In 2016, Medicare will begin shifting from pay-for-service to pay-for-performance

[Hayabusa Rider]

Yeah because self regulation by parties with a conflict of interest works so well?

Of course it can. Not by individuals, but those who know something about what is happening. I'd like to see professionals create a new system for Congress to eventually pass (and that would include health care advocates, actuaries who can compute costs, etc.) combined with modernization of infrastructure and allocation of resources to suit need. I've been on that for years, but people who's self interest is the highest possible, politicians, are doing it.

You won't trust your doctor, but instead those who can't do much better with a budget than a shutdown. I don't think that's wise.

 

[hardhat]

I agree that this new system is fraught with pitfalls-so many that no legislation could possibly cover them all. What I want to know is why we aren't moving away from increasingly complex systems to something like per diem care for a population? Healthcare is so nuanced, and there are so many factors influencing a person's health-many of which are outside of individual control, such as genetic history or quality of drinking water-that trying to make every individual pay their tab according to whether they happen to be sick doesn't make sense. We should be moving to a system of monthly payments based on the total cost of care for the population, and each individual's share of the cost based on his or her controllable risk factors. A person who weighs 300 lbs should pay more, but someone who gets jackknifed by a drunk driver running a red light shouldn't. And a population's bargaining power with a provider is so much stronger than any individual's.