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Physicians today, as human beings, are not exempt from the perverse economic pressures created by fee-for-service regimes to see more patients for shorter appointments and order more tests and procedures. If the incentives were changed to pay to foster better health outcomes, I am convinced physician behavior would change over time.

Pay-for-procedure or fee-for-service reimbursement rewards doctors and hospitals for volume - not keeping patients healthy or being efficiency. Pay-for-Performance is clearly one tool that can change the incentives to reward quality.

As economists have often pointed out, we pay doctors for quantity, not quality. As they point out less often, we also pay them as individuals, rather than as members of a team working together for their patients. Both practices have made for serious problems.

Insurance companies pay big bucks for procedures but next to nothing for patient consultations and preventive medicine, which is what most medicine is.

The growth of medical expenditures in the U.S. is not caused by administrative costs but by increases in the technical intensity of care over time - a.k.a. medical progress.

The vast majority of doctors really do try to take the money out of their minds. But to provide the best possible care requires using resources in a way that keeps you viable but improves the quality of care.

Many of us are alarmed at the skyrocketing cost of medical care, including patients, who are the consumers. However, medical malpractice is not the reason for these increasing costs.

The fact of the matter is right now politicians and insurance companies are making decisions. We're saying we want doctors to be making decisions. And I think that will lead to a higher-quality, lower-cost system over time.

Here's where the insurance companies really fail us. They over-pay hospitals, specialists and drug companies and then raise premiums to cover the costs. Further, when they pay hospitals 115% of what it should cost to care for a patient, they are paying for inefficiency that can be dangerous.