tort reform should be part of it, but no reason it has to be first
I respectfully disagree. Doctors are currently between a rock and a hard place: lawyers on the one side who see doctors only as "deep pockets" and sue at the drop of a blood pressure, and Medicare on the other who is trying to squeeze blood out of a turnip. There isn't much we can do about the militant Medicare bureaucrats at this time. There is something we can do about the lawyers: chop off needless malpractice lawsuits and the dueling-experts burlesque in our Courts.
One way to do that, as I've said several times, is to codify into Standards the Best Practices already published by the various medical organizations, get all of the parties to agree on those Best Practices, then have Congress put the force of law behind the Standards. (Note that government doesn't have a hand in creating the Standards, but requires the Courts to recognize and give weight to the Standards.)
Want to sue? Prove the doctor violated Best Practices Standards. It moves malpractice from dueling experts to a much simpler exercise in element identification, something lawyers learn how to to in law school. Shortens trials, prevents frivolous trials, reduces Court costs, and takes a huge monkey off the backs of doctors.
Remember, the doctors' malpractice insurance lawyers say "do this", the insurance companies and Medicare nitwits say "don't do that."
And who benefits from such a system? The doctors, you the patient, and the Medicare robots who can find more useful employment elsewhere.
And if we don't do that? Doctors are not stupid; if they can't pay off their student loans and continuing education, they will find less stressful employment elsewhere. THEN who will look after your health? Immigrants?
except of course that the “how-to” manual would remove the judgments of the best doctors and reduce them to short order cooks rather than master chefs