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Last Visited: 9/3/2007
Helen Darling, president of the National Business Group on Health, and Robert Berenson, M.D., a senior fellow at the Urban Institute, discuss physician payment during a recent forum sponsored by the AAFP's Robert Graham Center.
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Darling and health care policy expert Robert Berenson, M.D., a senior fellow at the Urban Institute, each spoke at the forum, explaining the role of primary care in reducing costs and improving health care while underscoring the impact of payment policies on the provision of primary care.
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Berenson told the audience that "primary care is dying in this country," mainly because of public and private payment policies that fail to adequately compensate family physicians for their services.
"The decline of people going into primary care positions has been pretty dramatic, (and has been) seriously affected by Medicare's payment system," said Berenson."As it happens, Medicare's payment system for physicians is increasingly and consistently adopted by private health plans."
Physicians, like other members of American society, "go where the money is," he added.
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This particular policy raised objections from Berenson, who said, "Fee-for-service is not a good payment vehicle for supporting what a good primary practice should be doing in the medical home."
"Fee-for-service is dysfunctional," asserted Berenson."I think it is uniquely dysfunctional in primary care."
Darling agreed with Berenson's overall assessment that the "current fee-for-service system is dysfunctional."