Truly Curing the Healthcare Crisis

Further to the last post…some 16 years after writing it…with that time to contemplate on what I wrote then…but still believing that the basis is true…I submit the following:

Incentives ultimately drive behavior. If you don’t believe that, go read Human Action by B. F. Skinner. Any system that is not designed with incentives to promote its purpose will fail in its purpose. Obviously, when you pay a healthcare provider only when you are sick, there is not much financial incentive for a healthcare provider to keep you healthy. Sorry to say that, but if you were always healthy, you would never go to a healthcare provider. Healthcare providers would cease to exist.

On the other hand, I realize since writing the last post in 1994 that healthcare providers are not going to agree to such a system, when they are not completely in control, that is, the patient is almost totally in control of their lifestyle once outside of the healthcare practitioners’ office with respect to their diet, medications, risks, and so forth. Combine that with incentive for the patient not to follow their healthcare practitioners’ instructions by partying hearty and so on, that is, the healthcare practitioner pays if the patient gets sick, and the patient doesn’t. Without incentives parallel to, or in partnership with, their healthcare providers, patients are not as likely to stay healthy.

As a result, there must be a partnership between the healthcare provider and the patient, whereby the healthcare provider will make less money, and the patient will pay more money, to the extent the patient is not healthy and requires greater health care costs, and the healthcare provider will make more money, and the patient will save more money, to the extent that the patient remains healthy and doesn't require healthcare costs.

The incentive theory is crystal clear and simple. Now for the hard part. How do you redesign and rebuild a complicated healthcare system to these theoretical specifications? I will continue working and writing on this, but in the meantime, I see a great pre-med senior thesis or a great doctoral thesis on this challenge. How about you? Your incentive is in curing the health care crisis, which is draining the life blood out of this nation.

Beality

Cure the Real Medical Health Care Disease

Preface: This is a copy of a real letter. Notice the date.

April 6, 1994

Mrs. Hillary Clinton
The White House
Washington, D.C.

Subject: Cure the Real Medical Health Care Disease

Dear Mrs. Clinton,

Imagine that you are a doctor. You get paid only when your patients are healthy. You do not get paid when they are diseased.

You are rewarded only if they become, and remain, healthy whether due to recommended life style changes, vitamins, or other health inducing activities, whatever proves to work. You are not rewarded when you and they engage in needless surgery, risky chemical therapies, or other therapies that do not prove to result in better health.

The new Hippocratic Oath should be, “A doctor does not charge patients when they are sick but only when they are well.”

It doesn’t take a rocket scientist to understand that if you only pay medical personnel when patients are sick, that the system then invites sickness. The incentives of the present medical establishment are completely the opposite of what they need to be to promote health. Only by reversing the incentive will health be promoted.

If doctors and other health care providers are paid only when they keep people healthy, instead of when they keep them sick, the cost of medical care will decrease dramatically and immediately, to rise as the general health of Americans increases. Americans will truly not mind paying doctors under these circumstances. The quality of medical care will, because of proper incentives, flourish.

The medical care crisis is yours to solve. By changing the incentives, instead of throwing more money at a failed system, you can not only solve the crisis, but usher in a new and enlightened era of medicine.

Sincerely yours,
/s/
The person now known as Beality

Cc: President Clinton
       Letters to the Editor, Washington Post
       Letters to the Editor, Los Angeles Times
       Letters to the Editor, Wall Street Journal
       The United States Surgeon General

***POSTSCRIPT: SEE THE FOLLOWING BLOG POST FOR AN UPDATE....