health care is going to become very HMO oriented;
This point is often missed by people that don't understand the history of managed care. HMOs
really worked for wringing many inefficiencies out of the system but all of the low hanging fruit are long gone. With the exception of the elderly most Americans with healthcare get it from some variety of HMO/PPO. There is no HMO model that will solve:
1) a whole bunch of old people with chronic medical conditions
2) insurance companies
3) an increasingly overweight/obese society
4) a sedentary society
5) conditions #3 and #4 developing in
early childhood
6) profit motive in hospitals, home health agencies, Big Pharma
7) unscrupulous trial lawyers
If every person in America belonged to an HMO . . . many of these problems would continue unabated. Much like the Medicare debacle that Bushies call reform . . . chopping off the fingers of trial lawyers . . . while an intriguing proposal in and of itself . . . is not a solution. It barely makes any knowledgeable person's top 10. Now if I happened to be a neurosurgeon, orthopedic surgeon, or obstetrician (and loved money) I might have a different perspective.