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Wednesday, October 10, 2012

Health Care Reform Articles - October 10, 2012


Universal health care and the Iron Triangle myth of U.S. policy makers

Donald Light on the Iron Triangle Myth

By Donald Light
Response to the October 4, 2012 Quote of the Day on the meme of access, cost and quality (http://www.pnhp.org/news/2012/october/aaron-carroll-repeats-meme-of-acce...):
In my comparative studies of universal health care systems, I find their cost/quality profiles vary quite a bit between each other, and over time for the following reasons. The more such systems pay by fee, the more providers drive up costs in the name of "quality" from which they profit, such as Germany from after World War II up to the 1980s. The Canadian system has been suffering from this seeming trade-off for decades. Access stays universal but there seems to be "an iron trade-off" between cost and quality, until systems start moving towards bundled payments and then population-based capitation or salary within a national health service and an ethos of shared responsibility to improve quality within a fixed budget. (Notice the so-called "iron triangle" has faded from view.)
http://www.pnhp.org/print/news/2012/october/universal-health-care-and-the-iron-triangle-myth-of-us-policy-makers


Doctors split on value of low-back injections

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