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Belmont Health Law Journal

Abstract

This is the way I see the progression of recent American history. Unfortunately, the South was always a bastion of fee-for-service care; it still largely is. Managed care has largely failed us because it was largely managing costs, not care, in the ‘80s and ‘90s. Providers talk about value-based care, and “better” is better, but “better” is very hard to define. This field is very trendy right now. I’m a big advocate for pay-for-performance, but you have to be able to measure performance. So, what’s next? The bottom line is that “better” is still way too expensive. Health costs are a crushing burden on both families and our nation. With our employer-sponsored benefit system, we are used to seeing only one quarter of the health care price tags on our pay stubs. We ignore the employer portion, which is largely taken out of our foregone cash wage increases, and we wonder why wages have been sagging in America for forty years. The healthcare sector is taking our cash wage increases from us, and that is an astonishing insight.

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