The director of health policy at the Bipartisan Policy Center says it is, and that government payments for health care should be based on quality not quantity. She focuses on the fee for service model specifically.
Though Medicare became law almost half a century ago, its payment system is still essentially intact: a "fee-for-service" (FFS) reimbursement system that pays providers for each intervention they perform, without regard to whether the treatment improves patient health. Health spending has soared since then: National health expenditures were $27.1 billion in 1960; today they are over $2.6 trillion.
The FFS system cemented the practice of largely focusing on treating disease instead of on preventing patients from getting sick in the first place.
Around the turn of the 20th century, this treatment model was appropriate. Acute, infectious illness, such as tuberculosis or influenza, were major causes of death at this time. But today, chronic disease -- long-term conditions requiring careful management -- are far more prevalent and costly.
The difficulty will be political. She outlines various existing laws that make it difficult to transition out of this model. She might also add that among the groups that will oppose this transition are those that benefit financially from it. If health care costs are cut, those cuts will affect someone's pocketbook.
