The Boston Globe has come down in favor of replacing the fee for services compensation system with a capitation system:
PAYING FOR healthcare on a fee-for-service basis is an inflation engine that, unless something changes, will cause health spending in this state to double by 2020. A legislative commission wants to replace fee-for-service with per-capita payments that would be handled by groups of healthcare professionals with full responsibility for an individual’s care. One-fifth of doctors in the state are already paid this way. Making it the norm could be the secret to better, less costly medicine.
Ideally, this shift in incentives will mean that a patient, for instance, will leave a hospital with enough discharge support so that she won’t be re-admitted a week later. Or, a primary-care physician checking an overweight patient for a strep throat will have enough time to talk to the patient about exercising more to lose some pounds. A well-crafted “global’’ payment system should pay for such preventive measures in ways that fee-for-service does not.
Their solution for the problems with capitation I’ve pointed out? A review committee:
A first step will probably be legislation to create some kind of public board or authority to work out the specifics of the sticks and carrots that would wean providers from fee-for-service. One carrot will have to be tax credits or outright subsidies to speed up doctors’ and hospitals’ adoption of electronic medical records. Such records are crucial to the coordination that accountable care organizations should be able to provide.
To help ensure that any new payment system produces better care and not just cheaper care, the oversight panel should include at least one representative of a consumer group.
It may not be fair or democratic but it’s bound to be opaque. That’ll be a marked improvement over the unfair, undemocratic, and opaque insurance companies.
BTW, did I mention that Massachusetts is planning to right the wreck of its state healthcare system by throwing 30,000 legal immigrants overboard? See below.
I’ve always said, if you want a faster more efficient system……….form a committee. yeah, right.
My favorite quip about committees is that a committee is a group of people who can’t do anything individually who meet to agree that nothing can be done.
I can’t tell you how many committees I’ve railroaded by coming in with a fully formed plan.
…fully formed plan.
Which is a variant of “A committee should be comprised of three people, two of whom are absent.”
Looks like the healthcare debate is really going to bring to the surface the US’s apartheid policies toward immigrants.