Monday, January 31, 2011

Money Isn't Everything, Even to Doctors

Time Magazine

Many health policy experts, including those who wrote the Affordable Care Act, believe there's only one thing that can get doctors to change their behavior — money. A new study may blow a giant hole in that belief, just in time to save the government millions or even billions of dollars.

"Pay-For-Performance" is the theory that health care wonks believe could bring the U.S. health care system back from the financial brink. Pay for quality; compensate for competency. If we can just reward doctors when their patients stay or get healthy, we can solve a lot of what ails us systemically. Healthier patients are less expensive to care for and place less strain on the medical system. If doctors are incentivized to keep their patients from getting sick (or sicker), staggering amounts of money and time could be saved. At least that's the theory behind some of the most experimental and innovative provisions in the new health reform law. (More on In Rural Areas, There May Be No Doctors to Tend to Your Sick Kid)

Right now, doctors don't get paid this way. For the most part, the government (via Medicare or Medicaid) or private insurance companies pay physicians for each individual task they perform. There are no penalties or rewards if these doctors choose the wrong treatments or if a patient's chronic disease isn't well managed. The more treatments, surgeries, or office visits a doctor performs, the more money he or she makes. [...]


  1. Impressive personally i think that step taken by an government is too good for both patient and the doctor...

  2. I believe the British tried this method. They gave their doctors a budget and whatever they didn't spend on patient care they got to keep. The idea was that the healthier your patients are, the more money you have left over.
    Didn't work. Doctors just ignored or fired unhealthy patients so they wouldn't use up the money.


    Rav Eidensohn, could you give us your take on this? Rav Malinowitz in Ramat Beit Shemesh instigated bad publicity against a sushi store for not having hashgocho. It turns out they did have a private hashgocho from a Rav Neiman who is also a mashgiach for Badatz Agudas Yisroel. I can't imagine there is anything wrong with this.

    Did Rav Malinowitz have a political agenda? It appears he does. It is well known that Rav Malinowitz has been trying to execute his own contrived cherem against the tzedoko organization Lemaan Achai because one of it's leaders was mefarsem against child molesters. The sushi store is owned by another family that leads Lemaan Achai. There are child molesters in Ramat Beit Shemesh that are being protected. Rav Malinowitz told a public gathering that no one is to go to the police under any circumstances, clearly going against the psak of the gedolei hador. Rav Malinowitz is a major author for Artscroll. The tireless askan grandson of Rav SF Mendlowitz wrote a public letter against Artscroll last week threatening to organize an Artscroll boycott if Rav Malinowitz does not back off Lemaan Achai and badmouthing it's leaders.


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