LyrArc Article Gist
Barry Schwartz, a Psychology Professor at Swarthmore College, and author of Paradox of Choice: Why More is Less, points out that the 35 years of research shows that you get exactly what you pay for, but it turns out to be the opposite of what you want, and there are a lot of ways that incentive based compensation can go wrong. In theory choosing a parameter like share price and creating incentives to promote shareholder interests through higher share price as a measure of executive performance is reasonable, but it assumes that there is no manipulation of share price, or other external factors do not distort the measure of performance. In reality you get a situation like Merrill Lynch and other financial firms that gave out huge bonuses and executive pay even while bad decisions- that were later to sink the firms- were being incentivized. Schwartz points to research worldwide by Bruno Frey, Oberhozer-Gee, Uri Gneezy, James Heyman and Dan Ariely, that shows that incentives tend to remove the moral dimension from decisionmaking. Heyman's reaearch showed that when people offer passers by a token payment for help lifting a couch from a van, they are less likely to lend a hand when they are offered nothing. The question people ask themselves he says when money isn't part of the equation is very different he says: what are my responsibilities, what should I do that will fulfill these responsibilities to other people and to my country? In his view even though we put a lot of faith in incentives as a society to influence behaviour in a positive way, they actually do the reverse. Even if they work for some time, after a while some people who have fewer scruples learn ways to game the system and gradually distort the way it functions, leading to perverse results endangering all....

LyrArc Article Gist
The costs of fraud in medical care from spurious Medicare claims to kickbacks for unecessary services is estimated at $125 to 175 billion. Costs of unnecessary care from overuse to unnecessary lab tests are between $250-325 billion. The amount wasted for on treatment for preventable conditions such as heart disease and diabetes. is $25-50 billion. This number is much higher when all the complications from obesity are figured in. These amounts alone add up to $500 billion. Add to it the problems and the costs of medical errors leading to bad drug reactions or other misdiagnosed procedures which cost an estimated $75-100 billion and the the total is upto $600 billion. These amounts are not going to be tackled by computerization of medical records. The whole manner and ways in which medicine is practiced today and the manner in which the public takes care of its health would have to change for an impact to be made in these numbers.