Comment by alexanderdmitri | Hacker News Reader

Comment by alexanderdmitri | Hacker News Reader

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alexanderdmitri

The problem seems to me that in the United States, the most common metric for success is money. Within most fields, if someone has a nice house, takes great vacations with the family, drives a nice car, those around them will say: Wow, { person.name } has really done well for themselves!

The example I always use is imagine two foot doctors (podiatrists). One has all those things above, the other doesn't (or at least not to the same extent). The reason the first has all those nice things is because this doctor performs the job well and makes extra money working with big pharma and big consumer-screwing insurance companies. The second doctor, while he/she also does a great job, decides not to work with big pharma or cut deals with insurance companies that screw his/her patients because that's the right thing to do.

Most people these doctors come into contact with, will not know (or even care to listen to [ever brought up server config during a family reunion?]) what goes into podiatry and what makes a good podiatrist actually good. They will perceive wealth and judge based on that for the most part. Can you really blame the doctor? They aren't being rewarded for doing the right thing, they are being penalized.

The travesty to me is that the doctors really are just being given peanuts compared to what big pharma and insurance are making with the rigged system.

A third alternative is, he just doesn't feel the need to spend all his money? They both could be making the same amount of money, with one blowing it all on random shit, and the other actually not having a need to do that?

This doesn't sounds like an issue of too much money though, it sounds like a combination of baseline compensation not yielding a high enough return, inadequate oversight agencies to catch this sort of behavior, and the consequences of being caught not being strict enough. It could even be argued that just paying more would discourage the corrupt behavior in your hypothetical examples because the doctors are taking those actions to simply make more money.

I'm just saying because of the lack of systemic solutions (or cures to fit the subject of the thread) you're describing, conscientious doctors are penalized to some extent and that's not cool.

Addendum: More oversight and regulation over all the doctors would be much more complex than just concentrating on the two enormous industries muddling the situation in the first place. Doctors' jobs have already become incredibly bureaucratized over the years and introducing more complex rules to simply address the symptoms rather than the root cause seems wasteful.

I agree with your addendum, I actually paused for about a minute while I was writing my reply to contemplate the right word to use for current oversight. Originally I was going to say insufficient/weak oversight but that seemed too much like it implied that the solution would simply be stronger/more oversight.

Agreed. There will always be doctors who 'bend' the rules or just don't care. Not to mention those who literally have no idea of the kind of damage they can be introducing in someone's life by prescribing certain drug. Until someone stands up to Big Pharma, the massacre will never stop.

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