Rather than reform the AMA's committee for setting fee-for-service pay, let's scrap it entirely and put docs on salaries that reflect their contributions to overall health
Thank you for your critical take on physician payment reform. It is an essential part of the brokenness of American medical care. I especially agree with your last sentence’s premise that the objective should be “promoting the overall health of individuals and the nation as a whole.”
I am a retired Family Physician whose career spanned the beginning of ’managed care’ to the complete financialization and monopolization of a new Medical Services Industry based on the premise of greed before care. Much of my experience was caring for the underserved in an underfunded safety net systems and working in the ”belly of the beast” in health insurance witnessing the evolution of its piracy first hand.
It broke my heart. We can do better.
As long as we focus on physician reimbursement we continue to empower the premise that physicians are and should be the drivers of health care. It is part of the reductionist and episodic paradigm that prevails in systems captured by financialized neoliberal end-stage capitalism.
When healthcare is first about money, physicians have allowed themselves to be captured by a financial system which, in return for assured, continuously growing reimbursement, physicians discarded their role of health professionals to become ‘providers’ of medical services in a system which focuses on wealth extraction from ‘consumers’ (formerly patients), businesses, and government. Actual health care is a collateral product. Incidental to the primary business.
Of course physicians should be salaried, but they deserve a better system to work in. A system where health professionals can serve the whole health of the population, not corporate masters. America is not ready yet to have that conversation.
Thank you for your critical take on physician payment reform. It is an essential part of the brokenness of American medical care. I especially agree with your last sentence’s premise that the objective should be “promoting the overall health of individuals and the nation as a whole.”
I am a retired Family Physician whose career spanned the beginning of ’managed care’ to the complete financialization and monopolization of a new Medical Services Industry based on the premise of greed before care. Much of my experience was caring for the underserved in an underfunded safety net systems and working in the ”belly of the beast” in health insurance witnessing the evolution of its piracy first hand.
It broke my heart. We can do better.
As long as we focus on physician reimbursement we continue to empower the premise that physicians are and should be the drivers of health care. It is part of the reductionist and episodic paradigm that prevails in systems captured by financialized neoliberal end-stage capitalism.
When healthcare is first about money, physicians have allowed themselves to be captured by a financial system which, in return for assured, continuously growing reimbursement, physicians discarded their role of health professionals to become ‘providers’ of medical services in a system which focuses on wealth extraction from ‘consumers’ (formerly patients), businesses, and government. Actual health care is a collateral product. Incidental to the primary business.
Of course physicians should be salaried, but they deserve a better system to work in. A system where health professionals can serve the whole health of the population, not corporate masters. America is not ready yet to have that conversation.