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I am not sure about your two non-coding examples.

There is a lot of effort expended to find non-surgical alternatives to many health conditions. Insurance companies in effect tell surgeons "you should avoid operating on people for this condition unless these other approaches have been tried first" in their reimbursement guidelines.

And the architect Mies van Der Rohe is famous for his precept that "less is more."




There is a lot of effort expended to find non-surgical alternatives to many health conditions. Insurance companies in effect tell surgeons "you should avoid operating on people for this condition unless these other approaches have been tried first" in their reimbursement guidelines.

As far as I can tell, not true in practice. For example see http://www.washingtonmonthly.com/features/2007/0710.brownlee... for some of the history of the attempts to bring sanity to back surgery.

As for insurance companies, they have some interesting perverse incentives going forward. Obama's health care plan says that they have to spend most of the money they bring in on medical care. This is intended to keep them from causing too much overhead. However the flip side is that the potential profit the company and top executives make is directly tied to how much medical care they get people to have, with the costs passed on to companies and consumers who are now legally required to buy insurance.

They will be very interested in making sure that the cost of medical care grows at a known rate. The growth being so that they can make more money. The known rate being so that they actually can make money. They will give public lip service to cost saving measures. But privately that isn't their incentive, and they are smart enough to know it.




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