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The Greedy Doctor Problem

universalprior.substack.com

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Re: The Greedy Doctor Problem

#61

Post by dasudasu »

teekert wrote: post #36

I think most countries with a civilized, social and sustainable healthcare system do this, right? Maybe this is the kind of market that can never be free, because you can never step away from a deal, as the alternative is often death. As such perhaps in these matters we should just have some faith in humanity. You know, it works for a lot of open source software. Capitalism is not a silver bullet, people have a consc…

Many countries with universal healthcare still pay by the act. In Canada, doctors are mostly independent service providers that bill the government directly. This can lead to two problems: a) they don’t do a whole lot of medical acts because it already pays so well that they can afford to slack off (e.g., work 3-4 days a week, see very little patients), or b) do a lot of unnecessary acts because it goes directly into their pockets.

Re: The Greedy Doctor Problem

#62

Post by coding123 »

For those that thought this was about healthcare, you didn't read the entire thing. Actually you should guess by the first example showing what looks like an NN setup that this has nothing to do with Healthcare.

Re: The Greedy Doctor Problem

#63

Post by bshep »

kuiper0x2 wrote: post #2

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 reminds me of something I think i heard ( or something similar ) in a movie :

“I’m not going to kill you, but you would surprised how much suffering you can live through.”

Re: The Greedy Doctor Problem

#64

Post by lotsofpulp »

michaelrpeskin wrote: post #35
kuiper0x2 wrote: post #2

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.

That's what I do. It's called "direct primary care". In the last 10 years, I've used two DPC doctors. I loved my first doctor because we had the same philosophies towards health. Last year she started drifting too "mainstream" and I didn't like her style, so I switched and took my money elsewhere. I found a new guy who is really aligned with me and it's been great. It's almost as if having choice and market can work…

I pay $25 to $30 per hour to housekeepers. I question the sanity of a doctor charging $135 per month for multiple people.

Re: The Greedy Doctor Problem

#65

Post by belval »

dasudasu wrote: post #61
teekert wrote: post #36

I think most countries with a civilized, social and sustainable healthcare system do this, right? Maybe this is the kind of market that can never be free, because you can never step away from a deal, as the alternative is often death. As such perhaps in these matters we should just have some faith in humanity. You know, it works for a lot of open source software. Capitalism is not a silver bullet, people have a consc…

Many countries with universal healthcare still pay by the act. In Canada, doctors are mostly independent service providers that bill the government directly. This can lead to two problems: a) they don’t do a whole lot of medical acts because it already pays so well that they can afford to slack off (e.g., work 3-4 days a week, see very little patients), or b) do a lot of unnecessary acts because it goes directly into…

Yep and it's a pretty big issue actually as it creates a lot of abuse in the system, doctors mostly interested in smaller "easier" acts that they are known to pay well, doctors getting referrals from a clinic outside of their administrative region (those pay more), and of course radiologists working 2-3 days a week because their acts are even better remunerated.

Add on top that by being independent, doctors will have their own company and be subjected to a much lower tax rate than a "normal" person earning 400k$/year.

Re: The Greedy Doctor Problem

#66

Post by treeman79 »

I blew half a million of healthcare companies money searching for answers. Which I eventually got. Entire time desperately trying to find a doctor to work with me. Instead had to educate myself for a couple of years. I would have loved to just pay a doctor a grand or more a month for a few hours to go over tests and discuss next steps. Would have been drastically cheaper for all involved.

Re: The Greedy Doctor Problem

#67

Post by durnygbur »

I wonder how software world has the most sophisticated practices and patterns for architectures, communication, and arbitration, yet we are played by lawyers and doctors like blind children. Once I was looking to address my non-obvious health issue. Insurances, appointments, referrals, hospital, ended up with an obsolete surgical procedure leaving visible incision scars. That was in Germany. Somewhere at the back of my head I was thinking "I'm smart, you're smart, we're pals and I can trust you right?". Now I'm just left with infinite hatred and distrust towards greedy medical frauds.

Re: The Greedy Doctor Problem

#68

Post by mattnewton »

shonenknifefan1 wrote: post #43
khafra wrote: post #31

Earlier quoted context omitted.

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

> To cure health care, give your care-givers a clear incentive to keep you well. Make sure that when you lose, they lose, and just as much. Buy lots of life and disability insurance from your care-givers, and have a third party, unable to act against your life or health, pay you to be the beneficiary.

So, basically bundling insurance with the healthcare provider, like kaiser?

Re: The Greedy Doctor Problem

#69

Post by ivalm »

lotsofpulp wrote: post #64
michaelrpeskin wrote: post #35

Earlier quoted context omitted.

That's what I do. It's called "direct primary care". In the last 10 years, I've used two DPC doctors. I loved my first doctor because we had the same philosophies towards health. Last year she started drifting too "mainstream" and I didn't like her style, so I switched and took my money elsewhere. I found a new guy who is really aligned with me and it's been great. It's almost as if having choice and market can work…

I pay $25 to $30 per hour to housekeepers. I question the sanity of a doctor charging $135 per month for multiple people.

Typical panel size is ~1200 patients. So to get $300k/year that’s $20.8/person/month.
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