Friday, January 23, 2009

Physician payment, primary care - More Money for Primary Care

Jacob Goldstein of the WSJ Blog on January 22 posted “Where Should the Money for Primary Care Come From?"

The primary care doctors say more money is needed is they are to continue to exist. But where is the money coming from?

Here are Goldstein’s choices.

A: Cut subsidies to Medicare Advantage
B. Pay hospitals less for such high-margin services such as radiology.
C. Lower Medicare reimbursements for care and procedures for specialists.
D. The money shouldn’t come out of existing health care spending.
E. Primary care doesn’t need more money.

These choices call for somebody’s oxen being gored. And in the 51 comments to your blog, a lot of these oxen from across the health care fields are bellowing. My favorite ox is Devon Herrick of the National Center for Policy Analysis who says the money should come from patients themselves functioning outside the 3rd party payment system. But, as we all know, this is unlikely. For we already have a U.S. single-payer system – CMS (Center for Medicare and Medicaid Servives )+ The Specialist-dominated RUC (Reimbursement Update Committee) Taken together they set doctor fees, and the health plans meekly follow.

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