Episode 315 Scott Adams: Why Healthcare Costs Could Fall by 75%. With Whiteboard

Date: 2018-11-24 | Duration: 13:36

Topics

Whiteboard discussion Categories of healthcare costs and how each could cost less

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> [!note] Rough Transcript
> 
> This is an auto-generated transcript and may contain errors.

## Transcript

[0:11]

hey everybody come on in here today is a special focused Periscope on the topic of healthcare cost I'm going to give it to you the way you've probably never had it uh that sounds a lot naughtier than I meant it to sound so once we reach thousand people we will share a sip of the tears of our enemies and we're going to talk about where I see the future of healthc care costs and I think it's good news or it could be join me now and drink the tears of our
enemies good tears all right one of the big challenges for even trying to understand healthc care and trying to figure out why everything is so expensive and where it's all going to go is how you categorize things and I've been trying for literally years to figure out what categories to look at to figure out where the big expenses are and whenever

[1:11]

where the big expenses are and whenever you see an article on this or somebody's got some statistics about healthare costs and breaking them down they use slightly different categories so it's just hard to make sense of where the opportunities are and where the problems are but I'm going to give you one breakdown that I think is close to getting in the neighborhood of useful and then I'm going to tell you all of the developments that are good news in those categories so I've made the following categories of costs so these are the areas and it's just one way you could break this down there are lots of other ways you could break it down and the problem is that all these areas overlap with the others so there's there's a a problem with getting them logically consistent but generally speaking you've got people you've got buildings you've got drugs you've got lab tests you've got insurance um transportation Etc and in every one of these cases there's something good happening that might lower those costs so let's take a look

[2:14]

lower those costs so let's take a look at a few of those things let's look at the cost of a doctor uh we've got these direct pay options now where you can say for $150 a month you can have all the doctoring you need by the same Doctor Who is a direct pay a doctor so there are a number of them already they seem to be popular and they work well and and you know it's the free market doing his thing so that that could be a huge Improvement in the cost of just the doctor's time there's also lots of tele medicine happening both for the VA and in other places I'm going to tell you more about that because my app um will also be uh hosting doctors uh I'll tell you more about that later but the idea is that lots of doctors are going online um I use uh Kaiser and I could already email my doctor and send pictures and and all that stuff so that should make a big difference um of course you've got uh better uh online resources all the

[3:15]

uh better uh online resources all the time WebMD is actually pretty great and that information is improving over time and then you've got the world of a wearables the little sensors that you can wear that will will help you uh track what's wrong with you catch Things Early that sort of thing now if you look at the world of drugs you've got regulations that can probably be fixed to improve the competitive landscape you know increase the bu buying power and of course Amazon is starting to work on that area with uh uh JP Morgan Chase and uh the third company but the so you're going to see a lot uh on meds but I'm wondering if someday we'll be able to 3D print some of this stuff probably not anytime soon but maybe someday then there's the supplies Amazon might have something to do with that you could have the supplies printed on demand you could have them delivered to

[4:16]

demand you could have them delivered to your home uh and you'll probably see a lot more competition there you could have for some stuff that is not icky there might be some ways to to share it Etc Transportation uh I thought I saw an article where Lyft was going to be doing some uh let's say low danger um Hospital runs for people who aren't so bad that they needed an ambulance but they don't have a way to get to the hospital themselves um and you might see more value in the tele medicine because you don't have to travel anywhere if you're just doing it by phone there's a real estate cost your doctor your hospital they need real estate and that costs a lot but again the tele medicine takes that cost away and a lot of your lab work you'll be able to you know put a blood sample or a urine sample in the mail and uh the real estate is centralized someplace cheap so the lab there's a number of startups that are working in the lab test space so you

[5:17]

working in the lab test space so you should expect that this will get a lot easier you'll do it at home it'll be simple it'll be cheaper then there's a world of equipment stuff that tests things and CAT scans and there's just a ton of stuff Happening Here with startups so you're going to see lower scanning devices you're going to see um uh very small desktop devices for testing your blood uh we already have a little device that you can put into your phone that will give you an actual FDA approved uh EKG so that's amazing so there'll be more sensors that work with your phone more miniature equipment that you could uh just call up your Uber driver and say say can you drop off a piece of test equipment I just bought at the drugstore the other day a uh uh thermometer that doesn't touch your body have you seen those yet you hold it you hold it about an inch from your head and push the button and it can tell your

[6:17]

push the button and it can tell your temperature from an inch away you just have to be in the room for half an hour so that your temperature in the room temperature have normalized so you're seeing huge advances in the shrinking of both the cost and the size of that equipment insurance is kind of the tough one but here are a few things I would say about that one is that if you have tele medicine that's available all the time it's going to be much easier to get a second opinion on anything so if you make it if you make it dead simple to get a second opinion you should be able to make a a type of insurance that covers that situation in other words if you're a doctor and you're you bought malpractice insurance should you be held responsible if your patient got another opinion CU if there were two op two opinions you know maybe maybe your insurance should say that doesn't uh

[7:19]

insurance should say that doesn't uh that doesn't seem like your fault because you got a second opinion or the customer do so that might help it might also help because big data is is getting smarter and smarter so more people are sharing their health information and we'll we'll get smarter and smarter about drug interactions we'll know more and more about nutrition and how that impacts everything that you're doing so the more we learn big datawise the lower the risk should be of doing something accidentally wrong and the the more easily you can get a second opinion just by picking up your smartphone and talking to a doctor in you know literally a minute you should be able to take off some risk you also should be able to take off some Risk by robot surgery maybe not in the short run but eventually we might get to the point where the robots are just so much better even if they're assisted by humans that you just don't have as many accidents the other thing you could do is by keeping people out of your building you

[8:21]

keeping people out of your building you don't have as many people getting um you know sharing germs one of the biggest one of the biggest causes of death in this country is is uh Hospital mistakes I mean think about it that's one of the leading causes of death is Hospital mistakes so the fewer people who physically go to a hospital because they can do things remotely the fewer opportunities there are to share germs and get something wrong the more second opinions you can get at a reasonable price the more likely you can catch a bad a bad decision early the more you're doing big data the more you've got sensors on your body the more you can check things on your own like your own heart the more likely you're going to avoid a big problem or at least have a a second check against what your doctor is telling you uh and then in nurses um I think you're going to see something like the gig economy where the nurses are

[9:21]

the gig economy where the nurses are coming to your house it's more like an Uber situation if you need a nurse there's one there in 15 minutes and you can watch them approach on your on your phone uh I think you're going to see a lot of medicine go to YouTube so that when people need to do simple things such as here's an example let's say you got an inhaler for your asthma and you needed to know the right way to use it and how to wash it out and and all that stuff all you have to do is have a a good YouTube clip that's 30 seconds long and the person can learn what a nurse would have told them so there's a whole lot of what a nurse does that's information and that can be moved to video and moved to the internet and there's a lot of stuff that nurses do that's a a small device test like testing your blood pressure testing your temperature and those devices are becoming you know commercial and accessible you just do that yourself um and then maybe Amazon will

[10:22]

yourself um and then maybe Amazon will be delivering small equipment and supplies someday and the it could be that the hardest thing you ever have to to do is maybe dress a wound and if you needs somebody to do that for you maybe there's an app for that and you find a neighbor who will do it for $25
$25 so that's sort of the the uh the broad scope the idea is that if you can break down these categories in some kind of rational groupings then you can start to see which startups and which Trends are working against those groupings and then you can figure out how do you accelerate that what what is the best thing the government could do what you could do as an individual what investors could do what's the best thing you could do to Goose any of these effects that are already positive what could be more positive I I'll tell you one thing that I think is going to happen um here's my prediction I don't know how long this will take but I'll

[11:22]

know how long this will take but I'll bet a lot of people will be doing some version of Airbnb for uh hospital stays meaning that your hospital bed will be an extra room in your neighbor's house or you know it could be anywhere but just an extra room in somebody's house if it has its own bathroom and if the if the nature of your problem is not one that you need a clean environment so let's say you don't need um something like shots and you need just the simplest monitoring and you know recovery and somebody stops by twice a day and checks you out maybe there's a video camera on you so that you're actually being watched 100% of the time so there's probably some way to take a hospital bed stay which is super expensive and compress it by 80 90% and somebody could still make a nice profit having a clean room in their house you know a hospital room now of

[12:23]

house you know a hospital room now of course it's only for very specific situations right not not for every situation but
but some um so you can see how many opportunities there are for this to improve in a in a substantial
uh Scott afraid that you do not have a clue about sickness now the people who say that um I I want you to know that my very next periscope is going to be troll school um I'm going to be teaching troll College because I noticed that a lot of people are trolling me poorly and and they need some help so I've put together and by the way I'm not joking about this I'm going to be teaching uh troll College in my very next

[13:27]

Periscope um so that's that's the background on this that's all I wanted to say on this top topic next time you see me troll College