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Os médicos rejeitam a maioria de medidas cost-saving na reforma do pagamento

por Nancy Ryerson, Staff Writer | July 25, 2013
Physicians are all for reducing the cost of health care — but most would rather the burden fall on insurance companies, device manufacturers and patients, according to a new survey from the Mayo Clinic.

The survey asked around 2,500 U.S. physicians about their perceived role in addressing health care costs. Only 36 percent reported that practicing physicians have a "major responsibility" for reducing health care costs. In contrast, 60 percent said trial lawyers have a major responsibility, 59 percent chose health insurance companies, 56 percent chose device manufacturers and 52 percent agreed patients have a major role.

The surveyed physicians were even less enthusiastic about eliminating fee-for-service models -- only 7 percent supported the idea, though more responded favorably when it was coupled with having a salary plus bonus compensation type.

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Respondents reacted favorably to cost-containment strategies that improved continuity of care, but did not respond well to the idea of bundled payments or penalties for admissions.

"The findings suggest that physicians do not yet have that 'all-hands-on-deck' mentality," wrote Dr. Ezekiel J. Emanuel, and Andrew Steinmetz of the University of Pennsylvania, Philadelphia in an accompanying editorial. "Indeed, the survey [...] suggests that in the face of this new and uncertain moment in the reform of the health care system, physicians are lapsing into the well-known, cautious instinctual approaches humans adopt whenever confronted by uncertainty: blame others and persevere with 'business as usual'."

The full study is published in the July 24/31 issue of JAMA.

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