The Experts: How to Fix Health Care (The Wall Street Journal)


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The Wall Street Journal turns to several leaders in the health care industry—including Dartmouth’s H. Gilbert Welch and Elliott Fisher—with the following question: “What single change could be made to the current health-care reimbursement system to help bring down costs?”

“The single-most effective intervention would be to prohibit third-party payment (i.e., health insurance),” says Welch, a professor of medicine at The Dartmouth Institute for Health Policy and Clinical Practice (TDI). “If all health care was paid for by individuals out of pocket, costs would fall dramatically.”

Fisher, professor of medicine and of community and family medicine and the director of the Center for Population Health at TDI, says “We don’t have to look far for a diagnosis: It is how we pay for care. Fee-for-service payment, in which each test, procedure, hospital stay and home visit is paid for separately, reinforces the fragmentation experienced by patients. The remedy is to shift to a payment system that rewards better care, not just more care, and we are seeing the beginnings of that shift now with the creation of accountable-care organizations.”

Read the full story, published 2/22/13 in The Wall Street Journal.

Fisher was a guest on The Wall Street Journal’s The Experts online video panel on 2/23/13.

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