I found an interesting article that applies the Prisoner’s Dilemma game to health care reform. In this setup, the doctor is one player, and an overweight patient is the other.  The first choice of the doctor is to cooperate with the patient, and spend his time discussing lifestyle and diet changes.  The alternative is that the doctor spends less time with the patient, and writes him a prescription which isn’t as effective for his overall health. The patient can either listen to the doctor’s advice, or completely ignore his suggestions and find a different doctor.  Ideally, the doctor invests more time with the patient to discuss lifestyle changes, and the patient follows through with the doctor’s advice. While this is the best outcome for both, most likely it won’t happen.

                The patient always wants a second opinion. If the doctor gives genuine advice, it won’t hurt the patient to be reassured by another doctor. If the doctor ignores the patient and writes him an ineffective prescription, the patient is better off seeing someone else. Therefore, doctor can never trust the patient to listen to him. It is in the doctor’s best interest to spend less time with the patient, and just write a prescription.  This cycle creates an environment where patients can’t trust their doctor’s advice, and the doctor can’t trust their patient to listen. There are no incentives for either person to cooperate. This imbalance is in part responsible for our nation’s growing healthcare problem. In order to fix the system, both sides have to be given better rewards for mutual collaboration. I think by legally limiting the use of prescription medicine, doctors will be inclined to discuss natural ways to lose weight with their patients. Also, I think this country needs to see obesity as a condition manageable by proper diet and exercise. Pills are unnecessary and less effective for most people.  People are responsible for their own diet choices, and society as whole is responsible for condemning an unhealthy lifestyle.

http://mindyourdecisions.com/blog/2009/08/18/how-to-improve-health-care-using-game-theory-the-prisoners-dilemma/