The Washington Post has a section today titled "Scenes from the 21st century doctor's office."
One feature, written by Manoj Jain, an infectious-disease specialist in Memphis, advocates for a new system of "bundled" Medicare payments to doctors. He notes that currently, "patients, insurance companies and Medicare pay separately for each procedure in the predominant 'fee-for-service' model. It's a design flaw of our health-care system, and one of the reasons for spiraling health-care costs." But, bundling Medicare payments into one could work like this: "The doctors and the hospital would receive one payment for a given treatment, such as an appendectomy or months of cancer care. Doctors and hospitals would develop a contract stipulating the fees each would receive for specific procedures" (3/9).
Related earlier KHN story: Tulsa Hospital Gives Medicare Patients Cash Back For Surgery (Galewitz, 10/26).
In a first-person patient perspective, Ruth Samuelson writes: "It seemed like a relatively simple process: When you get sick, first call your primary-care doctor. Second, visit said doctor. Third, follow doctor's orders: Fill prescriptions, take to bed, whatever. Fourth, get better. But what if you can't even get past Step 1?" She goes on to detail the difficulty of finding primary care physicians in Washington D.C. - she started looking in 2008 and didn't find one until December 2009 (3/9).