The perfect system of medical compensation is not an option

Quoting the increasingly insightful Arnold Kling;

"Keep in mind that there is no perfect system for compensating doctors. For example, if you pay them a fixed amount of money per patient, then their incentive is to see a lot of healthy patients and avoid the sick ones. If you pay them a fixed salary, their incentive is to work short hours. If you pay them for “quality care,” that means that a central bureaucracy, comparable to IPAB, has to define the meaning of quality."    

 and I add "folks will treat to the test" and the quality measure will lose whatever value it had as a measure.

So as usual it is "people respond to incentives" all the way down.


Currently the medical progressive elite and various rent seeking special interests seem to control the narrative and hence the anti fee-for- service propaganda blitz.