I don't think it has to be binary. For situations that are life threatening, I'll opt for a premium service and for situations that are not, I may opt for an alternative. I think almost anyone at our company can be trained to reliably operate and interpret an x-ray machine for the vast majority of use cases.

'For situations that are life threatening, I'll opt for a premium service'

1 - what does the 'non-premium', i.e. bottomn of the barrel service look like, is that incompetent people offering rock bottom prices (resulting in death?).

2 - are you sure you can identify a life threatening situation correctly? Because my father did not.

3 - how do you know the 'premium' provider in question results in better outcomes, rather than being the same rubbish well presented in fancy packaging?

Re #1 and 3: you have this problem with or without my system (take a look at plastic surgery clinics in Miami for example). Doctors can be incompetent too and the system is so opaque you can’t readily identify or measure the outcome.

I think markets are efficient here and there are plenty of services we operate in now with similar spectrums of quality (food, airlines, general contracting, dental work, etc).

The gap between my position and yours i believe fundamentally is that I believe people can and ultimately should be accountable for their decisions. I suspect you believe they need to be protected by a system of accreditation. I guess I don’t put too much weight into that.

When you own the outcome, you are far more likely to do research, ask questions, compare etc.

2- I’m very sorry to hear that. I believe most people can most of the time. The more people are tasked with doing this, the more likely they will be to invest the time and effort to understand their health choices, seek counsel of others and potentially lead healthier lives.

I too am a bit scarred by the medical system. My sister was diagnosed with colon cancer at 33 and it was discovered “just in time” because she kept rejecting the quick diagnoses multiple doctors in Boston gave her. Had she not self advocated she’d likely be dead. I made a similar mistake when my son was born during Covid. We went into an nyc hospital foolishly thinking that if you are nice, quiet and well mannered you will be treated with respect. My wife went into labor alone in a waiting room where she was abandoned for hours despite us telling them how long she was already in labor and her ringing the help button numerous times. I wasn’t allowed until she went into the delivery room but she never made it there.

The lesson for me was clear 1- do your research 2- be prepared to self advocate 3- doctors are humans. Humans make mistake, they have limited and often flawed memories but unlike software development professionals, they do not have the benefit of being able to deploy state of the art systems, technologies and libraries

Happy to take this offline if you care to. My email is in the profile.