Here is a story of an actual greedy doctor:
https://abcnews.go.com/Health/whistle-blower-helped-expose-m...
What a nightmare for the people involved.
The Greedy Doctor Problem
121–130 of 182 posts
Re: The Greedy Doctor Problem
#122Earlier quoted context omitted.
The golden days of the doctor “cartel” (and people in the healthcare chain in general) are over. https://www.beckersasc.com/asc-news/9-cms-pay-cut-for-physic... The 80s/90s/00s were probably the golden years for them, but they got in the political spotlight, and combined with the decreasing proportion of young to old people, the government is going to push down cuts to whoever lacks political power to push back. Such…
I'm kind of surprised that med schools haven't dramatically opened up their admissions, like law schools have over the past 20 years. It's such an obvious source of funds for the school.
The med schools are accredited by (a body completely governed by) the AMA. Number of seats is part of the accreditation.
The AMA does not want more competition and lower income per doctor.
Re: The Greedy Doctor Problem
#123Earlier quoted context omitted.
The median wait time to see a specialist in canada is 78 days[1]. Yes, in theory you could "just add more doctors". But there is clearly already less doctors than there needs to be. Policy that encourages doctors to work less exacerbates this issue. You can't just say "add more doctors" as if that helps anything. Shortages exist for a reason, and analyzing and fixing the system which creates the shortage is the only…
> You can't just say "add more doctors" as if that helps anything. Why wouldn't it? There are more than enough people who would want to become a doctor, and would be capable. Especially if the work/life balance would be better. At least in my part of the world, it seems that the system is rigged to keep the number of docters artificially low.
> Why wouldn't it?
I explained in my comment: There is a shortage of doctors. Unless you know 50,000 people with medical degrees searching for a job, you are going to have to fix the situation that created the shortage rather than just wishing more doctors would appear.
This is what dasudasu was doing. They identified a cause of the shortage (doctors are encouraged to work 60% of a work week) and your response was "so what, more doctors will just appear". More doctors have not been appearing.
Re: The Greedy Doctor Problem
#124The 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.
Actually, we are increasingly doing that already in the US. Value-based healthcare, aka Medicare Advantage uses something called risk adjustment. Payments are based on patient demographics and select disease categories (HCC codes) with bundled payments. The intent is to slowly get rid of fee-for-service healthcare.
Re: The Greedy Doctor Problem
#125Someone uses “greedy doctor” as an example to talk about an easy to understand version of the Control Problem, and the comments make it into a discussion of healthcare systems. I’m starting to think most readers on HN don’t really read the articles and go straight into the comment section..
Welcome to Hacker News, a popular discussion forum where vigorous conversations are initiated using the text of recent headlines.
"Please don't sneer, including at the rest of the community."
It's a particularly low-value form of comment, and also very common, I think mostly because we try to secure our identity in opposition to others. Since this mechanism appears to work the same way in everyone, such comments are repetitive and extremely tedious.
Re: The Greedy Doctor Problem
#126I 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…
Please don't take HN threads into generic flamewar, and please particularly keep off the nationalistic flamebait track.
We detached this subthread from https://news.ycombinator.com/item?id=29270645.
Re: The Greedy Doctor Problem
#127Re: The Greedy Doctor Problem
#128The ideal solution is to move to a country with a great public health care (say, Denmark or Switzerland).
Please don't take HN threads on generic tangents. This isn't a substantive response to the article; it just points towards a version of the same discussion people have been repeating for years.
Such massive generic topics are like black holes that suck in unsuspecting threads that fly too close. Solution: consciously steer clear.
https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...
Re: The Greedy Doctor Problem
#129The article proposes prepayment options. Why not go to the "other, other obvious" solution, which is results-based payments? In healthcare, that's value-based care. In other industries w/ agent-principle problems, it's called "taking on risk". You're incentivizing results and outcomes, rather than whatever specific actions lead up to those results. It means that the focus is no longer on the activity provided by the…
Then doctors filter what patients they take to guarantee these good outcomes. This is already done by some surgeons. Surgery is already a subset of medicine heavily judged on outcomes.
Cherry picking and lemon dropping does happen in value-based systems, but there has been work to address the issue. No simple answer, but basically you pay doctors more for select patients.
Re: The Greedy Doctor Problem
#130The 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.
they also have an incentive to keep you alive as long as possible since they don't get paid if you die.