The quality of care argument (and others along those lines) is the bulk of Munger’s point.
I dont think most Americans (will be an issue in other western countries as well to different degrees as well, but feel most comfortable discussing the American system) will be able to access those kinds of treatments in the coming years or even many of the currently available treatments. The healthcare system is unraveling and I suspect that, as usual, care rationing and access will be primarily based on money. Think getting much of the care we expect today for things like cancer will be more lottery based/rationed for the middle class with cash/concierge options for those with means.
Life expectancy already back to 1996 levels as it is. So just to get back to 2019 levels on that metric is going to require a lot of advancement/improvment.
It’s more than a little close. I don’t give a fuck if infant mortality fell from .3% to .05% or whatever when basically half of the country is terrified of seeing a doctor.
I don’t think it’s possible to have a useful discussion if you’re going to insist that the quality of medical care available in 1948 is pretty close to what we have now. I guess they’re pretty close if we’re comparing to what cavemen had. But if that’s your basis for comparison then a contemporary 2022 human with no access to health care is also far better off than a caveman as far as health/life-expectancy is concerned.
Life expectancy isn’t down because of health care though. Its opiate overdoses far more than anything else (and Covid)
I see broke people get advanced care every day. These people get hurt by a lack of preventative care
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Yes it’s not just mRNA there are all sorts of advances in cell and gene therapy under clinical development today which might produce effective treatments for things like Parkinson’s or Alzheimer’s, there are major oncology innovations every year across the industry and also things going off patent. Also things that were the big innovations of the last 10 years like immuno-oncology will continue to mature and be available for a broader range of indications.
I personally am in a rare class of people whose cholesterol is still way too high on the maximum dose of statins but there are now injections I can take that lower me to a normal range. Those will be off patent and more affordable in another 5 years or so. The idea that healthcare will be worse in 10 years is crazy.
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That’s your values I guess, but I don’t think that’s be shared by anyone in public health
Munger is a smart guy who has found a world view that is pretty damn close to the outer limit of kind to himself and still remotely plausible.
I get it, he likes to sleep at night. Most likely he has not had direct personal contact with anyone in the bottom 60% of wage earners in this country (which as of 2019 was a pretty important inflection point in terms of lived misery… I have no fucking idea what the economics of anything are now in 2022) since the 80’s.
As billionaires go Munger is one of the better ones, which really tells you all you need to know about billionaires as a class. It’s definitely very bad for humans sense of reality to have that much wealth. Power really does corrupt.
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Looking at life expectancy itself is not a great way to evaluate how good the health care we have is. For example, the life-expectancy of a Uruguayan is not that much different from an American. You think that if you’re an average Uruguayan and you’ve got rheumatoid arthritis in Uruguay you are going to be able to get on one of these new, expensive biologic medicines that is always on TV here? Chances are super low. Here, even if you are poor, there are ways to do it if you can navigate the system (which I agree is a terrible aspect of the system). And if you are insured, which is still most people, it’s probably not super hard for many(but still could be hard for some).
What do we think about I-bonds at <7%? I’m leaning against buying more.
Don’t strawman me. I said free healthcare in Britain in 1948 is arguably better than 100 million people being unable to afford healthcare here despite the obvious advances for those who can.
I know that is what you said. It’s still very wrong. Even if you are uninsured in the US you are still guaranteed access to emergency care (far more advanced than the richest 1948 bro) and there are programs like Medicaid available to many of those people. So the result is that they will get the care, but they will go bankrupt in the process. In 1948 the care for a lot of things didn’t even exist, so you would just be dead. I’d rather be broke than dead.
I was asking myself the same question. I think I’m going to add one more layer this year even if the rates aren’t as attractive. One thing worth pointing out, though, is that the fixed rate has increased from 0 to 0.40%, which ain’t nothing.
I’m gonna personally wait a few months to see what happens with rates and such. The current deal is available until about May, right?
If you look at the month over month data inflation has only gone up 1% over the last 5 months which is 2.4% annualized, the vast majority of the 7% year over year increase was from the first half of the year when interest rates were 0%. Housing has stopped going up, used cars are coming down, and gas is a dollar cheaper than a few months ago. I think the next rate in may will be in the 3.something%, I am not buying any more.
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(I assume we’re talking about where to hold cash and cash equivalents, not choosing whether to invest in I bonds vs. stocks.) If inflation ends up crashing, then I’m not sure I bonds become that much less attractive than a regular HYSA, since those HYSA rates will be quick to adjust downward.
If I buy another layer in 2023, then I’ll more or less have all the cash balance I want to hold in Ibonds, which I think is better than having them in a HYSA. I don’t really view them as a huge return-generating parking spot.
I dont think the poor and middle class will be getting treatment as much going forward. Prescription medicine, maybe. Things that require more access to healthcare facilities like surgeries and chemotherapy, think will be less available in ten years then they are today,
That’s a good trick when rates are rising. When they’re falling they’ll just cut it. The notice that they’re doing so will be buried in an email that may or may not make it through your spam filter.
This is correct. The longevity papers I read describe it as a collective “deaths of despair” impact. ODs and suicides mostly.
Deaths of despair are way up you say… guess in Munger’s worldview that is because people are envious of their well-to-do neighbor’s boat and shit?
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