pay doctors according to how healthy their patents are


Help me automate conflict resolution and cost-benefit analysis for this statement: 

We could pay doctors according to how healthy their patents are.

Reasons to agree.

  1. Doctors currently have little financial incentive to improve their patients' health, as they make more money when patients are sick.
  2. Rewards for good behavior and punishments for bad behavior can be effective in shaping outcomes.
  3. Doctors who do a better job should be rewarded and promoted.
  4. An algorithm could be developed to pay doctors based on the health gain of their patients, taking into account various factors.
  5. Patient feedback could be used to allocate pay bonuses to doctors.
  6. Capitated practice plans, where doctors are paid a fixed amount to care for a set number of patients, could incentivize keeping patients healthy.
  7. Wellness statistics for doctors could be made available, similar to treatment outcomes.
  8. A carrot and stick approach can lead to better societal outcomes.
  9. In business, financial rewards are tied to performance, and the same principle could be applied to healthcare.
  10. Patients often lack control over healthcare costs, and a performance-based pay system could help address this issue.

 

Reasons to disagree.

  1. Only a minority of a person's health depends on healthcare, with other factors like lifestyle and genetics playing a significant role.
  2. Anecdotal evidence of a doctor's effectiveness already drives patient choice, indirectly linking a doctor's income to their performance.
  3. A performance-based pay system could potentially be gamed, as in the case of Harold Shipman, a doctor with a high healthiness rating but also a statistically anomalous death rate.
  4. Some medical specialties, such as allergists, plastic surgeons, and chiropractors, depend on patients regularly visiting for ongoing care.

 

Origin of Idea

 

I had this idea when listening to an NPR story about how Doctors have no incentive to spend time with their over-weight patients in counseling them on how to live healthy lives. Doctors only seem to be paid when they give a prescription or put on plastic gloves. Instead, we should incentivize (pay) doctors to help their patents live healthy lives.

 

Other ways of implementing this principle

  1. Teachers who teach more, should also get paid more.
  2. Prisons that reform their inmates better, should be paid better. Statistics could be used, about which facility has the lowest repeat violent criminals, etc. Prisons could be viewed as educational facilities about how to control your temper. I image violent movies/music being banned. Opera, Dr. Phil, and a 24-hour soup for your soul channel being broadcast. If their was money in it, people would be competing who could come up with the best formula. Does Johny Cash music help sooth violent tendencies? Would motivational speakers help? All questions for the free market to fix.

 

Books that might agree

  1. Freakonomics (talks about incentives)

 

2. Identify Interests

Interests of those who agree:

  1. Aligning financial incentives with patient health outcomes
  2. Rewarding doctors who provide high-quality care and promote wellness.
  3. Empowering patients and increasing transparency in healthcare costs

Interests of those who disagree:

  1. Acknowledging the complex factors that influence health beyond healthcare.
  2. Maintaining the current system of patient choice and market-driven incentives
  3. Protecting medical specialties that rely on ongoing patient care.

Shared interests:

  1. Improving patient health outcomes
  2. Ensuring access to quality healthcare
  3. Managing healthcare costs effectively

 

3. Objective Criteria for Assessing the Validity of the Belief

  1. Evidence of the impact of financial incentives on healthcare provider behavior and patient outcomes
  2. Data on the relative influence of healthcare versus other factors on individual health
  3. Case studies of performance-based pay systems in healthcare and their effects on quality, cost, and patient satisfaction

 

4. Analyze Underlying Issues and Root Causes

  1. Misalignment of financial incentives in the current healthcare system
  2. Limited patient control over healthcare costs and provider choice
  3. Challenges in measuring and attributing health outcomes to specific healthcare interventions

 

5. Identify Unstated Assumptions

  1. Assuming that financial incentives are the primary driver of doctor behavior
  2. Assuming that patient health outcomes can be accurately measured and attributed to individual doctors
  3. Assuming that a performance-based pay system would be feasible to implement and maintain

 

6. Propose Top-rated Solutions

  1. Develop a pilot program to test performance-based pay for doctors in a limited setting, with careful monitoring and evaluation of outcomes
  2. Invest in research to better understand the relative impact of healthcare versus other factors on individual health
  3. Explore alternative payment models, such as capitated practice plans, that align incentives with patient health while allowing for ongoing care when needed

 

7. Conduct Cost-Benefit Analysis

Potential Costs of Agreeing:

Potential Benefits of Agreeing:

Potential Costs of Disagreeing:

Potential Benefits of Disagreeing:

 

8. Identify Key Resources

Best Supporting Evidence (Agreeing):

Best Weakening Evidence (Disagreeing):

Most Credible Supporters (Agreeing):

Most Credible Opposers (Disagreeing):

 

9. Analyze Values and Ethics

Values and Ethics of those who agree:

Values and Ethics of those who disagree:

 

10. Review Supporting Media

Supporting the Statement:

Opposing the Statement:

 

11. Explore Alternative Framings