title: When incentives and professionalism collide.
abstract: As Jin Ma and colleagues observe, an unfettered market approach in China has reduced access to care, increased patients' financial burden, and reduced emphasis on prevention and may have caused declines in quality and outcomes. A major driving force was that perverse incentives altered physicians' behavior toward self-interest at the expense of patients, even where professional ethics dictated otherwise. Other nations, including India, are grappling with the profit motive and its consequences. Chinese leaders are attempting to deal with these problems by expanding public investment and reducing perverse incentives. However, profit motives remain a powerful, potentially offsetting feature of a reformed system.
authors.affiliation: Program in Health Care Financing, Harvard School of Public Health, in Cambridge, Massachusetts, USA. hsiao@hsph.harvard.edu
authors.forename: William C
authors.initials: WC
authors.lastname: Hsiao
mesh_terms: D002681:China; D003695:Delivery of Health Care / Q000458:organization & administration; D018166:Health Care Reform; D019981:Health Care Sector; D005102:Health Expenditures; D006801:Humans; D010816:Physician Incentive Plans; D010818:Practice Patterns, Physicians'; D011634:Public Health / Q000191:economics; D011787:Quality of Health Care