Changing the way we pay: An A.M.A. journal prediction

“It is my belief that we are headed towards a health system that reimburses based on global capitation,” writes Randy Wexler, M.D., M.P.H. , on virtualmentor.org, a site of the American Medical Association. “Such a change allows the government and others to better estimate expenditures and places responsibility (risk) for cost on providers; the primary incentives in the new system will be the reduction of care determined to be unnecessary on a population level and, hence, of overall costs. …

“Many will say that they have heard such predictions before and nothing ever happened. They believe the same will occur will this time. I believe they are wrong. The percent of G.D.P. devoted to health care continues to rise. Baby boomers are starting to retire. We are in the middle of the worst economy since the Great Depression. The can has been kicked down the road for decades, but we have run out of road. Physicians will not be able to ignore the seismic changes in health care that are occurring all around them. “