Policy wonk John Goodman raised an interesting question in his health policy blog: who’s at fault for the problems in our health care system? Is it doctors or the payment structure under which they operate?
Goodman, president of the National Center for Policy Analysis, a nonprofit group that bills itself as a nonpartisan public policy research organization, says he believes the payment system needs to be revamped in order to affect better, more efficient care.
He writes:
Our view is that doctors are just like other professionals. They respond to economic incentives. The policy problem: how to change the incentives in the perverse way doctors are paid.
Those who believe doctors are at fault, Goodman says, think doctors are just too stuck in their “imperfect” habits and are unwilling to go the extra mile to achieve better results and lower costs. If you believe that, Goodman says, you believe the public policy problem boils down to “how to get doctors to adopt the best practices, learn to use computers, work in teams, adopt safety protocols, etc. in the face of psychological resistance.”
Food for thought. What do you think? Are insurance providers — from private companies such as Blue Cross Blue Shield to government payers such as Medicare — to blame for our cost and quality issues, not to mention our rampant uninsured?