In this New England Journal of Medicine perspective, Meredith B. Rosenthal writes about the prospect of achieving compromise in payment reform:
Which recipe will yield the best balance of meaningful incentives for cost control and quality improvement, risk protection for providers, and selection incentives remains to be seen. The prospects for payment reform, however, hinge more on politics than on economics. Given that the two major goals of reform are to constrain spending growth and to move money from more intensive to less intensive settings — from doctors who carry endoscopes and scalpels to primary care physicians, for example — there will be substantial resistance to even the best-designed plans.
How should Congress address issues of competing interests in payment reform? Could doctors come to an agreement or a compromise with our own community? What would help facilitate that?