As this medical gray area expands, researchers are now starting to unravel one of the most paradoxical findings in fee-for-service care.
Here’s how the authors of the Dartmouth Atlas Project describe it: “In regions where there are more hospital beds per capita, patients will be more likely to be admitted to the hospital.
According to one study, just 36% of practicing physicians were willing to accept “major” responsibility for reducing healthcare costs.
Of course, the first step, as with other habits, is to recognize the problem. The Etiology Of Our Fee-For-Service Addiction The current design of the American healthcare system – how it’s structured and financed – dates back more than 100 years. The model worked well for much of the 20th century because most patient problems were acute in nature.
But as people prolong their opioid or nicotine use, dependence grows. And so it has been with healthcare’s fee-for-service addiction.
Breaking the habit will require painful changes for doctors and hospitals.
That’s why only 7% of practicing physicians express enthusiasm for “eliminating fee-for-service payment models.” In response, Dr.
Ezekiel (Zeke) Emanuel of the University of Pennsylvania wrote in a editorial, “Physicians are hesitant, if not unequivocally opposed, to taking bold steps to re-engineer incentives in the system.” Although Zeke and I agree that doctors and hospitals ought to own and address these problems, we have different views on how drastic the solutions need to be.
As with any addiction, America’s dependence on fee-for-service has dire financial and health consequences. If medical costs continue to surge 2% to 3% higher than our nation’s ability to pay, the healthcare system will soon reach a breaking point.
This year, the estimated cost of care for an insured family of four will reach nearly ,000, paid for through a combination of employer health insurance (,259), payroll deductions (,151) and out-of-pocket expenses at the point of care (,534). Businesses, the government and insurers will have no choice but to ration care or slowly eliminate coverage for the nation’s poor, middle-class and elderly populations.