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Comment by breadwinner | Hacker News Reader

Patients must be incentivized to understand their care and question care that is unnecessary and wasteful. The partial solution you mention is the way to go, and if every employer adopted it, it will change the culture, and will at that point become a full solution.

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Capitalist structures have a long history of pushing ownership of problems to the powerless individual, then exploiting information asymmetries (and actively obfuscating the truth that would allow for better informed decisions) for profit.

Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous.

> Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous.

The situation is similar to taking your out-of-warranty car to a dealer for repairs. Sometimes, you may suspect they’re not being completely honest with you. What do you do in that case? You get a second opinion before agreeing to a costly repair.

Sure, and that’s possible (at significant added cost) in a portion of cases. But not all - you might be on an operating table or in the middle of a psychiatric event, etc etc, where time does not permit second opinions, and if the system is set up to “gotcha” as a baseline, then only the most minor, time insensitive, situations will receive fair pricing.

> if the system is set up to “gotcha” as a baseline

This is what we have to change. When physicians and hospitals know that patients are scrutinizing care plans they will find a new fairer baseline. That cultural change will subsume older practices.

I'm willing to take a risk there because if my car craps out, I'll buy another.

Wish I can say the same about health. If the doctor who has my entire medical history recommends x procedure, yes I'm not going to risk potentially having irreversible damage to my body.

> If the doctor who has my entire medical history

You think your primary care physician is the one that recommends surgery, and not a specialist?

Huh?? Did I say that?? The specialists I see also have my medical history.

In my example in the grandparent post to yours, it was actually the empathy of the medical provider toward my paying the bill that prevented the unnecessary test.

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