By Larry Marsh, Kansas City Star Midwest Voices columnist 2009
Many months ago when this whole health care debate began, President Obama promised to reward doctors for better outcomes and not on the basis of how many procedures they carried out. He promised that patients would benefit from changing the incentive system.
When this debate began President Obama promised to change the perverse fee-for-service system. The only change to incentives noted in President Obama's speech to Congress came in the form of some unspecified restrictions on a patient's right to file a malpractice law suit. This change does not help the patient, it just further distorts the whole health care system in favor of putting more money into the pockets of the doctors without any incentive-based benefit for patients.
Until our perverse health care incentive system is changed in this country, we will continue to find that patients will be further exploited by a system designed to maximize profits whether outcomes for patients are good or bad.
Neither the Republicans nor the Democrats in this debate have adequately addressed this fundamental perverse incentive system. Until they do health care costs will continue to rise rapidly and improvements in patient health per dollar of cost will not improve significantly.
For a more complete analysis of the perverse nature of our health care incentive system click on the following link:
The incentive structure of our health care system is all wrong
or type the following into your browser:
http://voices.kansascity.com/node/5163
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Little Understood; Enormously Important
Mr. Marsh, I truly appreciate you raising this subject. It is among the most important and certainly the least understood and least discussed issue in the debate. At its worst it is the research and development axiom: find a way to treat a condition, you’ve created a customer for life; find a cure, you’ve lost a customer for life.
To a lesser extent it is the incentivization for doctors to order MRI’s and the like because there is a reward (or at least no cost). Fee-for-service is what separates Mayo clinic (which doesn’t do this), for instance, from the rest of the profession.
I have very high regard for doctors; but I spent half an hour in my doctor’s waiting room last week watching a commercial on the HDTV selling various drugs. Better than Jerry Springer, I guess; but had my doctor’s business manager lost his mind?