My Take on Pay for Performance Healthcare

Pay for Performance Healthcare
Lisa was diagnosed with Reflex Sympathetic Dystrophy Syndrome. According to Dr. Shiel, Reflex Sympathetic Dystrophy Syndrome (RSDS),
…is a condition that features a group of typical symptoms, including pain (often "burning" type), tenderness, and swelling of an extremity associated with varying degrees of sweating, warmth and/or coolness, flushing, discoloration, and shiny skin. (Shiel)
Her physician told Lisa that there was no cure for RSDS and she would just have to deal with the pain. Lisa lost the ability to run and play with her children and she became bedridden. Lisa finally decided to get another opinion and it turns out she had been misdiagnosed with RSDS when in fact she had only twisted her ankle and it was pinching a few nerves in her foot. Lisa went to a chiropractor and in a few weeks she was back to running and playing with her children. What happened to Lisa is an all to common event that happens when physicians spend as little time with a patient as they can and often they make an incorrect diagnosis. Misdiagnosis is a correctable problem but not with our current system of healthcare. Every year one hundred thousand people are misdiagnosed because of the current healthcare system the government has in place. (Swisher) We need a system the rewards a physician for taking the time with a patient to make the correct diagnosis and that system is Pay for Performance Health Care. Pay for Performance Healthcare would not only improve the level of care given to its recipients but it would also save us money. There would be fewer malpractice suits against physicians and hospitals and this would increase the profits of the healthcare industry, one could surmise that the savings would be passed on to the patients. Pay for Performance Healthcare pays a physician based on the level of service they provide their patients and not how many of them they can see in a day. We should do everything in our power to provide the best level of healthcare possible to all of our citizens and Pay for Performance is the answer. Pay for Performance Healthcare is vastly superior to any current system available in the United States and should be implemented as quickly as possible.
Pay for Performance Healthcare rewards physicians for taking the time with a patient required to make a correct diagnosis. According to the publication of the 1999 Institute of Medicine's report,
…more people die every year in a hospital the result of various medical mistakes made, than die from car accidents, breast cancer, AIDS, and airplane crashes combined. The estimate that as many as 100,000 patients dying each year the result of healthcare accidents (that number may be as high as 200,000 per year according to more recent studies)…(Swisher)
Pay for Performance Healthcare will decrease the number of medical mistakes through the bonus structure given to physicians and hospitals for good patient care. The Pay for Performance Healthcare System according to Harvard researchers has “…shifted from a focus on processes of care to one that emphasizes patient outcomes, cost efficiency and use of information technology.” (Rosenthal) and that is exactly what this country’s healthcare system needs. The benefit of a healthcare system that rewards physicians and hospitals for the level of care given and the eventual outcome of their patients are almost immeasurable. Focusing on the patient’s needs, as opposed to, the amount of money a physician or hospital can make by seeing more patients is the solution for those hundred of thousands of medical mistakes made every year by physicians and hospitals.
The implementation of the Pay for Performance Healthcare system would result in fewer malpractice suits against physicians and hospitals and this would increase the profits of the healthcare industry. Malpractice insurance is the largest cost a healthcare provider incurs. According to David Weber “It can cost an ob-gyn in South Florida $209,000 a year to insure for delivery of babies.” (Weber) Eliminating the majority of malpractice suits would in turn lessen the cost of malpractice insurance to healthcare providers increasing profits. Greater profits for the healthcare industry could result in a reduction of healthcare premiums and a level of competition amongst healthcare providers the likes of which this country has never seen. Competition drives price in the healthcare the same way it does in any other industry. The greater the competition the lower the price and the lower the price the more money the public saves.
Pay for Performance Healthcare will institute a computerized information and file sharing system saving physicians time and potentially saving the lives of their patients. Under the current system if a physician wants a patient’s medical history they have two choices. Either they ask the patient to fill out a medical history form that gives them limited information or the patient has to sign a medical release form and send it to every physician that patient has every visited and wait for the information. The Pay for Performance Healthcare system would put a stop to these archaic practices by sharing the patient’s information at the touch of a button. The file and information-sharing program would give the physician a patient’s entire medical history via a secure database. Having that type of information quickly at hand would prevent accidental death by giving a critically ill patient medication they may be allergic to. According to Michael E Weiss
The general lack of knowledge of the immunochemistry of drug metabolism and immunoreactive metabolites also greatly hampers the ability to accurately use diagnostic tests to evaluate allergic drug reactions. Except for penicillin( n4, n5) and, to a lesser degree, anticonvulsant medications( n6) and sulfonamides,( n7) understanding of immunoreactive metabolites and the immunochemistry of medications is limited. (Weiss)
Instituting a large-scale series of networks and databases would also provide much-needed jobs to American workers. New jobs mean lower unemployment, which translates into money savings for the government. The United States Department of Labor’s Bureau of Labor Statistics claims the unemployment rate in the U.S. is 4.8%. That roughly translates to seven million people being unemployed. Many of those people are over forty-five a have a background in the field of technology. The United States government pays for the healthcare of a large percentage of the unemployed by way of welfare and other government programs. Pay for Performance Healthcare being implemented could potentially put large numbers of those unemployed people to work. If unemployment numbers lower so will the number of people the government will need to provide healthcare to. Every dollar the United States government can save in one place can be used somewhere else. The Pay for Performance Healthcare system could ensure that this generation of working adults and their children both has social security benefits.
Many private practices would argue that Pay for Performance Healthcare is an unobtainable healthcare system. They would suggest the cost of implementation of such a large system of healthcare would simply force many private practices out of business or at the very least force them not to accept government subsidized health care. All private practices would have to buy computers and the network software to use the system and it would be too costly. Others would say the Pay for Performance Healthcare system would be a violation of our right to privacy and that our personal medical information would be at risk. Private practicing physicians claim the cost of hiring an Information Technology department to its staff would be too costly. Some claim that the Pay for Performance Healthcare system is just ineffective. Finally many in the government health care industry claim there would be no benefit to provide incentives to physicians for a higher level of healthcare.
Pay for Performance Healthcare is a large system and would require all practices to have up to date computer systems, networking ability, and software to be part of the system but ninety nine percent of practices already have computers and networking capabilities. The only cost would be for software and that’s only if the government doesn’t supply it to all practices accepting Medicare and Medicaid free of charge. The government would absorb the majority of the cost for implementation of the Pay for Performance Healthcare system. It would simply replace the healthcare system already in place. The money all practicing physicians would save in malpractice suits and malpractice insurance would certainly pay for any initial out of pocket expense they may have incurred as a result. The privacy issue is already an issue and that won’t change. If somebody with malicious intent wants to get your personal medical information they can do it right now. Pay for Performance Healthcare will only make it more accessible to trained medical physicians that could make a more educated decision about how to proceed with a patients best interest in mind by giving them the latest and most up to date medical information about the patient they are treating. Most practices already have either an onsite Information Technology staff at their practice or they have an outside Information Technology company on call so that won’t change because of the Pay for Performance Healthcare system. Those who say that Pay for Performance Healthcare is an ineffective healthcare system should take a look at what is already in place and explain how it is a better system than the proposed Pay for Performance Healthcare system. Finally there are numerous reasons why the government should give physicians an incentive to provide a higher level of healthcare to the American people but if for no other reason it will cost the government less money in the long run by giving the voters a cleaner bill of health and Pay for Performance Healthcare will increase the likelihood of detecting deadly and debilitating diseases when they are still treatable.
Pay for Performance would give more money to physicians, reduce the number of malpractice lawsuits and the cost of malpractice insurance, provide physicians with current and up to date information about their patients more quickly, provide more Americans with jobs by instituting the system initially, and provide the patient with better overall healthcare at a smaller price to the government. That is what Pay for Performance Healthcare is all about. There is not a better system available in the United States or in any other country in the world. The United States of America has the best healthcare professionals in the world but the worst healthcare system and Pay for Performance Healthcare could change that if it were given a chance. Essentially Pay for Performance Healthcare is the best system of healthcare the United States government has ever had. It is being tested in certain markets in California to see just how successful it will be and so far everything looks great. Anyone unwilling to give a chance to a healthcare system with the potential to save one hundred thousand lives a year because of the initial cost of implementation is only looking out for their own best interest and has no place in subsidized government healthcare. Pay for Performance Healthcare saves lives and money and that is the only thing that matters.











Work Cited
"Health Care for All". Massachusetts. website. Stories of Harm: Health Quality Videos. March 12 2008. .
"U.S. Department of Labor Bureau of Labor Statistics". 2008. Unemployment Statistics. (Febuary 2008): United States Government. March 12 2008.
Charters, Lynda. "P4p: Between the Devil and the Deep Blue Sea?
Ophthalmologist Must Participate in the Development of Quality-of-Care Standards." Ophthalmologist Times October 1, 2007 2007: 88-89.
Karen N. Swisher, MS, JD. "Developing a Proactive Executive Fellowship in Patient Safety". website. Danger! Are Hospitals Hazardous to your Health. Feburary 13 2008. .
Scott Endsley MD, MSc, et al. "Getting Rewards for Your Results: Pay-for-Performance Programs". 2004. website. (march 2004). Feburary 13 2008. .
Weiss, Michael E. "Recognizing Drug Allergy." Postgraduate Medicine 117.5 (2005): 32-39.
William C. Shiel Jr., MD, FACP, FACR. "Reflex Sympathetic Dystrophy Syndrome (Rsds)". 2008. website. Medical information website. March 12 2008. .