Capitation invites socialization of medicine

Capitation of Physician's Fees And The Socialization of American Medicine

Some things can't work alone, a lock without a key; while other things need help, like soap needs water, and that's true of Capitation and government control of health care delivery. Even if Capitation of Doctor Fees and government control aren't combined at the outset, in time they will find each other, a result of the frustration and disappointment that both patients and Doctors will feel as they come to the realization that an authoritative force with power to penalize is necessary if the program is to survive. Even with that it hasn't.

What am I getting at?

The American physician's loss of control of their patient's care,or as aptly stated by my colleague, Doctor Colin Sinclair, "We've always had managed care . It's just a case of whose doing the managing".

It started with lower cost "Competitive Managed Care", when a distant third party, the "bill payer", had to pre-approve payment for the patient's care. This system is fraught with error. The corporate mind tends to see all patients and Doctors as being alike and believes that two plus two always equals four, while, we who deliver the care, soon learn that two plus two may equal three, four or even five when dealing with human beings and their health care needs.

"Capitation of Physician Fees".

This is well known formula for paying Doctors, for their services, in nations with government health care systems.. It amounts to Doctors accepting a monthly fee or [pay check] to care for an assigned number of patients, 24/7 as they say, for a contracted period of time, usually one year. For that prepaid fee the Doctor must give the patient as much care as they demand/request. I say demand because in nation's where Capitation is practiced the patients see the Doctor as a civil servant and the Docrior views the patient as a problem to be seen as little as possible. Work  hard or easy, the pay check is the same.  As Doctor Colin Sinclair would say "Any system that makes the Doctor want to stay away from the patients is a bad system".

Most patients and too many physicians unfamiliar with this method of Physician reimbursement are likely to accept this change, much as they did the earlier managed care concept, only to learn that it doesn't work and has been radically modified in the nations where it has been tried.

If Capitation of Physician's fees is widely practiced [by privately manged health care insurers] the Socialization of America's health is sure to follow. No different than soap needing water, or a glove looking for the hand. Count on it and history will support me on this.    Vincent W Cangello MD