Yeah I was planning to buy no more Apple products but they do something really right with the Watch and the iPhone. If you've ever been in a situation where you need help it turns out it's on the practical side not so easy

TBF Google had crash detection first, by a few years.

But I agree. If they can add a cheap part (better accelerometer) or re-use an existing one (pulse detection for a-fib) and provide really great possible benefits for some people? Sounds great.

>At some point iPhone and Apple Watch will probably be marketed as the devices you need if you don't wish to die early.

Or you'll have to turn over your data to get the reasonable health insurance rates and not fall in the risky rate bucket.

God forbid the US become a civilized nation and offer a real competitive national healthcare options. I live in one of the more expensive European nations when it comes to healthcare. €100~/mo with a €400~ deductible per year. Worst case scenario, I spend €1600/yr on healthcare.

Yep. If your employer isn't subsidizing it for you, €1600/month (not a year) for a good employee+family plan would be a bargain in the US. And the deductible would still be thousands, not hundreds.

How much do you pay when you factor in the taxes you also pay into the system?

If one gym had a yearly fee of $40 and then cost $1 every time you went, and another gym had a $8 yearly fee and cost $15 everytime you went, it wouldn't make sense to compare them merely on the per-visit costs.

Just to short circuit, I'm not trying to defend the American healthcare system. American healthcare is horrible on average compared to the average of other rich nations.

Also, a final note, but even if you have cheap out of pocket expenses, you aren't getting good value for your money if you don't visit a doctor for almost a decade. (Yes, I did e-stalk you for 60s to try to see what country to figure out average tax burden for healthvare, and ran across that fact on your intermittent fasting post)

In Canada my income tax rate is about on par with what I would pay in the states. If I lived in California my taxes would be higher.

Our sales taxes are a little higher than a lot of the states, though.

I’ll take that over the amount of money and time the US healthcare system siphoned off of me when I was healthy.

In general, the US pays more, and has less effective healthcare than countries with universal/single-payer systems[1][2][3].

There's plenty of reasons for that.

[1] https://grattan.edu.au/news/more-expensive-but-less-effectiv...

[2] https://www.scientificamerican.com/article/universal-health-...

[3] https://www.commonwealthfund.org/publications/issue-briefs/2...

I agree, but that doesn't mean OPs overall burden is capped at 1600 eur/year

These studies are using total spend - inclusive of taxation and direct payments.

Sorry, coming back to this late, but in the hope that you see it, I haven't visited the doctor _because_ it was expensive. Sure, I'm also young and it probably wasn't really necessary, but there were definitely a couple of instances I can remember from the last decade that I didn't go to the doctor until I thought I had no other choice.

I'm willing to pay a little more in the long term to have the peace of mind that I can go to the doctor for something less than an emergency and not face financial hardship. In the US, one doctors visit can easily cost more than 10 years of bills in a European nation, and it doesn't even have to be serious! A broken leg isn't life threatening, but it could break you financially if you aren't ready and able to shell out your high deductible.

Is that one of those "civilised" countries that denies parents the right to take their child out of country to get medical help, even when there's no cost to said "civilised" country?

I think that you are watching Fox News a bit too much.

The Apple watch has literally saved 3 of my older relative's lives already. It's amazing technology!

> a-fib detection

As a paramedic, not a physician, atrial fibrillation is not a life threatening event. Many people happily live with it for decades, unmedicated. It is more problematic if you are diabetic or hypertensive, but still not an acute medical event.

As a doctor, the proliferation of apple (and other) watch ECGs has done nothing positive but lead to a massive proliferation of severe health anxiety. Go take a look at /r/askdocs for anyone curious - dozens of apple and Samsung ECG questions, people sure they’re about to die. They have nothing.

I remain entirely unconvinced that putting ‘more’ health information at increased temporal frequency to consumers leads to any health benefit, and instead causes significant health anxiety and drain on health resources with false and misleading presentations for bad signals.

How do you reconcile your views on “nothing positive” when there are multiple reported accounts of it leading to early diagnosis events for serious issues?

It can be easily reconciled if there are far more instances of false positives than true positives.

Remember that a 99% accuracy for a condition that 0.1% of the population has still means 10 false positives for each 1 early diagnosis.

I don't what the numbers are for the conditions that the Apple Watch can detect, just discussing the general principle. Whether it's more useful or more harmful depends crucially on the real numbers.

Their post said “nothing positive”. That’s different than “not a net positive”.

There's some amount of luck and marginal effects that need to be discounted, otherwise you couldn't say "nothing positive" about a diagnostic that always says "you are dying", and you couldn't say "nothing positive" about a strategy that has you pick the opposite route and then repeat as many times as you want. And I think such a conclusion would be very dumb.

I'm not making a statement on whether the apple watch in particular is close enough to that line.

Can it occasionally do something positive?

Maybe - I am unconvinced, my sister who is a Cardiologist (and so actually deals with this more day to day) certainly has changed her tune from 2-3 years ago to the point where she and the cardiologists she works with see it as a pestilence.

I think the commenter you replied to gives a good reason why. The false positive rate is so high, and the flow on effect to resourcing so great, that I find it hard to say anything positive about what is being presented as a diagnostic miracle. You've got trillion dollar companies behind these devices, that by themselves have annual turnovers for the product in question at the level of small countries' GDPs. You don't think their marketing teams ham it up a bit whenever there's the slightest story that one of their devices was involved in someone that was treated?

here's a nice pop-sci-feel-good article I found within seconds [0]. The first couple are completely unrelated. the A-Fib ones, which are the main ones that apple goes hard at (at least during initial marketing, and which all the promo was focused on) - are basically irrelevant. They sound impressive to the layperson, but AFib is very common, often intermittent in the initial stages (but very rarely causes any harm when intermittent) and very frequently symptomatic when it sets in which leads to presentations, which leads to prompt diagnosis and management.

[0] https://www.imore.com/health-fitness/apple-watch/5-times-an-...

As a counterpoint, my cardiologist suggested I get an Apple watch so I could keep a better eye on things and send him any questionable ECGs. At least some doctors seem to think there are positives.

The very important point is that you probably have a known heart condition, if your doctor recommended this. The problem with many of these devices is false positives.