The Future Of Healthcare

November 6th, 2013   Submitted by doctorcoin


Unlike many in the society believe, the true future of healthcare lies not in it being free to all, but rather in it becoming cheaper and more accessible to all. Governments, of course, are unable to do that, since they only redistribute money and don’t innovate. But also, this future in which healthcare is cheap and accessible is actually not so far away. In fact, it has become a reality anyone can experience right now and the only question that remains is how long does it take for people to catch up with this reality and how fast the changes are going to spread within the industry.

When people notice an initial problem, they don’t usually immediately go see a doctor. That happens for various reasons: they don’t have the money on hand, the doctor is far away, the problem seems insignificant and not worthy of a doctor visit. And sometimes it’s not even a problem at all, but rather a question about staying healthy. When one finally decides to visit a doctor, they spend a lot of time with the doctor discussing the symptoms and the patient is not always honest, because they’re ashamed or simply forgetful. Time is wasted on both sides. The doctor also doesn’t have enough time to contemplate the symptoms or the advice they are pressured to give to a patient right away. Of course, the obvious solution would be to let people describe symptoms and ask questions online. The problem with this solution, however, is rather familiar to us: regulations and the current legal framework.

First of all, doctors are actively discouraged from giving advice outside hospital, because a patient may sue and then it’s the doctor’s personal problem, not the hospital’s. Also, med students are not allowed to advise patients even if they have enough knowledge already to handle some simple cases. Finally, doctors are very unlikely to recommend a more effective treatment if it’s potentially more risky, even if a patient is willing to take the risk, because of the possibility of a lawsuit.

All these problems arise from the fact that government is a monopolist in the consumer protection market and can prohibit people from giving advice either directly by licensing doctors, or indirectly by favoring patients in lawsuits and forcing all medical providers to conform to the same cumbersome regulations, rather than allowing competition in the area of quality standards.

The presence of such a monopolist raises prices, making this first visit to a doctor a lot more expensive than it should be. This situation, which limits the choices and makes things more expensive, inevitably hurts both patients and doctors (especially young ones).

The problem of high prices and the presence of a monopolist can be fixed by allowing doctors to be anonymous, but that creates two new problems: if you allow doctors to be anonymous then how do you pay them, and how do you know they are real doctors? The first one is currently rather simple to solve: Bitcoin. The second one is slightly more complicated, but nevertheless quite possible to tackle. In order to explain how, we must first look at how the system currently works.

The way it works today is that a government bureaucrat issues licenses to doctors. However, a bureaucrat is not qualified to assess whether doctors are good enough. They simply trust senior doctors in their assessments of medical students and issue licenses based on their opinion. Of course, government still puts in place requirements which senior doctors must use to assess medical students. A system in which senior experienced experts asses young specialists is a good idea. The bad idea is the monopoly on issuing licenses, which makes the market inefficient and more expensive.

Now imagine you could have a structure in which senior doctors could still assess young doctors, but the rules and standards by which they assessed them could be altered depending on which organization verifies that assessment. Even more interestingly, what if those assessing young students had more financial incentives to assess students correctly and diligently? What if we could tie a doctor’s additional income to his students, so that part of what a young doctor earns goes to the doctor who assessed them? If, for example, a student turns out to be an awful doctor despite the senior doctor’s assessment, then not only does this doctor lose additional income, but also the license issuing organization they work for may fire them. All this could be done without any fear of lawsuits or imprisonment which usually comes from government institutions.

Another interesting side-effect of the presence of a monopolist is that it is rather complicated to receive second or even third opinions. Because doctors are obliged to preserve doctor-patient confidentiality and patients do not have the time or money to visit dozens of doctors, this means that a doctor’s opinion may remain unchallenged. But what if a doctor’s opinion was published online for anyone to see, while keeping patient’s identity secret? What if other doctors, possibly from other fields of medicine, could review it and point out possible mistakes in it, or recommend an alternative course of action? Wouldn’t that add to the pool of choices a patient has?

Again, all of this is possible today. How? Welcome to CoinMD. It’s basically a website where doctors answer questions. Asking a question is free, but if you want to incentivize doctors to answer faster, you can donate in Bitcoin. All questions and answers are public, so anyone can judge the quality of the answers our doctors give. We’re only in the early stages of the project, so currently all of our doctors are hand-picked by the website administration. It’s a very close team. Later on, when the site grows, we will start allowing doctors to hire others – according to the principles described above – all the while allowing everyone to stay anonymous. That is, even though we don’t know who those doctors are in real life, we’ll be able, by looking at their answers, to store various measurements of their reputation and experience. Thus achieving an important goal of detaching reputation from identity.

The important implication of our approach is that it will be possible to create a completely private consumer protection organization whose first and foremost interest is in serving its customers. If customers are unhappy because our doctors are not good enough – we go out of business. Thus our emphases in the future should be on instituting procedures for assessing and hiring professionals. Those procedures will be defined by us, of course, but ultimately dictated by the market – which is you.

As a logical development of the idea, we foresee the emergence of a doctor-to-doctor market, where doctors pay other doctors for expert opinion about certain cases. This would further liberalize the market and make doctor’s advice more reliable for the consumer.

One of the most important doubts people may have about such an anonymous service is whether a doctor giving advice is indeed liable and what happens if a person hurts themself or dies following such an advice. While this is a legitimate concern, we believe that there is a stark difference between advice and action. One should not be able to hold a doctor liable for simply giving information. If you voluntarily agree to receive such information, then ultimately you bare the responsibility of acting on it. While a harsh statement for some, we believe that such an arrangement is able to save millions of lives worldwide. A person in Cambodia doesn’t care about liability, they care about help. We believe we can help and no one should have the right to deny a person this help. As with the FDA, government agencies are only interested in outcomes that don’t hurt their reputation. If a million people die because they haven’t received an experimental drug, this won’t be in the newspapers.

At CoinMD we believe it is time to put the disruptive power of Bitcoin to use in one of the most essential markets: healthcare. Governments not only stifle innovation in this market, they deny millions of people all over the world opportunities to be healthy and free of debt. We provide it, and we welcome you to join us.

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4 Responses to “The Future Of Healthcare”

  1. Seth KingNo Gravatar says:

    You are doing God’s work. Inevitably you will be lambasted by the mindless dolts who cannot fathom anything radically different from the status quo, even though everybody is unhappy. Furthermore, you’re likely to be challenged by the current medical cartels. So, please, PLEASE do your utmost to remain anonymous!

    Speaking of anonymity, why didn’t you choose to open your operation on Tor or i2p?

    And lastly, please hire a high-skilled web developer. Your site needs a lot of work!

  2. TylerNo Gravatar says:

    Excellent ideas

  3. Lee KNo Gravatar says:

    Wow, this is even more radical than what I Imagined a while back:

    Good luck, and let’s hope the state doesn’t take down your site.

  4. Craig J. BoltonNo Gravatar says:

    This is about 90% correct. What is not correct is the detailed government involvement in deciding how many medical schools to accredit, how many students to admit to each class in such medical schools, how many hospitals to certify, when a medical student can start up his own practice and give medical advice, etc. All those decisions are made by “senior doctors” and then rubber stamped by government. They are not made by nondoctor bureaucrats. Medicine in the US is a “self-regulated profession.”

    The fix is also much simplier than you imagine. It is simply to replace regulation by certification at all levels of medical care. You can demonstrate certain knowledge and skills you become a doctor. If you can’t demonstrate everything, you become a certified specialist regarding that part of medicine you do know and can practice.

    End of story.