Belmont Club » The murky future of healthcare

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Belmont Club » The murky future of healthcare.  My dear wife sent me this link and it’s got some really good ideas.  He’s a doctor, and I’m not, but aside from one appalling arithmetic error (10k x 25m does not equal 250m) it seems to make a lot of sense.  I have heard from a variety of other sources that part of the problem with our physician distribution is that MediCare payments actually encouraged a growth in specialists so we can argue about the need for more GP’s vs more specialists later, but that doesn’t diminish the importance of his ideas overall.

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2 Responses to “Belmont Club » The murky future of healthcare”

  1. Oh, Bother Says:

    Medicare will reimburse those procedures it deems worthy, and will pay more for procedures it values more. It may be that when Medicare established those reimbursement rates the line between generalist and specialist doctors was more brightly drawn. I will say that the first time I encountered a specialist procedure performed in a generalist setting was the mid-1980’s.

  2. Oh, Bother Says:

    I don’t know why that posted early. Forgive me.

    CMMS (Center for Medicare and Medicaid Services), along with the AMA and another proprietary body called AHIMA establish and enumerate the acceptable procedure codes, and assign reimbursement rates to those codes. Many people would give a great deal of money to know from what orifice they pull those rates. But here’s a clue: they’re set by … specialists! Yes, another proprietary group within CMMS that is dominated by specialists gets that job. Please see the attached for a clearly-written discussion: http://www.thehealthcareblog.com/the_health_care_blog/2008/05/more-on-physici.html

    Please don’t miss the comments. The third comment sheds light on the inevitable failure of a two-tier system of reimbursement. Bear in mind that another, different yet still two-tier system is what ObamaCare purports to establish. Conflict between the two tiers is being built into the system. CMMS sets the reimbursement rules. M question is, where do they expect to find enough doctors to staff their single-tier system?

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