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Re:Larry Page: I’d Rather Leave My Billions to Elon Musk Tha... by tokenadult on Thursday March 20, 2014 @08:12PM (#7439829)
I have heard that in China, they put a doctor on retainer and only pay him when they are well.

Since you indicated that you weren't sure if that is true, I can assure that it is not. Most doctors in China are paid formally by salary, and under the table by patients who can afford bribes on a fee-for-service basis.

Re:Larry Page: I’d Rather Leave My Billions to Elon Musk Tha... by qwerta on Friday March 21, 2014 @03:13AM (#7441061)
I think it was case in _ancient_ China. Current China is more capitalist than US will ever be.
Re:Larry Page: I’d Rather Leave My Billions to Elon Musk Tha... by Mz on Friday March 21, 2014 @02:40PM (#7443950)
Thank you.
Re:Larry Page: I’d Rather Leave My Billions to Elon Musk Tha... by Mz on Thursday March 20, 2014 @08:20PM (#7439855)
Thanks. Let me clarify that my main point (in mentioning what I had heard about China) was that there are potential alternate paradigms for paying doctors which do not directly incentivize dragging out illness. In the U.S., one of the best hospitals we have also has doctors on salary. They make the same amount regardless of how many tests they order. They credit this with helping make sure the focus is on giving the patient the best possible care without any conflict of interest subconsciously influencing the doctor's treatment plan.

Have an upvote.

Re:Larry Page: I’d Rather Leave My Billions to Elon Musk Tha... by dTal on Friday March 21, 2014 @06:51AM (#7441536)
As I see it, there are only two fundamental ways to pay for health care: you can can pay for treatment as and when you need it, or you can pay a flat rate in exchange for treatment at no additional cost. Hopefully we can agree that the former option is barbaric, as you are effectively denying modern medicine to anyone not rich enough to cover it up-front, which is most people. The latter option is essentially health insurance. Paying the doctor a retainer only when you are well is tantamount to making your doctor a de-facto health insurer (and all of the horrible consequences that entails).

Insurance works off averages, so it works more efficiently the more people buy in. Logically then, the most efficient health insurance is where everyone buys in. Hence, the most efficient system is nationalized health insurance, which comes with many other benefits - for example, it lends massive bargaining power to the people for reasonable drug prices.

You state in your original comment "I feel very strongly that our current "health care system" is very broken and one of the things wrong with it is not that it is monetized but how it is monetized." This implies that you don't believe in socialized medicine. What in your opinion is wrong with it?

Re:Larry Page: I’d Rather Leave My Billions to Elon Musk Tha... by nickbauman on Friday March 21, 2014 @10:06AM (#7442350)
I'm from Germany. Once I was hit by a car on my bicycle. The driver wasn't looking and hit me. My hospitalization was paid for by a nationalized system of public and private insurers. A short trial was held for fault. I was awarded money that would cover replacing my bike and a few hundred more dollars for my troubles.

In the US, I probably would have gotten a large cash settlement out of the deal. But a nationalized system like that in most other first-world countries does not require tort-reform because effectively the commitment to your health, cradle to grave, is a given.

Paying doctors piece-meal, like assembly-line workers or auto mechanics, creates perverse incentives and only tangentially works towards good outcomes.

Re:Larry Page: I’d Rather Leave My Billions to Elon Musk Tha... by Mz on Friday March 21, 2014 @02:38PM (#7443936)
Please do note that I put "health care system" in quotes. That was not an accident.

I worked in insurance for over five years. They are not in the business of taking care of people. They are more like some version of Las Vegas but all the "winners" first have to lose an arm or get run over by a car. I am not a huge fan of insurance.

I was a homemaker for many years. I also was studying to go into urban planning when my life got derailed by divorce and health issues. Urban planners used to plan pedestrian-friendly spaces in part with an eye towards health of the community members. I have also read a fair amount about the differences between how Europe handles things and how the U.S. does. Europe is generally more family-friendly and people friendly, which is good for the health of it's people.

Medicine is not about making people healthy. Eating right, exercising and living right are what foster good health. Medicine is crisis management when things go wrong. Viewing medicine as "health care" is fundamentally fubarred. You cannot crisis manage your way to good health. It simply cannot be done. Good health is built over a long period of time, with every bite you put in your mouth, every time you fail to become a drug addict or alcoholic, every time you find a way to get your sexual needs met that does not expose you to high risk of infection from strangers with unknown personal habits, etc.

So when the U.S. reduces discussions of "fixing our health care system" to the question of "who should pay for it?", the situation is already essentially hopeless. It cannot be fixed from that starting point.

As for who should pay for medical care (which is not, in my mind, "health care"): The government. Insurance is not in the business of taking care of people. It is a numbers game and, like Las Vegas, in order for the house to even keep it's doors open, much less make the occasional big payout, there have to be a great many more losers than winners. It's simple math in that regard and the actuaries look out for that end of it like vigilant hawks. And when the actuaries decide the company is paying customers too much money for X benefit on X policy, the policy gets sent to the legal department and they "clarify" what the paragraph in question means and the claims department gets retrained to "pay this benefit correctly" and we start sending denial notices to the customer for things we used to cover. That will never, ever, ever, ever, ever make this country healthier.

And I worked for a good insurance company with a very ethical reputation. From what I gather, a lot of other insurance companies are far more gruesome.

Re:Larry Page: I’d Rather Leave My Billions to Elon Musk Tha... by Ntrails on Friday March 21, 2014 @06:00AM (#7441433)
Remuneration in the medical profession is fascinating and trying to properly align incentives whilst avoiding unintended consequences is very complicated. I am not sure there is a model that properly works yet.