Harvard Business Review on Fixing Healthcare from Inside & Out

Fixing Health Care on the Front Lines

by Richard M.J. Bohmer

IN THE UNITED STATES and around the world, there have been plenty of proposals for curing what ails health care. All of them—new organizational forms, alternative payment systems, and free-market competition—aim to tackle a universal challenge: improving the quality of health care and reducing, or at least curbing, its soaring cost. But the reality is that regardless of what happens to the many experiments and reform efforts, including the one in Washington, the basic structure of the health care system in the United States and most other countries will remain in place for the foreseeable future. General hospitals, independent practices, and (in the United States) fee-for-service payment ...