First few Article Sentences
The healthcare market is scintillating with change. There is the prospect of millions of newly insured, wide adoption of electronic health records, and novel mechanisms to insure efficiency and improved quality. These and many other changes will alter the landscape for many years to come. We at the Western Clinician’s Network are focused on one subject that has not hit the headlines and does not even rise to the level of a cocktail discussion: How does all this change relate to the fundamental law of economics, “You Get What You Pay For.”
In the U.S. physicians are paid either on encounters (when we see patients) or when we perform procedures. As a result, the U.S. system is adept at producing encounters and procedures, but stunted in improving measures of public health or reining in costs. Our most highly compensated medical professionals and most costly healthcare systems provide care that evidence supports is necessary only about 50% of the time. So-called “pay for performance” programs may help rectify the situation but, as reported in the British Medical Journal recently the effort is not likely to succeed even with large investments. The pragmatist must then ask: How do we pursue a system that pays for what we want: measurably improved health of the individual?