Health Care Reform — Toward More Freedom, and Responsibility, for Physicians

August 6, 2009

Most discussions about health care reform focus on efforts to expand the number of people who are covered by health insurance. Yet the current system does not work well even for those who do have coverage. Costs continue to rise at an unsustainable rate even though health plans increasingly shift costs to patients and restrict coverage.1 For Medicare, the focus of cost control is largely on fee constraints, which has led to a shortage of primary care physicians, further exacerbating cost pressures.2 Making sure that no one is denied access to needed care is an ethical imperative; ensuring that we can collectively afford the cost of such care is a political necessity. [Premium (NEJM)]