Ask Lemmy

The logic is sound, but as you extend the idea, the group starts selling access to their doctor, and you basically pay a subscription for a doctor, and then you just have insurance by another name. It wouldn't be corrupt like modern insurance, but that's just because it's new, not because it won't get there, unless specific steps are taken to prevent that.

Really, the only thing thatt actually accomplishes here is you've removed profit and CEO nonsense from the equation. A community that implemented and organized all these potential communal services would just be a commune. Nothing wrong with that at all, we need more communist principles in our lives.

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.

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.

Congratulations you've invented communism lol

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!

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.

Farmers specifically? One doctor could probably take all the farmers within a couple hour drive on the interstate. That would only be a few land owners but the workers too with a nurse