DR. MARCIA Angell makes comments and recommendations on healthcare in her May 23 op-ed that should frighten everyone who has ever been ill. Her main points are that the current fee-for-service system of reimbursement to healthcare providers "rewards" them for doing tests and procedures, and that the United States needs a single-payer healthcare system.
Perhaps Angell forgets from her clinical days that healthcare providers do tests and procedures on patients who both need and want them. They are not done in a vacuum. Angell’s solution – to change the system to one wherein healthcare providers would be punished financially for doing tests and procedures – means a severe restriction in the quality and amount of care that providers would be able to offer their patients. And in a single-payer system, patients would have no alternatives. It would be like the post office before the days of Federal Express.
To decrease "incentives" for giving adequate patient care by in essence bribing healthcare providers to do less may save money, but on the backs of patients who would receive fewer services and have longer waits. Worse, in the end it would cause a decline in the quality of care all patients receive.
Dr. Henry Lerner