41–50 of 182 posts
The ideal solution is to move to a country with a great public health care (say, Denmark or Switzerland).
The obvious, obvious thing is to simply pay the doctor a fix priced each month wether they diagnose you with something or not. Well above what they would earn elsewhere. Their incentive then becomes to keep a good relationship with you so you continue to pay them. The best way to do that is to keep you healthy and happy.
I don't know if overpaying will work, because the marginal value of money goes down the more you have. Once your doctor is rich enough, he won't be overly concerned if you die and the checks stop coming in.
The real answer is the action-movie/not-that-uncommon-in-reality answer: Credibly promise to shoot the doctor if you die, or to shoot the doctor's family members.
The obvious, obvious thing is to simply pay the doctor a fix priced each month wether they diagnose you with something or not. Well above what they would earn elsewhere. Their incentive then becomes to keep a good relationship with you so you continue to pay them. The best way to do that is to keep you healthy and happy.
For specifically the doctor version of the principle-agent problem, Robin Hanson published an incentive-compatible solution over 25 years ago: http://mason.gmu.edu/~rhanson/buyhealth.html
The obvious, obvious thing is to simply pay the doctor a fix priced each month wether they diagnose you with something or not. Well above what they would earn elsewhere. Their incentive then becomes to keep a good relationship with you so you continue to pay them. The best way to do that is to keep you healthy and happy.
>The obvious, obvious thing is to simply pay the doctor a fix priced each month wether they diagnose you with something or not. Easy fix... "Just be wealthy!" lol... :| I've paid for the absolute best insurance I could find this year and gone to doctors my entire life that simply don't care. I've had everything from colonoscopies to MRIs done and I haven't spent more than one day in my entire life in a hospital overn…
Or have all doctors employed by the state on good fixed pay
The obvious, obvious thing is to simply pay the doctor a fix priced each month wether they diagnose you with something or not. Well above what they would earn elsewhere. Their incentive then becomes to keep a good relationship with you so you continue to pay them. The best way to do that is to keep you healthy and happy.
I’ve found that my employer-provided health insurance is less than worthless for routine health care. I actually pay less by going to providers who don’t accept insurance — even though I maintain bare-minimum coverage and an HSA. I don’t think I used my health insurance at all this year — at least not enough to come close to meeting the deductible.
My primary care doctor uses this model — I pay $300/yr for basically unlimited access. I have a therapist who I pay $75 a session. I use GoodRX for prescriptions and get better prices than the post-deductible price on my insurance plan.
Basically, I pay less out of pocket by not using my insurance. I also get to choose my doctors, and they treat me as an actual patient rather than a number. Health insurance in the US is a scam.
The obvious, obvious thing is to simply pay the doctor a fix priced each month wether they diagnose you with something or not. Well above what they would earn elsewhere. Their incentive then becomes to keep a good relationship with you so you continue to pay them. The best way to do that is to keep you healthy and happy.
This is basically the Kaiser model. Kaiser's doctors are salaried, rather than getting paid per procedure. Works pretty well! (I think the actual answer to the question in the OP is, at least in part, to license more doctors. Then the cartel doesn't have as much pricing power and medical care is less of a luxury good. The rich person should really hire a lobbyist.)
The obvious, obvious thing is to simply pay the doctor a fix priced each month wether they diagnose you with something or not. Well above what they would earn elsewhere. Their incentive then becomes to keep a good relationship with you so you continue to pay them. The best way to do that is to keep you healthy and happy.
Earlier quoted context omitted.
This is basically the Kaiser model. Kaiser's doctors are salaried, rather than getting paid per procedure. Works pretty well! (I think the actual answer to the question in the OP is, at least in part, to license more doctors. Then the cartel doesn't have as much pricing power and medical care is less of a luxury good. The rich person should really hire a lobbyist.)
I had Kaiser for a year and I actually enjoyed it. I saw a couple specialist but I never had any major work done so perhaps I am biased. It is funny to say it since I believe Kaiser originally was one of the opponents of a single payer system but using Kaiser kind of felt like what a government health care system should be. Very low friction. Oh I need blood work or whatever done, walk down the hall. Everything felt…
Dealing with ego. Dealing with huge bills even when having good insurance.
I sometimes hear people talk about doctors like they are going to cure you when you need them. The older I get, the more I see the profession as an art.
I remember Lance Armstrong commenting on his cancer treatment. He basically said he knew he had the best medical care because of his wealth. He said driving from doctor to doctor was just depressing/agonizing, and he felt it was unnessary.
The obvious, obvious thing is to simply pay the doctor a fix priced each month wether they diagnose you with something or not. Well above what they would earn elsewhere. Their incentive then becomes to keep a good relationship with you so you continue to pay them. The best way to do that is to keep you healthy and happy.
1. The doctor's stake is pretty limited.
The old royal court doctor model is the perfect model for this. It's based on the doctor having very few (one?) patient. If the patient dies, not only do you risk your substantial income and high status, but you might even lose your life if the royal family gets suspicious enough.
It's a good solution if you're very rich. Much richer than the average doctor.
2. When you have more than one patient, at some point you probably earn more by treating less.
The less work you spend on each patient, the more patients you can take on. The more patients you can take on, the more you earn. If you simply stop treating patients - "you're perfectly healthy, don't worry" - you can basically take on an unlimited amount of patients and collect their fees until they perish. (This sounds like a caricature of the US insurance system, from my western EU perspective.)
---
What about this convoluted system:
- The doctors get paid a recurring fee that starts small and increases the longer you keep a patient around. This counters the problem that patients can just be replaced by a younger and healthier patient.
- The doctors get assigned patients randomly. This addresses the problem that doctors would choose young and healthy patients.
- The doctors can only have a certain number of patients at once. This makes each patient more valuable, and the doctor will be incentivized to actually treat patients, instead of having as many as possible.
Oh wait...
Now, the problem is that a young, ambitious, greedy doctor would be incentivized to cull their set of patients and select for the most viable ones in the long run. This actually incentivizes them to kill off patients with minor defects?