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threethirtytwolast Thursday at 5:21 PM1 replyview on HN

You have got to be kidding me. No one on the face of the earth wants to pay a doctor for time. They want to pay for results.

Nobody is going to pay thousands of dollars for shitty advice or treatments that can potentially kill you... are you kidding me? What human will happily dish out thousands of dollars just to give "time" to the doctor for wrong advice. That has got to be a joke.

>If you want to pay for results only then you're free to negotiate a cash payment contract with your healthcare providers on that basis.

It needs to be law to make it on this basis. Every patient would demand this. The only person who wouldn't demand this is a doctor who's "time" doesn't provide results.

What's going on here is the patient has nowhere else to turn. If every doctor negotiates on "time" and the legal system is set up this way, what other choice does the patient have then to gamble thousands on something that won't work?

Let me explain it to you plainly. The system is set up this way so patients are indoctrinated to accept unfair treatment. They can even be aware of flaws in the system but they still have to accept it because the behavior is so wide spread.

It's similar to North Korea. If everyone in north korea stood up to Kim Jong Un, the sheer number of people getting screwed over vs. people in power is so overwhelming the government would topple immediately. But the system is pervasive. And that is the medical system in the US: Pervasive and systemic. And it goes deeper than just the unreliability of doctors here.

I WANT to negotiate based on results... but thanks to the cartel-like policies of the medical system all together, I can't. Ask any patient... EVERY patient wants this, but none of them can do it. Same as your average north korean... they don't want to starve under an unreasonable regime, but they have no choice.

You may not have realized it but your last sentence was a slip up... Your initial sentences was an attempt to justify time based payment by comparing and contrasting to other occupations like lawyers... but in your last sentence you were essentially (and likely accidentally) telling me to suck it up because I have no choice. That was not something any patient wants to hear.


Replies

nradovlast Thursday at 5:59 PM

You seem to be unclear on the basics of how this works. There's no need for any new laws. If you want to negotiate a value-based care agreement with a healthcare provider instead of paying on a fee-for-service basis then you're free to do so. Existing laws allow for that.

As for your absurd assertions about what every patient wants, you're just lying and making things up. Many patients (like me) don't want that or have no strong preference at all. Your comparison to North Korea is just deranged and bears no relationship to objective reality.

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