"As example, Liam Yore, an emergency room doctor, notes that emergency rooms pay a lot more for procedures than for so-called "cognitive medicine" like diagnoses and medical management. "Sewing a facial laceration pays far better than accurately diagnosing a heart attack," he writes. "The same principle applies to any procedure — from angiograms to colonoscopies." Start with that insight and it's not hard to build a model in which the ranks of doctors slowly fill with the sort of people who prefer surgical interventions to cognitive medicine because the other people drop out or don't have enough revenue to advertise, popularize, and modernize their practices. Changing that is hard. And Dr. Steffie Woolhandler and David Himmelstein aren't saying anything particularly controversial when they write that "there are a variety of bad ways of paying doctors, but no particularly good ones."
TW: When someone can articulate to me how this challenge can be resolved, is when I will seriously listen the the person explaining their health care reform bill. Again health care providers are rational, like the rest of us they will follow the revenues. It goes without saying though that in the meantime we not only spend our ourselves towards oblivion and provide shaky health care (to those than can afford it).
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