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Misaligned incentives. You shouldn't pay your programmers to fix bugs or lay down lines of code, but to produce working software. You shouldn't pay your docto
by Dove 16y ago
Misaligned incentives.
You shouldn't pay your programmers to fix bugs or lay down lines of code, but to produce working software. You shouldn't pay your doctor to treat you, but to make and keep you well. You shouldn't pay your mechanic to fix things, but to make your car run. And you shouldn't pay your dentist to fill cavities, but to keep your teeth healthy.
The DoD calls it performance based logistics. We build a system and promise to fix it whenever it breaks. If it's working X well for Y days of the year, we get paid $$$. Otherwise, we get paid $$ or even $.
It just makes so much sense. It weirds me out that maintainence is handled any other way. It's just begging for vendors to take advantage of consumers who don't know any better by selling things that are useless or even harmful.
- Perceval 16y agoYour scheme only works if the dentist can control for your genetics and veto your daily decisions to drink Coke, eat candy, and 'forget' to floss. But if your daily habits sabotage the efforts of a doctor who sees you only twice a year, the performance based logistics model doesn't really work.
- Dove 16y agoThe auto insurance industry seems to have figured out how to encourage drivers to behave safely. They say, in effect, "Based on what we know of your lifestyle, habits, and past rate of accidents, it will cost you $300/mo for us to assure your access to a functional car." Don't see why dentistry should be any different. My auto insurance gives me about $8/mo off for having anti-lock brakes. My dentist could give me $X/yr off for brushing. (And he can tell...) And of course, in general, I'm not trying to sabotoge his efforts. I want to be healthy as much as he wants to be paid. That is, after all, what I'm paying him for. If anything, it encourages him to encourage me to develop healthy habits.
- thailandstartup 16y agoHow about using one dentist to recommend what work needs to be done, and checking the quality, and using another dentist to carry out the work?