The New York Times
Robert H. Frank
Read the article here.
The United States spends twice as much per capita on health care as many other nations, yet achieves inferior outcomes by such varied measures as life expectancy, preventable deaths from specific illnesses, and infant mortality. Much of the performance gap stems from the fact that many of the nation’s 45 million uninsured fail to receive needed care.
The spending gap stems largely from a conflict inherent in how American physicians are paid. Elsewhere, most doctors are salaried. But under most American health plans, including Medicare and Medicaid, doctors are reimbursed according to how many tests and procedures they perform.
Most doctors undoubtedly recommend only those tests and procedures that they sincerely believe to be in their patients’ best interests. Yet those interests are seldom completely clear. And when doctors know that their incomes will be higher if they recommend additional procedures, many may tilt in that direction.