title: [Fee schedules and cost containment].
abstract: Medical fee schedules are controversial. In this paper we examine the reasons that justify the imposition of fee schedules in the presence of a socially financed health insurance system, and examine the ways of constructing a medical fee schedule. The weakness of fee-for-service tariffs is that they do not allow a control of health care costs if the volume of services is unchecked. Current solutions to this problem--audit of doctors' average cost per case, freeze on new medical practices, or the insurers' discretion in choosing the doctors they reimburse--have multiple drawbacks. Alternatives to fee-for-service payment--such as flat fees, or payment based on the quality of medical services--are discussed.
authors.affiliation: Service d'epidémiologie clinique, Département de rehabilitation et gériatrie, HUG, 1211 Genève 14. Thomas.Perneger@hcuge.ch
authors.forename: François R
authors.initials: FR
authors.lastname: Herrmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Perneger
mesh_terms: D003363:Cost Control; D005245:Fee Schedules / Q000191:economics*; D018588:Fee-for-Service Plans; D005251:Fees, Medical; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D011787:Quality of Health Care / Q000191:economics; D013557:Switzerland