About a month or so back I read an editorial in the Wall St Journal that really shed some light on the health care debate. It was written by a freelance writer in New York and it discussed the impact the bill would have on his personal health decisions. He pointed out that the bill had a mandate to purchase full coverage. For him as a single person in New York the purchase price of a full policy with all of the required coverage would run about $13k per year. Currently, he carried only a catastrophic coverage policy that cost about $2k per year. He figured that left him with $11k per year to cover all of his incidental medical expenses and if he stayed under that limit, he was ahead of the game. He rightly pointed out that this was his health plan, he liked it and that President Obama had repeatedly assured him that if he liked it, he would get to keep it. Unfortunately, that is not the case. The bill would force him to join the insurance pool precisely to utilize his $11k to subsidize others who had no insurance. While I was reading this editorial, it occured to me the efficacy of his plan. The AMA created something called Common Procedural Terminology or CPT codes. It has created a procedural based system. Every procedure has a CPT code and reinbursement is based on the code. The codes effectively dictate what is repaid to the physician. The practice of medicine becomes one long list of procedures. The more procedures, the more repayment. Doctor compensation is not results based, it is procedures based.