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Letters |1 September 2009

Toward a 21st-Century Health Care System: The Devil Is in the Details

Robert M. Hansen, MD, MBA

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Potential Financial Conflicts of Interest: None disclosed.
  • From Redding Anesthesia Association Medical Group and Therapeutic Pain Management Clinic, Redding, CA 96001.
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Potential Financial Conflicts of Interest: None disclosed.
TO THE EDITOR:
The first recommendation in the article by Arrow and colleagues (1) to replace fee-for-service payment with an alternative, such as capitation, would require revolutionary changes in how physicians are organized among themselves and how they relate to hospitals and other facilities. Although the Kaiser Permanente model exists, most physicians in the United States practice fee-for-service medicine. The vague description of a payment system that enhances innovation, which is a laudable goal, requires concrete details. In addition, no evidence exists to suggest that capitated systems promote innovation. Anecdotally, the opposite is...
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Hansen RM. Toward a 21st-Century Health Care System: The Devil Is in the Details. Ann Intern Med. 2009;151:366. doi: https://doi.org/10.7326/0003-4819-151-5-200909010-00022

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Published: Ann Intern Med. 2009;151(5):366.

DOI: 10.7326/0003-4819-151-5-200909010-00022

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