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Lots of respect for Dr. Johnston (and we met years ago when he was just starting at Dell Medical School), but the whole premise of "value-based-care" (VBC) is built on the fiction that "fee-for-service" (FFS) healthcare is broken (or the "wrong incentive"), and it's not. We know this because FFS works reasonably well in every other industrialized country. The US is the (big) outlier - but it's not because of the FFS model of healthcare.

The reason is because we're the only country that tiers health coverage - which only serves one purpose - to support tiered (and uncapped) pricing. Single-payer healthcare works - but isn't necessary (or a good fit for us). What's necessary is single-pricing. That's the systemic flaw - not #VBC versus #FFS.



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