Obama’s Radical Plan For How Doctors Get Paid
Click here for reuse options!…most American doctors aren’t paid on whether they deliver that improved health. Their income largely depends on whether or not they performed the surgery, regardless of patient outcomes. Their patient’s knee could be good as new or busted as always at the end — but, in most cases, that doesn’t factor into their surgeon’s ultimate pay.
This can make health care expensive, as it provides a big financial incentive to do extra scans and tests and procedures that might not, at the end of the day, improve patient’s health.
Copyright 2015 Liberaland
22 responses to Obama’s Radical Plan For How Doctors Get Paid
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Jake January 27th, 2015 at 17:02
Kinda reminds me of the old joke
Q. What do you call the guy who came last in his class at medical school?
A. Doctor!
FatRat January 27th, 2015 at 18:22
lol
Carla Akins January 27th, 2015 at 17:39
Yeah, I don’t know. Patient health requires equal commitment from the patient and luck of the genetics draw. This is too much like paying teachers based on student performance, there are too many factors beyond their control.
Jake January 27th, 2015 at 17:52
What if we only paid politicians according to how much better our lives are under their tenure.
Carla Akins January 27th, 2015 at 18:22
That would actually make sense but I don’t think Sam Brownback would ever get out of hock.
Robert M. Snyder January 27th, 2015 at 20:04
I am of a mixed mind on this. Let’s use the teacher example, which I think is apt.
Suppose you are one of three eighth grade Math teachers. The students coming into your classroom have spent the previous year in the classrooms of three seventh grade Math teachers, named Samuelson, Johnson, and Anderson, to whom they were randomly assigned. Over a period of years, you have noticed a distinct pattern. Students who studied under Johnson are significantly less well-prepared than those who studied under Samuelson or Anderson, despite the fact that they were randomly assigned to those classrooms.
In real life, things are never quite that simple. Students are not randomly assigned, and other factors can be at play. For example, it could be that Johnson’s classroom is located next to the wood shop, which is very noisy.
So in theory, we should be able to look at statistical measures in order to determine which teachers (or doctors) or the best performers. But why not use the data as a starting point for deeper analysis? If Johnson’s students are routinely underperforming, then somebody needs to ask why. And if it turns out that a noisy wood shop is to blame, then somebody needs to correct that situation. The data are useful, but the teacher (or doctor) are not the only variables in the equation.
But wait a minute! Why hasn’t Johnson spoken up and demanded that the noise problem be addressed? Perhaps if Johnson’s pay increases were directly tied to the performance of his students, Johnson would be more highly motivated to see that the problem is corrected.
It is my understanding that if a Medicare patient needs to be readmitted to a hospital within a certain timeframe for the same condition that was initially treated, then Medicare will not pay for the patient’s original hospital stay. This is intended to provide an incentive for hospitals to ensure that the patient is fully and properly cured. But what if the patient is prescribed an antibiotic that they fail to take after leaving the hospital? Is it fair to penalize the hospital for the patient’s lack of compliance?
Carla Akins January 27th, 2015 at 21:02
The Medicare incentive is appropriate because it covers a systemic workflow, and they don’t provide actual patient care. The patients issue doesn’t have to be cured (like diabetes) but the hospital needs to be able to show they provided the patient with the tools and resources needed to manage their diabetes.
Robert M. Snyder January 27th, 2015 at 21:31
Your response prompted me to research this a bit further. I found this article, which puts things in perspective:
http://kaiserhealthnews.org/news/a-guide-to-medicare-readmissions-penalties-and-data/
This policy sounds reasonable, and far less punitive than I had assumed.
mea_mark January 27th, 2015 at 20:45
I think it should be a factor, just not the most important factor. Maybe something like Doctors who have a high success rate get a bigger tax break for doing good work for the citizens of the country. We just need to be careful that Doctors don’t refuse to treat people because the odds are bad for recovery and success.
Carla Akins January 27th, 2015 at 20:57
But Drs working with the rural poor, coal miners, etc would still be at a distinct disadvantage. I only see it interfering with patient care.
Carla Akins January 27th, 2015 at 18:39
Yeah, I don’t know. Patient health requires equal commitment from the patient and luck of the genetics draw. This is too much like paying teachers based on student performance, there are too many factors beyond their control.
Carla Akins January 27th, 2015 at 19:22
That would actually make sense but I don’t think Sam Brownback would ever get out of hock.
Robert M. Snyder January 27th, 2015 at 21:04
I am of a mixed mind on this. Let’s use the teacher example, which I think is apt.
Suppose you are one of three eighth grade Math teachers. The students coming into your classroom have spent the previous year in the classrooms of three seventh grade Math teachers, named Samuelson, Johnson, and Anderson, to whom they were randomly assigned. Over a period of years, you have noticed a distinct pattern. Students who studied under Johnson are significantly less well-prepared than those who studied under Samuelson or Anderson, despite the fact that they were randomly assigned to those classrooms.
In real life, things are never quite that simple. Students are not randomly assigned, and other factors can be at play. For example, it could be that Johnson’s classroom is located next to the wood shop, which is very noisy.
So in theory, we should be able to look at statistical measures in order to determine which teachers (or doctors) or the best performers. But why not use the data as a starting point for deeper analysis? If Johnson’s students are routinely underperforming, then somebody needs to ask why. And if it turns out that a noisy wood shop is to blame, then somebody needs to correct that situation. The data are useful, but the teacher (or doctor) are not the only variables in the equation.
But wait a minute! Why hasn’t Johnson spoken up and demanded that the noise problem be addressed? Perhaps if Johnson’s pay increases (and the principal’s pay increases) were directly tied to the performance of the students, Johnson (and the principal) would be more highly motivated to see that the problem is corrected.
It is my understanding that if a Medicare patient needs to be readmitted to a hospital within a certain timeframe for the same condition that was initially treated, then Medicare will not pay for the patient’s original hospital stay. This is intended to provide an incentive for hospitals to ensure that the patient is fully and properly cured. But what if the patient is prescribed an antibiotic that they fail to take after leaving the hospital? Is it fair to penalize the hospital for the patient’s lack of compliance?
Carla Akins January 27th, 2015 at 22:02
The Medicare incentive is appropriate because it covers a systemic workflow, and they don’t provide actual patient care. The patients issue doesn’t have to be cured (like diabetes) but the hospital needs to be able to show they provided the patient with the tools and resources needed to manage their diabetes.
Robert M. Snyder January 27th, 2015 at 22:31
Your response prompted me to research this a bit further. I found this article, which puts things in perspective:
http://kaiserhealthnews.org/news/a-guide-to-medicare-readmissions-penalties-and-data/
This policy sounds reasonable, and far less punitive than I had assumed.
mea_mark January 27th, 2015 at 21:45
I think it should be a factor, just not the most important factor. Maybe something like Doctors who have a high success rate get a bigger tax break for doing good work for the citizens of the country. We just need to be careful that Doctors don’t refuse to treat people because the odds are bad for recovery and success.
Carla Akins January 27th, 2015 at 21:57
But Drs working with the rural poor, coal miners, etc would still be at a distinct disadvantage. I only see it interfering with patient care.
Jimmy Fleck January 27th, 2015 at 18:12
Well let’s give doctors an incentive to only see healthier patients that are likely to respond well to treatment. Nothing could possibly go wrong with this right?
Jimmy Fleck January 27th, 2015 at 19:12
Well let’s give doctors an incentive to only see healthier patients that are likely to respond well to treatment. Nothing could possibly go wrong with this right?
FatRat January 27th, 2015 at 19:22
lol
jstsmlbrlcnsrvtvguy January 28th, 2015 at 12:30
I dunno… heard some countries already do something like this… can see how for-profit health insurance companies — which should be illegal — would like the idea of not paying for tests and procedures which someone or another deems to be unnecessary. ????
jstsmlbrlcnsrvtvguy January 28th, 2015 at 13:30
I dunno… heard some countries already do something like this… can see how for-profit health insurance companies — which should be illegal — would like the idea of not paying for tests and procedures which someone or another deems to be unnecessary. ????