, Volume 8, Issue 4, pp 383-386
Date: 14 Sep 2011

Conflicts of Interest and the Future of Medicine: The United States, France, and Japan

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As the promise of health care reform in the United States continues to face political and legal hurdles, few questions evoke as heated a debate as those surrounding cost control. Though most stakeholders agree that too many dollars change hands in the U.S. health care economy, politically tenable solutions to the problem have been elusive, as evidenced by the paucity of substantive cost-control measures in the current reform efforts. At the heart of the debate are fundamental tensions between patient choice and societal cost, between autonomous physician decision-making and adherence to clinical guidelines, and between free health-care markets and government oversight of those markets.

This past spring, the Independent Payment Advisory Board (IPAB) was introduced in the United States as a key component of the deficit reduction plan and was designed as a neutral body with the authority to cut Medicare spending if the federal health insurance program exceeded certain targets. A predictabl ...