The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Physicians need to be aware of and guard against the liability risks of having nonphysician clinicians provide services that do not meet the standard of care of the practice due to the staff member's inadequate experience or supervision.
Physicians are cautioned that the two obstacles to reforming post-marketing clinical trials are the FDA's reluctance to revisit past approvals and its inability to enforce pharmaceutical companies' commitment to conduct Phase IV trials.
Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.
A physician outlines the RAND Health Insurance Experiment and its conclusion that the deductible feature of consumer-directed health plans can reduce health care spending significantly.
Consumer-directed health plans will result in a more responsive and sustainable health care system in which patients will take more responsibility for management of their chronic conditions.