PAYMENT MECHANISMS TO PHYSICIANS - INSTRU MENT FOR A SANITARY POLICY

Payment mechanisms for physicians have always been subject of debate. The profession tends to prefer fee-for-services, while health care ins titutions prefer to pay doctors by salary or capitation. The definitio n of the payment mechanism is not an administrative decision, it is fr equently the output of an intense political negotiation. Recently an i ncrease in salaried physicians has been observed, even in countries wh ere the profession is powerful. In nations like Mexico, where the Stat e is the dominant actor, salary or capitation can be used as an instru ment to encourage quality of care and better geographic distribution. In this paper, several country cases are reviewed.