I set aside a fixed amount of money per year that I am prepared to spend on healthcare. At the end of every year I rate my quality of life for that year on a scale of −10 to 10.
If my rating is 10 I give all the money to the doctor. If my rating is 2 I give 2⁄10 of the money to the doctor and burn 8⁄10 of the money. If my rating is −3 then I burn all the money and the doctor has to pay me 3⁄10 of my budget, which I then burn.
If I score 4 or less on the GPCOG (which is NOT to be administered by the doctor) then my quality of life rating is automatically set to −10. For context, the GPCOG is widely used to screen for dementia.
At some point in your life, the doctor(s) in question will be able to calculate that they can make more by doing something else (or by stealing from or blackmailing you) than you’ll pay them in the future for the contracted activities. Money and simple metrics simply cannot create alignment.
This is my proposed solution:
I set aside a fixed amount of money per year that I am prepared to spend on healthcare. At the end of every year I rate my quality of life for that year on a scale of −10 to 10.
If my rating is 10 I give all the money to the doctor. If my rating is 2 I give 2⁄10 of the money to the doctor and burn 8⁄10 of the money. If my rating is −3 then I burn all the money and the doctor has to pay me 3⁄10 of my budget, which I then burn.
If I score 4 or less on the GPCOG (which is NOT to be administered by the doctor) then my quality of life rating is automatically set to −10. For context, the GPCOG is widely used to screen for dementia.
At some point in your life, the doctor(s) in question will be able to calculate that they can make more by doing something else (or by stealing from or blackmailing you) than you’ll pay them in the future for the contracted activities. Money and simple metrics simply cannot create alignment.