Could the depressed economic climate actually be a positive factor for health care reform?
Though distressing and painful, the economic downturn will provide an impetus for more robust health insurance reform and health care delivery reform than would otherwise be possible. What cost cutting measures might be best accepted? Transferring the financial consequences of flawed care to those best positioned to improve it. For example, I’ve encouraged federal legislation that would allow Medicare to pay hospitals and their medical staffs a fixed price for hospitalization and the 30 days following discharge. It would enable doctors and hospitals to benefit financially if they lower hospital readmissions due to preventable complications and suffer if the frequency of readmissions rises. Similarly, physicians who succeed in lowering the frequency of costly health crises for chronic illness patients should share in insurer savings. How might less technology and better bedside diagnosis reduce costs? As Dr. Abraham Verghese recently wrote, careful attention to physical examination find
