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Comment by pyrophane | Hacker News Reader

My concern is that this sort of approach to medicine is going to result is the "top specialist" tier of doctors spending more time treating complaints that don't really require their particular level of expertise. You probably don't need to see the world's best cardiologist if you just have high blood pressure, but if you are paying 40k a year for a concierge medical service they might feel that the need to get you in front of him or her in order to justify their fee. Otherwise what are you paying for? Consequently this amazing heart doctor spends an hour telling you to eat better and exercise rather than evaluating someone's complicated and life threatening condition.

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You're right. And more importantly, the 'world's best cardiologist' won't remain that if he continues to treat mundane cases.

In theory though, the market should address that right? e.g. a version of this that's $10k a year but can handle 10x the volume because you triage patients with competent nurses and PAs and save the expert's time for the cases where they can actually make a difference.

Starting to sound an awful lot like the U.S. health care system...

Yeah, I had the same thoughts when I was writing that. The key difference is that the current system is so convoluted that there is almost no meaningful market for consumers on the actual care side of things.

A normal market would partially address this by adding doctors. In the USA, new medical schools have to be approved by the AMA.

why is this market failure automatically attributed to too much regulation instead of the wrong kind of regulation. Wealthy elites paying 40k to set a broken bone shows exactly why deregulating would be disastrous, medical decisions are rarely made rationally. There is a quote from the article that implies that these elites would pay anything.

"But when you have kids, you jump the line. You just do. If you have the money, would you not spend it for that?"

Unregulated markets do not work for this type of irrational actor. Please stop spreading lies about how to fix this problem. Instead maybe look at countries that regulate it correctly(Spain).

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