Comments on: NEJM on Medicare reimbursement: "No easy fix in sight" http://www.kevinmd.com/blog/2007/05/nejm-on-medicare-reimbursement-no-easy.html medical blog Mon, 23 Nov 2009 01:35:28 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2007/05/nejm-on-medicare-reimbursement-no-easy.html/comment-page-1#comment-74808 Anonymous Wed, 09 May 2007 11:43:00 +0000 http://clients.emmense.com/kevinmd/2007/05/nejm-on-medicare-reimbursement-no-easy-fix-in-sight.html#comment-74808 Centralized planners can never never set prices that are an accurate reflection of real costs and value in a complex marketplace. When a marketplace sets prices, the end result is a number that communicates costs relative to value that are the end result of a complex web of other economic considerations completely out of sight of the two participants and far too complex for any committee to appreciate.<br/><br/>It is not that RVS is poorly done, it is rather that it is a flawed idea. Furthermore, it puts practitioners in the position of an internal struggle for social-political power relative to each other as the path to improving ones compensation. Society is better served when the focus is the production of better value for the patient/customer. Centralized planners can never never set prices that are an accurate reflection of real costs and value in a complex marketplace. When a marketplace sets prices, the end result is a number that communicates costs relative to value that are the end result of a complex web of other economic considerations completely out of sight of the two participants and far too complex for any committee to appreciate.

It is not that RVS is poorly done, it is rather that it is a flawed idea. Furthermore, it puts practitioners in the position of an internal struggle for social-political power relative to each other as the path to improving ones compensation. Society is better served when the focus is the production of better value for the patient/customer.

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