Was just thinking that there should be doctor clubs, where a bunch of people pool their money to hire a dedicated general physician. Or to have a shared tailor, or group cafeteria, or whatever.
The ratio of people covered to specialists would probably determine whether it’s feasible. You’d want the specialist to still get paid a healthy (and guaranteed) salary and to have a more satisfying relationship with customers. And the members of the club to get better service / product than they would otherwise with middlemen taking a cut.
I am sorry but this just sounds like today’s society with nothing new added to it. You just said there won’t be any middleman anymore. And just magiced away a lot of issues, which often are solved by the middleman.
The doctor’s club would still need people to run the club. There needs to be someone your farmers can approach to find an available doctor. They can’t just shout it into the wind.
Your farmers won’t have the logistics to bring their food to the people. They won’t know how much to bring where. They won’t have the equipment to do so. And if you solve all of these issues they won’t have enough time to farm anymore.
Universal healthcare isn’t a new concept and doesn’t require people to buy exclusive access.
And you still talk about compensation but based on your explaining money would be useless. Everyone has free access to these shared specialists.
Well, fair criticism aside, I didn’t say money would be useless. The idea is if one doctor can see a thousand people a year, then a thousand people pool their money and hire their own doctor. Not an infinite service for finding a doctor. (Of course you’re right they still need to find each other and then find that one doctor, which sounds like real middleman stuff) But sort of this less abstract relationship - as it is you pay thousands to health insurance, not a specific doctor, and then when you go to see a doctor they pop in for 5 minutes then off to the next patient.
Wasn’t saying farmers would hire the doctor, was throwing out examples of services. Another one might be a neighborhood cafeteria - how many people can one or two people prepare lunch for everyday, then pool that many guests. Kind a very specific consumer coop.
If you see my other replies here I’m interested in universal healthcare. More was thinking about options because doesn’t seem to be an intermediate step for how far away the U.S. at least is from universal healthcare.
Doctor here in general practice.
This works well in principle. One of many problems here is healthcare need is not spread around uniformly. In your example you just consider number of people and number of providers. This is ok of you are just thinking of primary care (it works like this in many places). It breaks down when there are surges. What happens during flu season? What happens if there is a fire and 30 people need treatment for smoke inhalation. What happens when the doctor needs to take a vacation or gets COVID during flu season? There is redundancy built into a larger healthcare system which makes access more robust over a wider range of conditions.
Also, doctor’s don’t always want to work in all places.it can be harder to recruit doctors to some areas.
There are a whole host of issues here. I agree though that having a middlman take a large cut of money to “grease the system” does contribute to it’s inefficiency. The healthcare system is broken on so many levels that any one change like this would be set up to fail. We need a major overhaul.
Thanks for commenting! Having experienced the difficulty in getting traction on a state level campaign for an unrelated issue, I’m discouraged about the prospects for a nationwide overhaul of our health system, although that’s what I’d prefer to see.
Do you have any thoughts on what the pathway for such an overhaul would look like?
The system we have is built like an unsteady house of cards which is cemented together using ridiculous amounts of money. To dismantle and rebuild it without having to close inner city and rural hospitals would take a decade or more. This means the first step is campaign finance reform and overturn citizens united since the change would have to outlast more than one political regime. Then maybe work one single payor and universal medical record. Many steps from there.
Congratulations you’ve invented communism lol
Just turned to my buddy and said exactly this and came back to see your comment. Literally lol’ed. Fuck whoever is down voting you
Lol well I am a socialist. But to be fair in this formulation money is still changing hands
What you’re describing for healthcare would be direct primary care with a capitation pay model.
Traditional wisdom is that about 1% of a doctor’s patients need care per day, so a doctor with 2000 patients should see about 20 patients per day. This is about standard for your office-based, 20 minute appointment doctors. For direct primary care the number per day is lower: for example, if the doctor does 1 hour appointments, you’d be aiming to see about 8 patients per day, with a panel of about 800.
The doctor is likely going to expect to be paid about $400,000, possibly more if they have employees working for them.
No one is answering your question.
I live in a town of about 5,000 people. General practitioners near me make about $500,000. If everyone was forced to pay in that would be $100 each a year.
But then there would be a lease and an administrator doing the appointments etc… Hopefully the administrator can handle the payments too. Lease $5,000 a month and administrator $5,000 a month. Ooh medical supplies. I’m not sure. $2,500/ month? Still only adds $30/year for those 5,000 people.
1 practitioner would be available on average 20 minutes per person a year (assuming 4 weeks off and 40 hour work weeks) but I bet there’s around 500 people who take up most of the doctors time with their stuff and then thousands that only see them once every couple of years.
To scale up would add another $100 a year per doctor per resident of this 5,000 person team and probably up to 3 or so doctors the other costs wouldn’t change significantly.
It’s an interesting thought. Thanks for asking!
https://en.m.wikipedia.org/wiki/List_of_countries_and_dependencies_by_number_of_physicians
https://en.m.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
Consensus seems to be around 40 doctors per 10,000 population, costing about $6000 per person per year (about half of what the USA currently spends)
Here’s the problem. Let’s say you have a doctor club, where everyone pays the same amount regardless of how often they use the doctor. For people who need the doctor a lot, that’s great. They pay a lot less than they would if they had to pay per visit. For people who just need one checkup a year, they end up paying a lot more than if they just paid for their annual checkup. And they would quickly figure that out, and drop out of the program.
So now the people who are all basically healthy aren’t in your pool anymore. They’re paying for their annual checkup at another doctor. So only the people who need the doctor a lot are paying in. So you have to hire more doctors and increase the cost of the program, because everyone who is in it needs a lot of doctor time.
But then the same thing happens again. People who need more visits a year are getting more out of the program than they are paying in, and people who need fewer visits a year are getting less than they are paying. So the people who need the fewest doctor visits drop out. And so on as the cycle repeats.
You get the idea. There’s a game theory term for this that I am forgetting, but the result is spiraling costs and more dropouts. This is why the ACA (for you non-Americans, that’s the Affordable Care Act, which was attempting to reduce US healthcare costs) had a health insurance mandate. Requiring everyone to be part of the program is the only way to make something like this work.