In so many ways, the faith-of-our-father's battle between "socialized medicine" and some "free market" version is passe. These days, the aggressive middle, I would submit, is finding ways to offer guarantees that are wisely constructed to incent efficiency and not to become their own worst enemy.
In this study, Medicare lifts quality by offering program participants "bonus pay".
The new Medicaid part-D program has been doing better than expected in driving drug costs down, an unexpected outcome that warrents further investigation.
In other trials, preventive medicine regimes were able to cut treatment costs significantly.
Driving even 1-2% per year of costs out of US healthcare's overall economic equation is a *huge* difference to long-term projections of the cost of entitlements.
Here's the next set of perverse incentives to rightside:
But his larger point is a perfectly good one: we now know an enormous amount about how to prevent heart attacks, with powerful drugs like statins, smoking cessation, exercise and diet. With the right preventive care, people can cut their risk of a heart attack by up to 80 percent, cardiologists estimate.
“We have made major improvements in prevention,” Dr. Gregg W. Stone, the director of cardiovascular research at Columbia University, says. “But it’s difficult. It takes frequent visits, a close relationship between a physician and a patient and a very committed patient.”
...
There is only one problem with this shining example of a medical practice: it is losing money.
But a lack of insurance is only one of the two huge problems with health care. The other is the perverse system of incentives that nudges doctors and patients toward expensive tests and procedures when cheaper preventive measures might actually produce better results. Partly as a result, costs are rising rapidly for the 250 million people who do have insurance.
sullylink
