Comment by k_sh | Hacker News Reader

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Comment by k_sh | Hacker News Reader

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The patients don't, but doctors[0][1][2][3][4] and drug manufacturers[5][6][7] and distributors[8] do.

[0]: https://edition.cnn.com/2018/03/11/health/prescription-opioi...

[1]: https://www.healthleadersmedia.com/strategy/doctor-tied-insy...

[2]: http://www.waff.com/2018/08/22/doctors-indicted-overprescrib...

[3]: https://www.kansascity.com/latest-news/article214834685.html

[4]: https://www.hsph.harvard.edu/news/hsph-in-the-news/opioids-d...

[5]: https://www.vox.com/science-and-health/2018/9/7/17831710/ric...

[6]: https://www.masslive.com/news/index.ssf/2018/06/mayors_join_...

[7]: https://www.usnews.com/news/politics/articles/2018-05-16/6-m...

[8]: https://www.theatlantic.com/business/archive/2017/09/opioid-...

So much truth in this.

In Germany doctors have a "budget" per quarter allotted by the public insurers for every patient they treat.

All meds and treatments they prescribe come out of that budget, if at the end of the quarter the doctor ends up being above that budget, then he's stuck with those costs and has pay from his own profits.

In a setup like that, the doctor is held personally responsible for not overprescribing.

Just like insurers only pay a certain amount for meds for certain conditions/treatments. Creating pressure on the pharma industry to also offer smaller packages of drugs, instead of forcing wisdom teeth patients to buy a whole 50 pill bottles.

It's not perfect because it suffers from a bit of the opposite problem of underprescription and doctors being shy about prescribing expensive treatments even when they are needed.

But if that really becomes an issue then patients can just change the doctor, they are always free to do that and never forced to visit a specific doctor.

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