Wednesday, June 17, 2009

No can think outside the box on healthcare

I find the debate on reimbursement fascinating in that it assumes essentially the same system as the US has now. That is a fee for service system which is what resulted in the expensive and inefficient system we have now. For example, I do not see any mention of capitation fees, in which primary care doctors are paid a fee based on the number of patients who sign up with them. The fee is to keep them healthy as well as co-ordinate care provided by specialists. People tend to do what is in their personal economic best interest, and the corollary is that when a large group of people behave in the same way it means that the system rewards this behavior. I do not see any interest outside a small group of experts in taking a look at what does and does not work elsewhere, and no real knowledge so that reinventing the wheel has become a requirement.

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