Constraints of the Mind, Constraints of the System
your Saturday roundup
Professionally, I focus on creating social benefit startups. In my Saturday morning emails I share what I’m learning and thinking. Topics range from better living and parenting to business and philosophy.
I’ll be taking two weeks off from the newsletter. See you after that.
What are You Waiting For? AI is moving so fast, it is hard to keep up. I wonder if people are aware of all of its capabilities. Computers can play games better than humans. Computers have been trading stock for a while. AI can translate dozens of languages. Computers can write stories, websites, music and research reports. And it's starting to make movies. AI seems to drive safer than humans. LLMs aced the bar exam. AI can diagnose disease better than humans. Plus AI has a better bedside manner. AI passed the Turing test. And it can do theoretical physics and other science. Yet people talk about AGI being in the future. What are you waiting for it to do next before you change your outlook and plans? Put away groceries?
Constrained Healthcare. Demand for healthcare keeps growing. Yet we place artificial constraints on the supply. Instead let’s build more capacity. One of the problems is narrow interests capturing regulatory processes like I mentioned in my last post. Here are some examples of ways we could have more healthcare supply. What are others?
We could relax or remove rules around “certificate of need” which requires state approval to open a health care facility.
We could train more doctors by creating more residency slots.
We could make it easier for doctors with training and / or experience abroad to work in the US without doing a full residency again. Some states are trying this.
We could let nurse practitioners offer primary care without having a doctor involved.
We could allow pharmacists to do more routine prescribing.
Civic Track Challenge Pitch. I’m helping to organize the Yale Innovation Summit Civic Track Challenge Pitch Competition. Apply to pitch your creative, actionable ideas — including ventures, civic ideas, and other public innovation — to enhance civic engagement in cities.
Until next time,
Miles
Regarding health care: In addition to an emergency room, every hospital should have a 24 hour walk-in urgent care center. People know how to get to their local hospital(s) but who knows where their nearest urgent care center is if they have yet to use one?
This writer opposes socialized medicine but does agree with safety nets. Fund (all or part of) hospital urgent care centers with tax dollars, but limit number of patient visits per year to two, and no chronic condition treatments, those kinds of things, to avoid desperate patient abuse and alleviate some emergency room overcrowding. Taxpayers cannot fix every ill in the world. Do not impede access to private urgent care centers in any way when establishing taxpayer subsidized centers.
Require doctors to treat the elderly equally to twenty-somethings giving patients clear assessments of age risk, so they can make their own treatment choices. My mother at 84 had a bowel obstruction requiring surgery. The head surgeon told her to go home to die, that the surgery was too risky at her age and they would not do it. We got a second opinion and she turns 96 this month. That surgeon wasted staff and another doctor's time because of age discrimination. (Yale NH Hospital.)
Get insurance companies out of the way of doctors. Also, stop Medicare abuse by doctor groups. I started getting monthly phone calls from my doctors office, which were intrusive as far as I was concerned, and it turns out that just by answering the phone I legitimately gave them the ability to bill Medicare. Not fraud, but certainly abuse of my tax and insurance dollars. That doctors group was a medicare money machine. I left them.