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...guest list. Joining the CEO at the intime gathering of 20, according to the flier, would be "Obama administration officials, Congress members, business leaders, advocacy leaders and other select minds," plus "health-care reporting and editorial staff members of The Washington Post." In other words, for a fee, businesses and lobbyists could have access to the sort of high-level opinion makers that the Post has access to as well as the journalists, all in a cozy, off-the-record gathering, where they could "build crucial relationships with Washington Post news executives in a neutral and informal setting." The flier...
Undoing these waste-promoting incentives - the "fee-for-service" payment system that awards more fees to doctors and hospitals for providing more services, and the regulated electricity rates that reward utilities for selling more power and building more plants - would not solve all our health-care and energy problems. But it would be a major step in the right direction. President Obama has pledged to pass massive overhauls of both sectors this year, but if Congress lacks the stomach for comprehensive reforms - and these days it's looking like Kate Moss in the stomach department - a more modest effort...
...give providers incentives to keep us healthy and reduce unnecessary treatments, to encourage doctors and hospitals to promote a culture of low-cost, high-quality care. One reason the Mayo Clinic already provides low-cost, high-quality care is that it keeps its doctors on salary, insulating them from fee-for-service inducements to overserve; unfortunately, Mayo is hemorrhaging cash on its Medicare patients, because the current system penalizes responsibly conservative care. Doctors don't get paid for thinking about a case or returning a phone call or explaining why an MRI isn't necessary; hospitals don't get paid...
...supposed to incentivize HMOs to keep us healthy, but it slashed needed as well as unneeded care in a frenzy of willy-nilly cost-cutting and short-term profit-taking, triggering a national backlash. And if Congress gets into the details of what would be reimbursed under a new fee-for-quality structure, the same interest-group politics that have distorted and ultimately paralyzed the current system could dominate the new system; that's why Obama has proposed to depoliticize those decisions through an independent agency similar to the military-base-closing commission. Still, changing the dysfunctional payment system while...
...Still, those savings could mean the difference between national solvency and fiscal catastrophe, so Obama is targeting two major barriers to data-driven medicine. The first is the perverse "fee-for-service" incentives that now plague our health-care system: hospitals get paid more if you stay longer and come back often; doctors get paid more if they do more tests and procedures - and you come back often. More services, more fees. "You've got to follow the money," says former Senator Tom Daschle, Obama's initial choice for health czar. "We reward volume, so that's what...