Towards Single Payer, Doctors Get Shafted

The National Commission on Physician Payment Reform issued a report yesterday that calls for the elimination of the fee-for-service (FFS) model used to pay doctors. The Commission declares a nonpartisan status but far left progressives see moving away from FFS essential; they consider it the primary obstacle to socialized medicine.

In March 2012 the Society of General Internal Medicine convened the commission to suggest new ways to pay the nation's physicians.

Steven A. Schroeder, M.D. former president of the left-leaning Robert Wood Johnson Foundation chaired the commission with former Senator Majority leader Bill Frist, M.D. as Honorary Chair.

RWJ funded the commission's report along with the California Healthcare Foundation, another progressive non-profit, and has been an advocate of a single payer system for decades.

Frist, whose father founded HCA Hospitals, contends "We can't control runaway medical spending without changing how doctors get paid...This is a bipartisan issue. We all want to get the most from our health care dollars, and that requires re-thinking the way we pay for health care." 

RWJ's Schroeder who is now a professor of health and healthcare at the University of California says, "The way we pay doctors is profoundly flawed...We need to move rapidly away from fee-for-service and embrace new ways of paying doctors that encourage cost-effective, high quality care. The Commission's recommendations put us on that path."

The National Commission's report title page states "Our nation cannot control runaway medical spending without fundamentally changing how physicians are paid." 

The Commission made twelve recommendations calling for "drastic changes to the fee-for-service payment system." 

The authors blame the high cost of healthcare and the "generally poor" return of investment on the way in which doctors are paid. The report specifically targets as a major problem specialists who have higher reimbursement rates than primary care doctors.

The commissioners know the difficulty in moving towards a fixed-payment model in a society that values the right of the individual along with his doctor to choose any course of treatment. From the report:

It will be necessary to continue recalibrating fee-for-service payments to encourage behavior that improves quality and cost effectiveness and penalize behavior.

The 24-page report also promulgates the standard myths about the American healthcare system. According to the premise of the document, the U.S. is not only plagued by exorbitant costs but "uneven quality."

This enormous investment of resources has not produced a commensurate improvement in the nation's health. At its best, American health care is unsurpassed anywhere in the world.

However, the health status of Americans pales in comparison to other nations.

The World Health Organization ranked the U.S. 37th in health status--behind, among others, Oman, Morocco, and Paraguay. A recent Institute of Medicine study concluded, "Americans... are, on average, in worse health than people in other high-income countries."

In an excellent analysis David Hogberg explains why a general comparison of our healthcare outcomes to other countries is misleading. Such broad generalizations do not take into account numerous factors unique to each nation. For example, concerning infant mortality rates, Switzerland, France and Belgium do not follow the same United Nations' guidelines as the U.S. when including or excluding any infant that shows a sign of life.

The Commission in its report also insists private insurers have higher administrative costs than the government administered Medicare program. The figures usually touted are 2% for Medicare and 13% to 22% for insurance companies.

Dr. Robert A. Book of The Heritage Foundation debunks this "fuzzy math" in a 2009 paper concluding "Medicare administrative costs per beneficiary have substantially exceeded those costs for the private sector, this despite the fact that, as critics note, private insurance is subject to many expenses not incurred by Medicare."

Leftists have spent billions over the last 40 years producing a barrage of propaganda promoting a single payer system. This report is just their latest effort to replace doctors with government bureaucrats. It's full of dangerous half-truths, lies and shady figures. At the end of the road as Hogberg suggests, everyone may have health insurance but very little health care.

Read more M. Catharine Evans at Potter Williams Report