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Economism and the Commercialization of Health Care

Published online by Cambridge University Press:  01 January 2021

Howard Brody
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Extract

Pay-for-performance (P4P) represents an effort to improve the quality of health care by paying physicians more if they meet specified target measures. There are both empirical and theoretical reasons to be deeply suspicious of P4P schemes applied at the level of the individual physician or health provider. Most P4P programs were implemented before there were any good data to demonstrate that they achieved the desired results. Once such schemes were in use, the available data are far from reassuring. Common findings are that providers may do more of the specific procedure that is being measured, but in the process may neglect to do other things that equally affect quality of care. Payers often find that the cost of implementing a P4P program far exceeds the value of the very modest resulting improvements; and payments may unfairly benefit providers who are already meeting quality targets while disadvantaging those who make the most strenuous efforts to improve.

Type
Symposium
Information
Journal of Law, Medicine & Ethics , Volume 42 , Issue 4 , Winter 2014 , pp. 501 - 508
Copyright
Copyright © American Society of Law, Medicine and Ethics 2014

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References

Petersen, L. A. Woodward, L. D. Urech, T.et al, “Does Pay-for-Performance Improve the Quality of Health Care?” Annals of Internal Medicine 145 (2006): 265–272.Houle, S. K. McAlister, F. A. Jackevicius, C. A., “Does Performance-Based Remuneration for Individual Health Care Practitioners Affect Patient Care? A Systematic Review,” Annals of Internal Medicine 157 (2012): 889–899.CrossRefGoogle Scholar
Berwick, D. M., “The Toxicity of Pay for Performance,” Quality Management in Health Care 4 (1995): 27–33.CrossRefGoogle Scholar
Qaseem, A. Snow, V. Gosfield, A.et al, “Pay for Performance through the Lens of Medical Professionalism,” Annals of Internal Medicine 152 (2010): 366–369.CrossRefGoogle Scholar
See for example Hettiger, S. Natinsky, P. Neller, J., “The Effect of Payment Reform on Physician Practices: Part 1: The Shift from Fee-for-Service to Outcomes-Based Reimbursement,” Michigan Medicine 111 no. 5 (2012): 14–18.Google Scholar
Ekins, P. Max-Neef, M., eds., Real-Life Economics: Understanding Wealth Creation (New York: Routledge, 1992);Teivainen, T., Enter Economism, Exit Politics: Experts, Economic Policy, and the Damage to Democracy (New York: Zed Books, 2002).Google Scholar
Brody, H., The Golden Calf: Economism and American Policy (CreateSpace/Amazon, 2011).Brody, H., “Bioethics, Economism, and the Rhetoric of Technological Innovation,” in Hyde, M. J. Herrick, J. A., eds., After the Genome: A Language for Our Biotechnological Future (Waco, TX: Baylor University Press, 2013): 177–191.Google Scholar
Harvey, D., A Brief History of Neoliberalism (New York: Oxford University Press, 2005).Mirowski, P., “Postface: Defining Neoliberalism,” in Mirowski, P. eds., The Road from Mont Pelerin: The Making of the Neoliberal Thought Collective (Cambridge, MA: Harvard University Press, 2009): 417–455.CrossRefGoogle Scholar
Somers, M. R., Genealogies of Citizenship: Markets, Statelessness, and the Right to Have Rights (New York, Cambridge University Press, 2008).Sandel, M. J., What Money Can't Buy: The Moral Limits of Markets (New York: Farrar, Straus and Giroux, 2012).Frank, T., One Market under God: Extreme Capitalism, Market Populism, and the End of Economic Democracy (New York: Anchor Books, 2001).Google Scholar
Gasper, D., The Ethics of Development (Edinburgh: Edinburgh University Press, 2004).Google Scholar
Mirowski, P., Never Let a Serious Crisis Go to Waste: How Neoliberalism Survived the Financial Meltdown (New York: Verso, 2013).Google Scholar
See Somers, , supra note 8, at 73–74.Google Scholar
See Sandel, , supra note 8.Google Scholar
Id., at 10–11.Google Scholar
Polanyi, K., The Great Transformation: The Political and Economic Origins of Our Time (Boston: Beacon Press, 2001).Google Scholar
See Brody, , Golden Calf, supra note 6;Weber, M., The Protestant Ethic and the Spirit of Capitalism, trans. Parsons, T. (Mineola, NY: Dover, 2003).Google Scholar
See Brody, , Golden Calf, supra note 6;Bigelow, G., “Let There Be Markets: The Evangelical Roots of Economics,” Harpers Magazine 310, no. 1860(2005): 33–38.Google Scholar
Hilton, B., The Age of Atonement: The Influence of Evangelicalism on Social and Economic Thought, 1785–1865 (Oxford, UK: Clarendon Press, 1986).Google Scholar
See, for example, Morici, P., “Obama Blind to Facts on Extended Unemployment Benefits,” UPI Analysis, January 24, 2014, available at <http://www.upi.com/Top_News/Analysis/Outside-View/2014/01/24/Obama-blind-to-facts-on-extended-unemployment-benefits/UPI-52531390570263/>(last visited November 10, 2014).(last+visited+November+10,+2014).>Google Scholar
Weber, M., The Protestant Ethic and the Spirit of Capitalism, trans. Parsons, T. (Mineola, NY: Dover Publications, 2003).Google Scholar
Ryken, L., Worldly Saints: The Puritans as They Really Were (Grand Rapids, MI: Zondervan, 1986).Google Scholar
Chait, J., The Big Con: The True Story of How Washington Got Hoodwinked and Hijacked by Crackpot Economics (Boston: Houghton Mifflin, 2007).Google Scholar
See Mirowski, , supra note 10.Google Scholar
Cassidy, J., How Markets Fail: The Logic of Economic Calamities (New York: Farrar, Straus and Giroux, 2009).Smith, P. B. Max-Neef, M., Economics Unmasked: From Power and Greed to Compassion and the Common Good (Totnes, Devon, Uk, Green Books, 2011).Google Scholar
Powers, M. Faden, R., Social Justice: The Moral Foundations of Public Health and Health Policy (New York: Oxford University Press, 2006).Google Scholar
Kawachi, I. Kennedy, B. P., The Health of Nations: Why Inequality Is Harmful to Your Health (New York: New Press, 2002).Wilkinson, R. Pickett, K., The Spirit Level: Why Greater Equality Makes Societies Stronger (New York: Blooms-bury Press, 2009).Google Scholar
Id. (Wilkinson and Pickett).Google Scholar
See <http://avoidablecare.org/>(last visited November 10, 2014).(last+visited+November+10,+2014).>Google Scholar
Brody, H., “Medicine's Ethical Responsibility for Health Reform—the Top Five List,” New England Journal of Medicine 362 (2010): 283–285.Cassel, C. K. Guest, J. A., “Choosing Wisely: Helping Physicians and Patients Make Smart Decisions about Their Care,” JAMA 307 (2012): 1801–1802;see also <http://www.choosingwisely.org/>(last visited November 10, 2014).CrossRefGoogle Scholar
Id. (Brody);Berwick, D. M. Hackbarth, A. D., “Eliminating Waste in US Health Care,” JAMA 307 (2012): 1513–1516.Fuchs, V. R. Milstein, A., “The $640 Billion Question—Why Does Cost-Effective Care Diffuse So Slowly?” New England Journal of Medicine 364 (2011): 1985–1987.Google Scholar
See <http://conference.lowninstitute.org/>(last visited November 10, 2014).(last+visited+November+10,+2014).>Google Scholar
Wilper, A. P. Woolhandler, S. Lasser, K. E.et al, “Health Insurance and Mortality in US Adults,” American Journal of Public Health 99 (2009): 2289–2295.CrossRefGoogle Scholar
Philips, W. R., “Questioning the Future of Family Medicine,” Family Medicine 36 (2004): 664–665, at 664.Google Scholar
See Mirowski, , supra note 10.Google Scholar
Woolhandler, S. Ariely, D. Himmelstein, D. U., “Why Pay for Performance May Be Incompatible with Quality Improvement: Motivation May Decrease and Gaming the System Is Rife,” BMJ 345 (2012): e5015.CrossRefGoogle Scholar
Malina, D., “Performance Anxiety—What Can Health Care Learn from K-12 Education?” New England Journal of Medicine 369 (2013): 1268–1272.CrossRefGoogle Scholar
See Mirowski, , supra note 10.Google Scholar
Callahan, D. Wasunna, A. J., Medicine and the Market: Equity v. Choice (Baltimore: Johns Hopkins University Press, 2006).Google Scholar