The way doctors are reimbursed is based on a formula that ranks the amount of effort the doctor has put in and not on the actual value they are providing. This

The way doctors are reimbursed is based on a formula that ranks the amount of effort the doctor has put in and not on the actual value they are providing. This means that specialists, tests, and other advanced areas receive the bulk of the money regardless of the actual impact on the patient. This leads doctors ordering unnecessary tests and a lack of general practitioners and an abundance of specialists. I don't recall exactly how Britain and Canada do it, but I'm pretty sure it's not the same way. Here's how it works: The RBRVS Fee Schedule.[6]Medicare uses the resource-based relative value scale (RBRVS) to pay for physician services. Under this formula, Medicare offi­cials compute the “objective value” of an estimated 7,000 procedures.[7] Each component of a medical service is assigned a weighted value that is calculated by using social science measurements of the time, energy, and effort required to perform a given proce­dure, including resource inputs such as medical equipment, malpractice insurance, and administra­tive costs. These weighted “values” are then con­verted into dollar amounts and used to determine the fees that Medicare pays to physicians for those ser­vices.[8] The diagnosis related group (DRG) system reimburses hospitals using a similar strategy.[9] http://www.heritage.org/Research/HealthCare/bg1882.cfm http://www.heritage.org/Research/HealthCare/bg1882.cfm