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Legal Reforms Necessary to Promote Delivery System Innovation
Timothy Stoltzfus Jost, JD;
Ezekiel J. Emanuel, MD, PhD
JAMA. 2008;299(21):2561-2563.
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At the center of any serious health care reform must be reform of the delivery system. The current fragmented fee-for-service system produces haphazard quality, fosters the use of unproven interventions, and increases costs. Although this delivery system fails to generate optimal results, the best alternative is unknown. Indeed, it is unlikely that there is a single best way to organize and deliver health care services. Sustainable reform must facilitate innovation by fostering different ways of organizing and paying for health care services.1
The current legal environment has created major barriers to delivery system innovation. Innovation will not occur if each novel way to organize and pay for care needs to be adjudicated case-by-case or is threatened with legal proceedings. What are the problems with the current delivery system? What legal reforms are needed to encourage delivery system innovation?
Problems With the Current Delivery System
The current health . . . [Full Text of this Article]
Author Affiliations: Washington and Lee School of Law, Lexington, Virginia (Dr Stoltzfus Jost); and Department of Bioethics, The Clinical Center, National Institutes of Health, Bethesda, Maryland (Dr Emanuel).
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