Originally Posted by MP0WER
Just playing a little devil's advocate below....
My biggest complaints:
1.) Pegging physician salaries to healthcare outcomes is notoriously tricky. How do you do this without making physicians select their patients? If you pay physicians based on how their patients do, you will provide an incentive for them to treat the healthiest individuals, or the individuals with the best prognosis. The current reimbursement system is crap ($1500 for a 30 minute PCI, while $1500-$2k for a 4-5 hour CABG/bypass procedure), but we have to be careful how we organize the new compensation system. Prevention MUST be emphasized. It is ridiculous that a 30 minute health counseling session is billed the same as a 30 second procedure. One of the reasons our country sucks in terms of life expectancy is that we have terrible preventive services. We are great at fixing the problem once it occurs (arguably the best specialist services in the western world), but we are useless at preventing these illnesses in the first place. And yes, they ARE preventable, for the most part.
2.) I don't like the idea of mandating healthcare through employers. We need to break this cycle. It's horrible that if someone is laid off, they lose insurance coverage for them AND their family. We need to move away from employer provided health insurance to a social insurance model, where everyone has to buy their insurance separately.
3.) Cuts to medicare spending. This is very disturbing, as medicare already compensates may doctors at cost or below cost. If this trend continues, you will see more doctors dumping their medicare patients, leading to a real shortage of physicians for the underprivileged.
4.) I think they struck down the provision that would have allowed medicare to expand coverage? This , in my view, is a good thing. I am all for insurance coverage for those who cannot afford it, but I am adamantly against a single-payer system.