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- François R Herrmann and Thomas Perneger.
- Service d'epidémiologie clinique, Département de rehabilitation et gériatrie, HUG, 1211 Genève 14. Thomas.Perneger@hcuge.ch
- Rev Med Suisse. 2009 Nov 11;5(225):2254-7.
AbstractMedical fee schedules are controversial. In this paper we examine the reasons that justify the imposition of fee schedules in the presence of a socially financed health insurance system, and examine the ways of constructing a medical fee schedule. The weakness of fee-for-service tariffs is that they do not allow a control of health care costs if the volume of services is unchecked. Current solutions to this problem--audit of doctors' average cost per case, freeze on new medical practices, or the insurers' discretion in choosing the doctors they reimburse--have multiple drawbacks. Alternatives to fee-for-service payment--such as flat fees, or payment based on the quality of medical services--are discussed.
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