With all the discussion about the roll out of Obamacare, I was curious what folks think about whether it will work, whether we can pay for it, etc.  I am in favor of universal care, but I am concerned that the current plan does nothing to control costs. It is almost a blank check to the healthcare industry with no way to control costs.  I would be in favor of the government directly providing healthcare to the uninsured through government operated clinics and hospitals.  I think this would be more likely to keep costs down while still providing care to all.  What are your thoughts?

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Mari,

Had we merely expanded Medicaid to guarantee free-clinics in everybody's area, reformed the malpractice standards to combat what is poorly termed "defensive medicine," dramatically curtailed the radical patent abuse that we see from companies like Novartis, and reformed the licensing standards to abolish the practice of imposing residency supply quotas for the purposes of keeping costs high, we wouldn't have any need for this ACA.        

There are three drivers of healthcare cost spikes. The big driver is reckless ordering of procedures by hospitals, in the name of patient safety, for increased revenue. Another possible driver is the restriction of the supply of primary care doctors, due to the AMA's deadly tardiness when it comes to accrediting  more primary care residencies. Another big driver is the increasing number of pure businessmen, administrators who often aren't either doctor or nurse, employed by hospitals and pharmacies who sometimes take nothing like the Hippocratic Oath and care only about money, and are more than willing to use unethical means to get it. Of course, these hospitals are often recognized as "non-profit" and don't pay any kind of corporate tax.

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