Saturday, April 10, 2010
Hospital Medicine 2010 panel on health care reform
Yesterday morning’s plenary sessions included a panel discussion on health care reform featuring Eric Siegal, MD, FHM, Patrick Conway, MD, MSC, Leslie Norwalk and Ronald Greeno, MD, FHM. The tone, though not overtly partisan, was generally favorable to the recently passed bill.
What did I learn? Mainly some specifics in this bill that confirmed many of my fears about unintended consequences. The administrative arms of the new health system will have discretionary power to make all sorts of new changes without legislative approval. Just one example is the new subsidiary of CMS, the Center for Medicare and Medicaid Innovation. The perverse incentives and potential new crimes created by this package are staggering. With the prospect of increased bundling of all sorts of services the new catch phrase is “aligned incentives”, really a euphemism for collusion among providers to limit care.