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when healthcare providers on a fee-for-service base that means in the simplest terms services the more fees now no one questions the goodwill of people who go into the caring professions in health care because they want to cure the sick but if you have everyday the incentive to provide more of the service that you believe in after a while providers are gonna come to believe like the person who has only a hammer that everything out there is a nail and when providers have that incentive the result is going to be excessive use and less attention to all forms of cost including back-office activities in health care that really do not affect the quality of care but theres just no reason to try to save money because people are reimbursed not for the quality that they provide but for the number of services that they provide