tinokid (u/tinokid) - Readit News

tinokid commented on Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks fortune.com/2018/03/10/je... · Posted by u/MilnerRoute

csallen · 7 years ago

I never complained about the punishment, nor did I equate the punishment itself to emotional thinking. What I called emotional and dangerous was the unsupported claim that the punishment wasn't enough to be an effective deterrent and should therefore be increased.

tinokid · 7 years ago

And that is the claim I was contesting. You seem to have an odd intuition that a line of argument that does not reduce to a computing problem is "emotional". Even if one does not believe in retributive justice at all, an adequate deterrent is still going to be in proportion to the seriousness of the crime. It's not something that admits of a resolution by facts and figures alone.

tinokid commented on Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks fortune.com/2018/03/10/je... · Posted by u/MilnerRoute

csallen · 7 years ago

I'm just not sure what you're responding to. Is anyone here saying or even implying that four years is cruel? Is anyone feeling sorry for the doctor?

tinokid · 7 years ago

Well you yourself said it reflected the same kind of "emotional thinking" that led to millennia of "torture and abuse". What I am trying to show is that there are plenty of good reasons for this kind of punishment (whether or not one accepts a retributive component to justice). It is not simply a knee jerk insensitive reaction.

tinokid commented on Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks fortune.com/2018/03/10/je... · Posted by u/MilnerRoute

csallen · 7 years ago

Nobody is "concerned" about the convict's reputation and future employability. You are misreading people's statements and thus misunderstanding their points. Namely, that the justice system serves a greater purpose than simply making you and me feel better and causing harm to perpetrators.

What point is there in discussing the so-obvious-it-goes-without-saying good-bad polarity of this situation? If we myopically give in to our emotions, rather than dispassionately examine the best course of action, then we'll miss an opportunity to improve the system and deter future incidents.

Stated another way, by attempting to redirect the course of this conversation, you are saying that virtue signaling by pitying current victims and demonizing the perp is more important than preventing future victims. If anything is highly disturbing, it's that.

tinokid · 7 years ago

You're missing the point because you don't understand the gravity of the crime.

A minimum wage fast food worker is constantly observed by a phalanx of cameras that will incriminate her should she attempt to steal five dollars from the till, but a surgeon in an operating room performs an infinitely more consequential task with nary a recording device in sight. Why? The immense trust and responsibility invested by society in medical doctors.

There is a common misconception that a medical license is basically just a reward for a demonstration of technical mastery, much as a developer job flows from passing a coding interview. But in reality the technical aspect is only secondary; the primary purpose of all those years of training is to ensure that the student understands the fullness of the obligations associated with the profession and is properly disposed to accept them.

In a case like this, the person understood and accepted those grave obligations, as well as all the privileges that came with them, only to toss them out the window when the opportunity arose to make a few extra dollars. That is what is being punished here. Four years is hardly too long, or cruelly retributive.

tinokid commented on Doctor Gets 4 Years in Prison for Insys Opioid Kickbacks fortune.com/2018/03/10/je... · Posted by u/MilnerRoute

koolba · 8 years ago

It’s really not. Four years is hardly a deterrent. It’s barely a slap on the wrist considering the number of lives destroyed by that plague.

What’s makes this particularly heinous is the trust we place as a society in medical providers. The vast majority of people will take whatever medicine a doctor prescribes. No questions asked. Abusing that position of power is sickening.

tinokid · 7 years ago

This is absolutely correct and should not have been downvoted.

It is the abuse of a position of trust that aggravates this crime relative to that of a simple outlaw street dealer.

Commenters who are concerned with the effect on the convict's reputation and future employability are simply not in touch with reality....this was a grave breach of the basic ethics of the medical profession and seriously harmed the innocent patients involved. There is no return to work after something like this...any more than with a scientist who falsifies data, a teacher who sleeps with minor students, a lawyer who steals from escrow, etc.

I find it highly disturbing that there is more discussion in this thread as to the effect on the doctor's return on investment from his medical degree rather than on the individuals who bodies were damaged by someone they were supposed to be able to trust.

tinokid commented on Unnecessary medical care is harming patients physically and financially (2015) newyorker.com/magazine/20... · Posted by u/oftenwrong

skadamou · 8 years ago

> "3) when provided by a doctor whose track record is demonstrably non-inferior to that of other practitioners"

This is interesting. I think there will always be a somewhat normal distribution of medical skill among doctors so how do we decide whose track record is good enough to preform which procedures? We probably don't need top preforming doctors to implement every procedure but then how do we decide which procedures warrant a top doctors time? And if there is a shortage of qualified specialists in a region or if something is particularly urgent isn’t an under achieving doc better than no doc at all? Maybe. Maybe not. I think there is a lot of gray area here. I guess ideally the hope would be that the distribution of skill among doctors is really narrow so the difference between top docs and bottom docs is not that pronounced. Even still, I think there are some interesting problems around ranking/rating doctors against one another.

tinokid · 8 years ago

Right, it's not easy and there are adverse selection issues when you start incentivizing doctors to avoid complex cases that are more likely to involve complications. And the scientific basis for a given procedure is likely more important than minor variations in doctors' technical competence levels.

That said, insurers have better insight into this than almost anyone else. If they see a young person with almost no medical claims go in for an elective foot surgery with Doctor Lexus, and then all of a sudden that person is attending physical therapy and filling opioid prescriptions every month, that's a bad sign. If it happens more than once, insurers should feel empowered to go ahead and shut the good doctor down. But this does not happen.