I haven’t backtracked to the original article this editorial cites. In my view, it looks like big evidence of the impact of FFS (fee for service).

Quality Care at Bargain Prices

[Among] the top five teaching hospitals … UCLA was the most extravagant, averaging some $93,000 per patient. Johns Hopkins, at $85,000, and Massachusetts General, at $78,000, came next. The Cleveland Clinic, at $55,000, and the Mayo Clinic, at $53,000, were far more cost-effective.

…. patients usually do no better — and often fare worse — where the spending is highest….

Few will be surprised to discover that doctors in high-expenditure institutions are typically paid on a fee-for-service basis, which means they earn more if they do more. Mayo Clinic doctors, by contrast, are on salary and have no financial incentive to do anything more than the patient clearly needs. …

It’s just starting to sink in to me: this editorial (if it’s accurate) seems to suggest that for all practical purposes, the most expensive hospitals pay doctors on a commission basis. That is CREEPY.

Hey, insurance companies, how do you like that?

Somebody please correct me. Fool that I am, I keep thinking health care ought to be organized around what’s best for the patient. It’s not?

Change note: reflecting on the comment from md@anonymous, below, I’ve removed the word “exclusively” from the last paragraph.