moniker prior to seeing this post. Curely.co (app is Curely)

  4. I tried finding a doctor that would take me on as a patient and I only went to 3 doctors in my area and they all said that they were not taking on anymore patients.  I was sick at the time and clearly sick and no one would see me.  The office people had no compassion.  I finally went to Walmart and saw the nurse there and got the round of antibiotics that I needed at the time for my sinus infection.  So I did that several times for my annual sinus infection, went to the Walmart nurse to get antibiotics, then one day, the nurse wouldn't give me any antibiotics.  The overweight nurse Nazi told me that I only had a cold and would have to wait it out and drink lots of fluids.  WTF, is there a test for that, to determine whether it's a cold or a sinus infection.  I didn't even get my money back for the visit.  Desperate, I went online and discovered that unless it's a controlled substance, you can purchase uncontrolled drugs online legally.  I purchased 4 rounds of antibiotics online for the price of one nurse's visit at Walmart.  It was peace of mind to know that if I got sick, I'd have what I needed on hand.  Now I practice more and more alternative medicine and changing my diet so that I don't get sick once a year.  I've gone from taking 4 prescription medications a day in 2007 to not getting sick at all in 2014.

  5. You sound like you've had a medical emergency or even know someone who has. No, you don't have time to calmly look around for the cheapest options. I'll let you die if you don't pay me a million dollars. Yeah you have "freedom" to go ahead and die, but it's hardly the world most people want to live in.  By the very nature of the business it can never be properly  controlled by market forces.

  6. There actually is currently an Uber for medicine: its called Concierge Medicine, and it works as long as you are: 1) basically healthy and 2) wealthy. There is a fundamental fallacy in the application of the rational actor model and associated cost-benefit analysis to patient utilization of medical resources; even modifications incorporating assumptions of bounded rationality that approach realistic decision making undermine the entire analytical structure. Not only are people generally incapable of categorizing health risk in the future arising from decisions now, but the financial structure (with third party payers) decouples the patient/consumer from the real cost of the service. The idea that market forces can bring about either: 1) cost containment or 2) quality control has a ready counter-example that currently exists: cosmetic surgery. Here there is the classical supply/demand relationship between the consumer and service provider (since no third party payers), the price of cosmetic surgery is substantially higher that its "real" costs by any metric you would like to use (i.e. facilities, supplies, expertise/training of personnel), and the incidence of misadventures is certainly no better for equivalently complex medically indicated procedures. 

    This video is, unfortunately, too typical of the uninformed, superficial analysis that percolates through current discussions about economics of healthcare.

  7. When Uber become too much for governments to handle it will become regulated also.  Can our markets please dictate supply and demand?!?!

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