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The political atmosphere fueled by the public’s continued frustration keeps healthcare issues in the forefront.  Is insurance coverage, universal or otherwise, the real issue that will cure the “healthcare crisis” in America?  A recent piece written by Maggie Mahar points to the complexity of issues and the fact that “covered” individuals have very real problems receiving necessary services. One of the significant problems identified is the shortage of Primary Care Physicians (PCPs).  The shortage is expected to continue as medical school graduates require higher paying specialties to offset the tremendous debt from school.

As discussions of healthcare reform continue, one of the focuses is around the “medical home” model. This model calls for every American to have a “home” for their medical care, a PCP.  The PCP will coordinate care and manage referrals to specialist. Avoiding unnecessary costs and gain efficiency from healthcare IT such as electronic medical records.  

Commonwealth Fund president Karen Davis explained how physicians would be compensated: “in addition to fee for service [the practice would receive] a monthly . . . fee for being a medical home. It’s a blended system of payment, which has worked very well in Denmark, where  people have well-established relationships with primary care and compensation for primary care is on a par [with] or even higher than compensation for specialty care.

Does this sound like the managed care, gatekeeper model of the late ’80s and early ’90s mixed with concierge medicine?