Alan Sager and Deborah Socolar think so. They've penned an op-ed for the Boston Globe in which they argue that the political power wielded by hospitals and insurance companies makes them less inclined to accept cuts in payments. And since you can't fight City Hall, they recommend the following:
Only by persuading doctors to be fiduciaries, not entrepreneurs, can we craft health care that is self-regulating, covers everyone, extirpates waste, and spends only what's affordable. This requires a financial, legal, and clinical peace treaty between payers and doctors. Different ways to do this should be tested quickly.
One approach: We urge development of small clusters of primary care doctors and other professionals that live within budgets, accepting capitation payments calibrated to patients' health. Raising primary care doctors' incomes by half would sharply increase their supply and their time to listen to patients and coordinate care.
Payment-related paperwork will be slashed. Doctors could not gain financially by giving unnecessary care - or by withholding needed care. Savings will be recycled to expand coverage and benefits and fulfill the promise of the state's reform law.
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