In What Bipartisanship Looks Like, Part 1: Healthcare, I waxed poetic about the report What is Driving U.S. Health Care Spending: America's Unsustainable Health Care Cost Growth by the Bipartisan Policy Center. The authors of this publication explore 13 factors that are driving the insane growth of healthcare spending in the US. Number one on the list is: fee-for-service reimbursement.
When we're talking about exorbitant medical fees, we're talking mostly about doctors' fees. Physicians make way more in the US than other developed countries - like about twice as much. What do other countries do to contain physician fees? Many things, including:
- Fees are regulated.
- Healthcare budgets are determined in advance.
- Doctors are mostly on salary and not paid on a fee-per-service basis
- GP gatekeepers control referrals to specialists.
- Defensive medicine is minimized through no fault malpractice systems.
- Defensive medicine is minimized by government-imposed guidelines on diagnostic procedures and treatment.
- Other medical professionals, such as nurse practitioners, assume primary care responsibilities.
There are a lot of lessons to be learned here.
Reference:
International Profiles of Health Care Systems. The Commonwealth Fund May 2017 Edited by Elias Mossialos, Ana Djordjevic, Robin Osborn and Dana Sarnak
General Physician Job Average Salary. Accessed 11/1/2017: http://www.worldsalaries.org/generalphysician.shtml