WSJ: "Let Doctors Cure Health-Care Costs...Working Within A Fixed Budget

For years, the efforts to cure the health-care system's ailments -- including runaway costs,
less time physicians can spend with patients, and the rules and reports that consume more time of physicians and hospital staff --- have failed.

The ailing fee-for-service model could be replaced by salaried -physician groups working within a fixed budget.

Practicing physicians are not accountable for the number and the costs of the resources used in diagnosing and treating a patient. They also aren't accountable for costs generated by specialists to whom they refer a patient, and neither are the specialists.

It is as if a homeowner needed to worry about the household budget costing more than necessary. Setting limits on total costs over an episode of illness has no master control working against constraints.

The ultimate success of these Medicare innovations is unlikely unless the care-delivery system is controlled by salaried, primary-care physicians groups held accountable of staying within a budget.

(Read more on A17, Monday WSJ by Dr. Mitchell T. Rabkin, of Harvard Medical School and John S. Cook, an independent consultant in health-care payment.)