Payment Reform ‘Deadlock’

Paul Levy's Facebook photoNo, we won't be All Paul Levy All The Time. But the Beth Israel Deaconess chief and blogger extraordinaire has a particularly cogent guest post today on Kevinmd.com, which bills itself (himself?) as social media's leading physician voice. Analyzing why payment reform has stalled, he notes that the economic downturn meant that many promises made in the 2006 health care reform had to be broken. And now, everybody is blaming everybody else for the continuing cost spiral.

Truthfully, everyone is the problem, and so this is an accurate representation, but it is not a helpful approach. Deadlock is the result. At times like this, people often look for a global solution to sort things out. That is a mistake. There is not a politically possible global solution. There are too many legitimate vested interests to pass a bill or adopt a regulation that shifts hundreds of millions of dollars of costs from one group to another.

... Instead, it is a time for incremental changes that are directionally appropriate. There are things that can garner majority support that will move the system towards a more sustainable level. But to agree on those, the rhetoric needs to be toned down, both within the field and from the government. The demonization of any particular sector destroys the kind of trust that enables people of good will to invent solutions that create value for all.