Perverse incentives.

This is one of the most powerful, most awful things I’ve read.

The root of the problem is that patients are not payers.

It doesn’t take much tinkering to turn that truth into a “silver bullet” for mandatory socialism.

The root of the problem is that recipients are not purchasers.

Okay, so that doesn’t roll trippingly off the tongue.  I’ll work on it.

UPDATE–Just now finished the article.  I’m not an Ayn Rand fan, but the article’s writer closes by quoting her.  And the end of that statement (by an Atlas Shrugged doctor who went Galt) is the best Rand I’ve seen:

“Let them discover the kind of doctors that their system will now produce. Let them discover, in their operating rooms and hospital wards, that it is not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it—and still less safe, if he is the sort who doesn’t.”

About wormme

I've accepted that all of you are socially superior to me. But no pretending that any of you are rational.
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5 Responses to Perverse incentives.

  1. Edohiguma says:

    Well, in 2011 I saw again how bad our system has become when you have to rely on nationalized healthcare. My grandma was in for breast cancer treatment, and, across the board, well… I had to let my mother do that talking and actually walk out of the room or else I would have probably punched someone.

    A doctor telling us “She can’t leave until she has gone through this examination” was pretty much the one point where I was close to really hitting someone. And yeah, she can leave whenever she wants.

    My grandma was 80 then, and she required those rubber stockings for her veins. Nurses failed to put them on in the morning. How can that even be? That’s basic, bread & butter nursing.

    Yeah. It’s insane.

    • wormme says:

      I don’t really know how to respond. Started to say I’m sorry, then realized I’m not. Just angry and resigned. That seems an odd combo, right? It’s like wanting to punch ghosts. Not being an atheist, I’m in awe of your self-control.

      • Edohiguma says:

        Angry and resigned pretty much hits it. I don’t think it’s that odd. When you have to deal with insanity odd becomes the new normal.

        My grandmother passed away earlier this year while I was in Japan. A few days after the mother of the woman I love died from pancreatic cancer. Yeah, timing’s kind of odd. Needless to say I stayed in Japan for that funeral.

        No, it wasn’t the cancer that killed my grandma, it was just that she was almost 82 and just old. It’s normal. I can rationalize it much better than the rest of the family because I’ve seen it a bazillion times. Heck, even the breast cancer surgery was more of a “this can take years to develop, but if you want to be sure…” kind of thing. The cancer that would have killed her doesn’t exist yet, she was just too stubborn for that.

        But the thing there was, from what my mother told me, she was dragged to hospital, got a stomach tube for nutrition (through the stomach wall, yep) and they didn’t really want her to go home. My mother eventually had enough and took my grandma home. A few days later she died. In hospital they’d have kept her alive with that tube, even though she was already pretty gone. Mentally especially. Saw her mother and her dog from 60 years ago, a clear sign that she was ready to go. But yeah, in hospital I know what would have happened there. They’d have brought her back because without clearly defined “don’t reanimate” instruction plastered pretty much everywhere they will bring you back without mercy whether you like it or not.

        Seen it a bit too often myself. The system here, in regards to old people, is as if they have a duty to live, rather than a right to live and die with dignity when their time’s up. Our retirement homes under nationalized healthcare are effectively storage units for old people. 40 beds per ward, 30 immobile patients, that’s pretty normal. Night shift starts washing the patients so that day shift can be done with it before lunch. It’s a government certified, nationalized wasting away.

        Every person I know, who has seen this at one point, says “I’d rather kill myself than end up there”.

  2. Blake says:


    You don’t have to be a fan of Ayn Rand to admit the woman understood all too well where we were going to end up.

    Statists seem to think Rand was writing an instruction book, at times.

    • Agreed, Blake. Her writing on economics/culture/politics/liberty in Atlas Shrugged is beautiful, impassioned, stirs the blood. Her idea of romantic love as revealed by the same book, now that leaves something to be desired. But still it’s well worth the read, until the very very very end, and it’s a long book. 😉

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