More care, worse outcomes. Misaligned incentives. Complete ignorance of the macro view. Buckets of waste. Gaps in medical education. Lack of coordination and accountability. Solving health care locally.
In other words, Atul Gawande’s most recent dispatch in “The New Yorker” is, in my opinion, required reading. A snippet:
When it comes to making care better and cheaper, changing who pays the doctor will make no more difference than changing who pays the electrician. The lesson of the high-quality, low-cost communities is that someone has to be accountable for the totality of care. Otherwise, you get a system that has no brakes.