I had a chance to trade some tweets with Scott Adams. I love Scott’s Periscopes but I think he has a naive view of healthcare. Here’s his latest Periscope where Scott Adams solves the healthcare problem.

My original tweet to Scott was  confuses curing sick people with insurance. Need to solve insuring the uninsurable and low income who won’t buy unless free

to which he replied:

Ryan here probably does the best job of summarizing Scott’s contention that if technology was totally unleashed on healthcare, it could be completely solved and everyone would have all the healthcare they needed at such a low cost it would be “cheap enough for everyone (99%) to afford it.”

The problem is that in the real world, what we’ve witnessed are huge increases in healthcare costs in no small part due to technology! That’s not to say that I’m not a huge fan of technology development but this stuff doesn’t come without costs that need to be recovered. I think it’s a wonderful thing to imagine where health cost is just a commodity but we’re certainly not going to see that in my lifetime!

The point I was trying to make with Scott was that even as technology reduces costs, there will be new and even more wonderful technologies being developed. All those wonderful new machines are expensive and if you want access to them, you better be rich or have insurance. Maybe someday things will be different but not in any future I can foresee.

Scott Adams had a condition called spasmodic dysphonia which limited his ability to speak for which he had an operation. I’m going to bet this cost him a pretty penny and being wealthy it wasn’t an issue to pay whatever he had to pay out of pocket. The rest of us need to hope and pray that we never get anything like this and if we do, we have insurance to cover it! No amount of “reducing healthcare costs through technology” would have prevented Scott’s condition nor would it have (necessarily) reduced the cost of the surgery.

In my case it was DVT or Deep Vein Thrombosis commonly called blood clots in the legs. It’s life threatening and I incurred a $250K hospital bill. However, being a good citizen, I had heath insurance. Doctors really don’t understand why DVT occurs although they know situations where it is more likely such as long plane rides. That wasn’t the case in my instance and so nothing I could have done would have prevented the condition. Fortunately, there was new technology available to save my life and fortunately I had insurance so no one needed to decide whether I should get the best care possible.

I’m actually a bit surprised by Scott here. It’s usually people who never had a serious health issue who think that insurance is for paying for the sniffles and getting their teeth cleaned and are mad that they have to pay a deductible. There’s lots of ways to reduce costs in these areas but once you’ve had something major, it’s then you realize I could go bankrupt and lose everything I’ve built over the years if I don’t have some type of insurance. Or be wealthy as in Scott’s case.

In today’s world, Obamacare tried to solve two problems and bungled them both while totally destroying the individual insurance market.

  1. There are people who have chronic or catastrophic health issues who don’t have insurance because they are unemployable, lost their job with a company who provided insurance, were dropped by their insurance company, or never had insurance.
  2. No matter how inexpensive insurance for catastrophic health insurance becomes, the poor still won’t buy it because they’d rather have food than pay for something that might never happen. And if it does, they know they can go to the emergency room.

As we continue to struggle through Repeal and Replace, I’m still looking for clarity on how or whether we as a country wish to address these two issues.

Saying “we’ll just use technology” is naive.






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