Rabkin examines health system flaws
Posted 9/16/2009
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Dr. Mitchell Rabkin, CEO emeritus of the former Beth Israel Hospital -- and an active Havard Medical School professor -- takes a look at some of the problems any effort to reform our nation's health care system will face.
In an op-ed in today's Washington Post, Rabkin and John S. Cook point to two major flaws that need to be addressed:
-Fee-for-service payment. This worked reasonably well decades ago when there was less to know, less the physician could do, and less he or she could charge for. But with the abundance of technologies and treatment possibilities now available, fee-for-service is inflationary and will continue to be so. This is becoming widely recognized, but few have come up with effective ways to deal with our nation's ever-rising cost.
-In general, physicians are not accountable for cost. The actions for containing costs are largely in the hands of the insurers. Payment policies, shaped pretty much by Medicare, give insurers the decision on what to pay for and what not, and how much to pay. That has neither controlled inappropriate rise in health care costs nor cut down on unnecessary care.
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