Our main problem in health policy is overemphasis on medicine (2007)

This is why we need medical payments to be capitated, not fee for service. The way medical care currently works has horrible incentives. Medical providers have an incredible informational advantage so patients just do whatever their doctor tells them. Since doctors get paid for doing things they routinely tell people to do things that are proven to have little efficacy. Medical providers should instead be paid per patient they cover. Especially now that hospitals are so consolidated it&#x27;s relatively easy to tell if health outcomes are better or worse than average over the group of patients they cover. By punishing providers for achieving bad outcomes and sharing the savings they obtain by cutting waste we can drastically reduce healthcare costs.<p>Medicare and Kaiser permanente are leading the charge with this style of insurance and have already shown it to be cost effective while not reducing the quality of outcomes.

One thing this article misses are medical procedures that improve the quality of life, but have no bearing on life expectancy.<p>For example, if you knock out your front row of teeth, not only do you look weird to people (a pirate), but also you can no longer easily bite into a hamburger, and your speech is impacted. You will have trouble pronouncing words that contain &#x27;v&#x27;, &#x27;th&#x27;, or &#x27;f&#x27;.<p>Getting implants is not going to increase your life expectancy, unless you live in a society devoid of knives (our external teeth). But the increase in quality of life is often worth it.<p>That being said, in the US dentists seem to take way too many X-rays. They take X-rays before the doctor even sees you. Then the doctor tells you what you could have told them.<p>Source: personal experience.

(OP here)<p>This essay set may superficially appear to be another repetitive salvo in the interminable US healthcare political conflict, but I recommend reading a bit deeper. I think the perspective these essays offer (that, at the margin, medical spending doesn&#x27;t affect people&#x27;s wellspan much, at least not in the US) is both quite important and underrepresented in most discussions of healthcare.

A lot of $ is spent on medicine because medicine works. Alternatives such as diet, exercise either are spotty in efficacy or do not work. Medicine offers a quick fix and in some cases the only fix. Someone who has cancer will need to be treated with medicine, not diet.

(2007)