Toward a 21st-Century Health Care System: The Devil Is in the Details
Authors: Robert M. Hansen
Journal: Annals of Internal Medicine (2009)

Letters1 September 2009Toward a 21st-Century Health Care System: The Devil Is in the DetailsRobert M. Hansen, MD, MBARobert M. Hansen, MD, MBAFrom Redding Anesthesia Association Medical Group and Therapeutic Pain Management Clinic, Redding, CA 96001.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-5-200909010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The first recommendation in the article by Arrow and colleagues (1) to replace fee-for-service payment with an alternative, such as capitation, would require revolutionary changes in how physicians are organized among themselves and how they relate to hospitals and other facilities. Although the Kaiser Permanente model exists, most physicians in the United States practice fee-for-service medicine. The vague description of a payment system that enhances innovation, which is a laudable goal, requires concrete details. In addition, no evidence exists to suggest that capitated systems promote innovation. Anecdotally, the opposite is true. My wife worked as an emergency ...Reference1. Arrow K, Auerbach A, Bertko J, Brownlee S, Casalino LP, Cooper J, et al. Toward a 21st-century health care system: recommendations for health care reform. Ann Intern Med. 2009;150:493-5. [PMID: 19258550] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Redding Anesthesia Association Medical Group and Therapeutic Pain Management Clinic, Redding, CA 96001.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoToward a 21st-Century Health Care System: Recommendations for Health Care Reform Kenneth Arrow , Alan Auerbach , John Bertko , Shannon Brownlee , Lawrence P. Casalino , Jim Cooper , Francis J. Crosson , Alain Enthoven , Elizabeth Falcone , Robert C. Feldman , Victor R. Fuchs , Alan M. Garber , Marthe R. Gold , Dana Goldman , Gillian K. Hadfield , Mark A. Hall , Ralph I. Horwitz , Michael Hooven , Peter D. Jacobson , Timothy Stoltzfus Jost , Lawrence J. Kotlikoff , Jonathan Levin , Sharon Levine , Richard Levy , Karen Linscott , Harold S. Luft , Robert Mashal , Daniel McFadden , David Mechanic , David Meltzer , Joseph P. Newhouse , Roger G. Noll , Jan B. Pietzsch , Philip Pizzo , Robert D. Reischauer , Sara Rosenbaum , William Sage , Leonard D. Schaeffer , Edward Sheen , B. Michael Silber , Jonathan Skinner , Stephen M. Shortell , Samuel O. Thier , Sean Tunis , Lucien Wulsin Jr. , Paul Yock , Gabi Bin Nun , Stirling Bryan , Osnat Luxenburg , and Wynand P.M.M. van de Ven Toward a 21st-Century Health Care System: The Devil Is in the Details Umesh Gidwani Toward a 21st-Century Health Care System: The Devil Is in the Details Philip Cohen Toward a 21st-Century Health Care System: The Devil Is in the Details Lester Mayers Metrics 1 September 2009Volume 151, Issue 5Page: 366KeywordsAppendectomyBehaviorConflicts of interestEmergency departmentHealth careNursesSurgeons ePublished: 1 September 2009 Issue Published: 1 September 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...