April 14, 2013

WHICH IS LIKE SAYING FARMERS SHOULD CONTROL AGRICULTURE SUBSIDIES:

Docs Told They Must Drive Health System Change (David Pittman, 4/11/13, MedPage Today)

Emanuel drew a gasp from the crowd when he noted the U.S.'s healthcare spending last year -- $2.87 trillion -- makes it equivalent to the fifth largest economy in the world. "We spend more on healthcare in this country than the 66 million French spend on everything in their society," he said.

The federal government's share of health spending through programs like Medicare, Medicaid, and Veterans Affairs equates to the 16th largest economy in the world -- bigger than Turkey, the Netherlands, and Switzerland.

The only way to reduce that spending is to move away from a fee-for-service model that rewards volume over value and quantity over quality, Emanuel said, noting that the fee-for-service system has driven the spending growth that we have today.

"We need to take the responsibility now as a group in pushing for payment change," Emanuel said. "It's the only way we can facilitate the transformation and re-engineering that the system needs and we need to care about."

He called on physicians to "get our house in order" and "collectively campaign" for these changes.

If physicians take the lead, they can enhance their autonomy and design the delivery system they want, but that system will also assign them financial risk.

"I see no way of getting out of that," he warned. "It's not a dilemma. It's just the inherent nature of what it means to assume autonomy."

Modern medicine is just another consumer good, one that is subsidized to the enormous degree that Mr. Emanuel notes. The notion that those selling the commodity to consumers will drive money out of the system is ludicrous.  Only by unleashing the power of consumers can you effect serious change. 

Posted by at April 14, 2013 9:31 AM
  

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