Tim Noah of Slate is beginning a series comparing the health care plans offered by the Presidential candidates. I'm reserving judgment on the quality of his analyses. (And I wouldn't make a fetish of the fine points differentiating plans with strong family resemblances at this point anyway; we can be certain they will change considerably when and if they reach Congressional consideration, if they ever do. Probably more instructive are what the early proposals reveal about whether their proponents are in touch with reality, as opposed to uttering pre-programmed ideological rhetoric; are willing to talk about costs, benefits, and their limitations--e.g., "rationing" of care; and their particular alliances with the medical-industrial state.)
Noah does drop in an interesting kicker, which has nothing in particular to do with the plan he is reviewing this week (or, most likely, any of those to come):
The best way to impose discipline on the medical system would be to eliminate fee-for-service payments to doctors and replace them with straight-up salaries. No politician within a mile of the political mainstream is willing to suggest this. But in his new book, A Second Opinion, Arnold Relman, former editor of the New England Journal of Medicine, makes a powerful case that this must be done. Relman points out that the people responding to market forces in the current commercialized medical environment aren't patients, who usually lack the knowledge to make informed choices, but doctors, who maximize their income by maximizing the number of procedures they perform.
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