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Updated: Aug 15, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Paying fairly for good outcomes: which formula works?
1Department of Nephrology and Hypertension at St. John Hospital and Medical Center, Detroit, Mich, USA.
Abstract:
I see the single-based payment systems moving more toward the middle, toward an American-style system using competitive bidding with outcomes-based focus. The American system is moving in the opposite direction despite knowledge of the flaws of a single-payment system. Modernizing our payment system by desegregating Medicare Part A and Part B, applying information technology, and value-based reimbursement along with a bold move toward an HSA methodology could empower patients and physicians, reinvigorate our system with cost savings, and move us in the direction that all industries in a free market system should have the freedom to move.
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