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You seem to be holding up HMO's as a model. I find that laughable. The only way government can control costs is limit services, any other suggestion is smoke and mirrors.

Andy @ 8:39 AM PDT, Jun 30, 2009

The only solution is single payer. After WW2 when Europe was broke, they went to a single payer system. 30 nations now have it! The US is the only country in the world who has a forprofit system, compliments of Richard Nixon.

speak truth @ 6:21 AM PDT, Jun 30, 2009

This is all hogwash! The Single Payer system could be administered for 1.5% as opposed to 31% for profits skim for millionaire CEO's, Advertising drugs, beancounters (not doctors)overuling your doctor,forcommissions. We have enough money in the system to pay for everyone: medical, mental, dental, vision, long term, nursing home, you name it. The american people are being bamboozled and hoodwinked. Go to PNHP.org.

liz allen @ 6:19 AM PDT, Jun 30, 2009

Britain has set up a National Institute for Clinical Excellence or NICE to use the cost-effectiveness model to decide what to pay for. Skyrocketing prices of drugs and devices have led to a growing number of countries to limit drug pricing. National Institute for Clinical Excellence can asses the drugs that the country needs and the price its citizens can pay. It is a trend that is likely to accelerate during the present global economic slowdown. Bangalore India

H.N.Ramakrishna @ 4:50 AM PDT, Jun 30, 2009

key is the goal, not the result or treatment Our problem is not even that as no one has told doctors not to do that. The stories of over use of diagnostics and treatment are obvious indicator of relative freedom of doctors. The cost issue will not go away that easily. So far, people are not looking at a win-win situation. Everyone is fighting for their piece of pie and hurting each other. Basically, we need is a culture of collaborative success not competition success. We did few articles around that on our blog. dr. r.k.pandey blogs.biproinc.com/healthcare www.biproinc.com

Dr. R.K. Pandey @ 7:51 PM PDT, Jun 29, 2009

Good article. You've hit on a lot of the major points, and how they get fixed will take a lot of discussion. But one thing that can be fixed right now is how you participate in your own health. Eating right, losing weight, exercising more, and making better lifestyle choices are the single most important things that any of us can do to help prevent serious illnesses from occurring in the first place. That's not to say that it will work 100% of the time, but lifestyle accounts for a fair amount of your overall health. There are a myriad of online tools, forums, weight and fitness trackers right there, available whenever you want or need.

lori @ 6:54 PM PDT, Jun 29, 2009

Some existing caps, like requiring referrals from the primary physician and charging that physician for too many referrals to specialists are not necessarily good medicine. I had to have a total knee replacement because my primary did not want to refer me to a rheumatologist or an orthopedist. When I finally was allowed to see an orthopedist, my age and the severity of the arthritis make my recovery very difficult (painful and longer than normal). Be careful what you ask for; it can ricochet for a bad outcome.

Kathy K. @ 5:14 PM PDT, Jun 29, 2009

The solution lies in a "safety net" public option for ALL of us, that can be upgraded in our personal discretion. We will cover everyone for all the basics - a sort of HMO system without the 30% profit and the endless waste of over-billing and admin - then people can buy incremental insurance for PPO and Out of Network style benefits if they want the larger battery of tests, the more personalized approach and the less cost-conscious treatment. Administrative waste is the first place to cut costs - we should not get 15 bills for the same procedure, each one contradicting the others.

apples and apple pie @ 12:09 PM PDT, Jun 29, 2009

I keep hearing about computerizing records. But what about the provision in HIPAA (pushed through by Clinton, implemented by Bush) that allows *anyone* to get one's medical records, if they are stored and/or transmitted electronically? supposing i don't want some drug company knowing i need this drug, or that treatment? Under Obama's plan, i'm screwed, since hospitals will be required, under the guise of "modernization" to store my records electronically. Does anyone think that if i say so, the hospital or doctor will print out my records and send them via snailmail? i don't

John Galt @ 11:46 AM PDT, Jun 29, 2009

You're all just dancing around the main problem: Health care is held hostage to Big Pharma and Big Insurance. Our Congress, which is worse than the "Oldest Profession" is on the take to maintain the status quo -- and ensure their own re-election. Single payer is the only way to go. Everybody knows it; everybody has observed the difference in health care and prescription costs in other "developed" countries. And nobody does anything except suggest bandaids.

Ramona @ 11:15 AM PDT, Jun 29, 2009

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