pull down to refresh
43 sats \ 10 replies \ @BallLightning 7 Feb \ on: Public Service Announcement - beware of dentists HealthAndFitness
I was thinking for a long time about healthcare incentives i different systems. If the doctor is paid by an hour, he is incentivised to slack and skip some necessary procedures. If he is paid on work done, he is incentivised to do unnecessary procedures. I don't see how this is fundamentally solvable.
You could pay a doctor/dentist to keep you/your teeth healthy. (Kinda like a subscription, but you only pay when you are healthy) When the patients are not healthy, the doctor makes less money. A doctor with a lot of healthy patients makes more money.
This way, the doctor is incentivized to keep you healthy in the long term.
reply
I've only heard of this but has it actually been implemented? It seems to suffer in that it incentivises letting hard to treat or chromic cases die, as they will never actually be healthy. Type 1 diabetes will surely not be incentivised to be treated that way.
reply
Also - the health of your teeth is extremely tied to your eating habits. If you don't eat sugar, and not many carbs, you will have zero cavities, flat out.
If you're bathing your teeth in sugar multiple times a day, your teeth will suffer greatly.
reply
In most people not cleaning the teeth at the dentist at least once a year will lead to loss of alveolar bone leading to loss of teeth. This will happen even without cavities. It was significant mechanism of tooth loss throughout history and many wild animals today lose their teeth by this mechanism (which in their case obviously leads to death).
reply
I disagree on this one. I just listened to a podcast with Dr Kevin Stock (https://www.kevinstock.io/), a dentist who's also on the carnivore diet.
Apparently there's tons of archeological evidence that before agriculture, people, people had close to perfect teeth and jaw development. Cavities are mostly something that happened post agriculture, and then REALLY took off when sugar became cheap in in the 1850's.
reply
You disagree about the alveolar bone loss?
I've only heard of this but has it actually been implemented?
Not to my knowledge
It seems to suffer in that it incentivises letting hard to treat or chromic cases die, as they will never actually be healthy.
Yeah, I guess such a system cannot be applied universally.
reply
I remember reading somewhere that in China, there was a system whereby a doctor was paid, but only as long as the patient was healthy. This may have been only for emperors, though.
Incentives are REALLY hard to get right.
I wonder how bad the US health care system would be, if there were a robust system of alternatives to regular care? In other words, if the American Medical Association had not been able to act the way it acts currently - basically a giant corrupt union supported by the government, that kills all potential competition?
reply