{"id":1338,"date":"2014-02-10T13:51:59","date_gmt":"2014-02-10T02:51:59","guid":{"rendered":"http:\/\/blog.panicola.com\/?p=1338"},"modified":"2014-02-13T15:37:07","modified_gmt":"2014-02-13T04:37:07","slug":"making-of-medicare-review-by-andrew-podger","status":"publish","type":"post","link":"https:\/\/blog.panicola.com\/?p=1338","title":{"rendered":"Making of Medicare &#8211; review by Andrew Podger"},"content":{"rendered":"<p>PDF of book review:<br \/>\n<a href=\"http:\/\/blog.panicola.com\/wp-content\/uploads\/2014\/02\/AHv38n1_BR1_MakingOfMedicare_PodgerBookReview.pdf\">AHv38n1_BR1_MakingOfMedicare_PodgerBookReview<\/a><\/p>\n<p><em><span style=\"line-height: 1.5;\">More important than the \u2018ideas\u2019 were the interests and\u00a0<\/span><span style=\"line-height: 1.5;\">institutions. The medical profession won the battle in the\u00a0<\/span><span style=\"line-height: 1.5;\">1940s for fee-for-service against not only the advocates of a\u00a0<\/span><span style=\"line-height: 1.5;\">salaried national health system along the lines of the British\u00a0<\/span><span style=\"line-height: 1.5;\">National Health Service, but also against advocates of private\u00a0<\/span><span style=\"line-height: 1.5;\">approaches, who saw advantage in the friendly societies\u2019 use of\u00a0<\/span><span style=\"line-height: 1.5;\">\u2018lodge payments\u2019, which were like capitation grants. The\u00a0<\/span><span style=\"line-height: 1.5;\">subsequent challenge, debated for decades (and still relevant\u00a0<\/span><span style=\"line-height: 1.5;\">today), was to \ufb01nd an affordable and equitable system\u00a0<\/span><span style=\"line-height: 1.5;\">consistent with fee-for-service. Whatever the balance of public\u00a0<\/span><span style=\"line-height: 1.5;\">and private health insurance, fee-for-service exacerbated the\u00a0<\/span><span style=\"line-height: 1.5;\">problem of \u2018moral hazard\u2019 where doctors, professing interest\u00a0<\/span><span style=\"line-height: 1.5;\">in their patients, are able to add to costs beyond what their patients\u00a0<\/span><span style=\"line-height: 1.5;\">or customers may be willing to pay because the costs are met by\u00a0<\/span><span style=\"line-height: 1.5;\">third party insurers.<\/span><\/em><\/p>\n<p><em>Other interests that needed to be managed\u00a0over the decades included the private health insurance industry,\u00a0the union movement and the States. There were also factions\u00a0within each interest group, most signi\ufb01cantly between specialists\u00a0and general practitioners (GPs) within the medical profession,\u00a0and among a range of GP organisations. <span style=\"color: #ff0000;\"><strong>It remains the case that governments will wisely avoid taking on both the specialists and\u00a0GPs at the same time, and will ensure any proposal provides\u00a0at least one group with bene\ufb01ts they value, whether in terms of\u00a0narrow self-interest or genuine improvements for their patients.<\/strong><\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>PDF of book review: AHv38n1_BR1_MakingOfMedicare_PodgerBookReview More important than the \u2018ideas\u2019 were the interests and\u00a0institutions. The medical profession won the battle in the\u00a01940s for fee-for-service against not only the advocates of a\u00a0salaried national health system along the lines of the British\u00a0National Health Service, but also against advocates of private\u00a0approaches, who saw advantage in the friendly societies\u2019 &hellip; <a href=\"https:\/\/blog.panicola.com\/?p=1338\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Making of Medicare &#8211; review by Andrew Podger<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9,22,6,3],"tags":[],"class_list":["post-1338","post","type-post","status-publish","format-standard","hentry","category-healthcare","category-policy","category-politics","category-rapid-learning-health-systems"],"_links":{"self":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/1338","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1338"}],"version-history":[{"count":4,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/1338\/revisions"}],"predecessor-version":[{"id":1384,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=\/wp\/v2\/posts\/1338\/revisions\/1384"}],"wp:attachment":[{"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1338"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1338"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.panicola.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1338"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}