It is wildly popular to say that the chief culprit in the U.S. health care system is the traditional fee-for-service payment system, which rewards physicians for volume but not quality, leading to high-cost, low-quality health care. It supposedly follows that the fix is a system of “value-based” payments. Despite the popularity of these arguments, both aspects have been shown to be wrong. Studies show that the rising cost of American health ...

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There is an accepted storyline in American health care that is so ingrained in our culture that it is almost beyond question. It goes like this. The chief culprit underlying the high-cost, low-quality American health care system is the traditional fee-for-service payment model, which rewards physicians for the volume of services they provide with no consideration for the quality of care being delivered. The answer, the story goes on to say, ...

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There is growing recognition that the broken American health care system is taking a toll, not just on patients and their families, but on health care professionals as well. Nearly half of all physicians in various surveys now report that they are burned out. Inevitably, the experts are lining up to further study the issue and to teach doctors better coping skills. In terms of the need for further study, I am but a simple country doctor, but I think the ...

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What happens when you place an entire nation’s health care in the hands of an overly-controlling, ineffective government bureaucracy and huge corporations whose mission it is to squeeze as much money from the system, no matter the cost, including people's lives? You get the carnage that is the American health care system. You get my week as a family doctor in the worst health care system in the world. This week a diabetic patient who ...

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The most profound health care legislation enacted since the Affordable Care Act, The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is a huge mistake. It adds another vast layer of bureaucracy to a health care system already overburdened by such things, and penalizes physicians who take care of the most complicated patients. The head of the Centers for Medicare and Medicaid Services (CMS), who administer the program, admits ...

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Results of a study released JAMA Cardiology demonstrated that lower readmission rates among hospitalized heart failure patients, a key focus of recent Medicare value-based payment efforts, were associated with increased patient mortality. In other words, patients admitted to the hospital for heart failure are being re-admitted less frequently, but dying at higher numbers. Value-based pay, as it turns out, where monetary incentives and penalties are tied to ...

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The most common dividing lines in the national discourse on health care reform simply miss the mark. If one looks beyond the partisan posturing, each side has valid points, but also glaring weaknesses. We may need to work together to get health care right. I was recently invited to a political gathering to discuss health care reform. The room quickly divided along traditional lines. From left of the political spectrum, there were ...

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Yet another round of attempted health care reform has come and gone, and once again, failed. And so, the traditional open enrollment season for health insurance is upon us, and as usual, many Americans are facing outlandish increases in premiums, skyrocketing deductible amounts, and shrinking coverage. Americans are increasingly enslaved and endangered by the rising costs and the growing dysfunction. Fixing things is, to put things in the proper perspective, ...

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From the CMS website, October 30, 2017, “Today, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma discussed the agency’s efforts to streamline quality measures, reduce regulatory burden, and promote innovation … We need to move from fee-for-service to a system that pays for value and quality -- but how we define value and quality today is a problem. We all know it: Clinicians and hospitals have to report ...

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If we listen to the president, fixing the American health care system is too complicated.  It is not actually that complicated. The number one issue is cost. Even with many millions of people unable to access care, we already spend close to twenty percent of every dollar in the U.S. on health care. If we hope to include everyone in the health care system, then we need to lower health ...

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