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Hospitals and I think doctors get paid by diagnosis and treatment rather than by outcome. So for example, a doctor has an incentive to so a fast C-section and get paid more for doing surgery than for monitoring and assisting a 16 hour labor. I won't say any doctor chooses the C-section because he's greedy, but doctors are human. At the same time, the hospital gets paid for 48 hours of care after delivery. I got to tell you, after delivering some of my babies, I could have hopped off the table and walked home with the kid. After others, I really needed a good week of rest to recover. The same thing happens whenever people go in for surgery or treatment of an illness.
A related problem is that the GP who takes the time to spot and treat your chronic illness gets paid at a lower rate than a surgeon. So the fellow that watches your blood pressure and gets you to stop smoking and prescribes the medication to get your cholesterol down so you don't have a hear attack at 50 gets paid less than the surgeon who does the by-pass. As a result, we have too many surgeons and not enough GPs. Does that make sense?
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