1. Patients have to have financial incentive to NOT overuse the system, which much private insurance allows. This problem will decrease in the future as companies increase deductibles. MSAs can help along these lines, but this is not the forum for that;
2. The tort system must acquire some rationality; and
3. Much of hospital costs are due to ridiculous, cookie-cutter regulation. I can write pages of examples--not local, but ubiquitous--of wasted resources that drive costs up, do little good except in rare cases, and suck resources away from the provision of good patient care. In fact, a hospital administrator and I (who are too old to get any backlash and too damned ornery to care) are writing a paper on this very thing. State surveyors and JCAHO surveyors have become ridiculous. And I say that running one of the few operations that I know of that hasn't been cited for any deficiency by any of the three surveying organizations (AOA also--we are triple accredited) in 25 years.
Well, those are not insightful--everyone knows them, so sorry if I sound pedantic. I am with you on privatization; we just disagree on whether Part D is it.
Isn't that the cause of (or at least related to) a lot of the regulation? Rules and regulations are often designed with lawsuit protection in mind. It's not for the benefit of patients; it's for the protection of doctors and hospitals.
Part D is not *the* solution, but it's a steer in the right direction. Seniors are used to thinking of gov't as being the entity that takes care of them. If we can get them used to at least a bit of their medical needs being met in private plans, then maybe they can be nudged to even more. The Advantage plans that are coming along with Part D are even closer to that.
We can't dismantle Medicare, but we can erode support for it. And Part D is the best shot at that. But only if Conservatives stop with the "gov't program" slogans, and get honest about what it is.