Best assessment I've read in the public media in 30 years. Two suggestions: 1) Competing Oligopolies should be considered, so long as each controls the full spectrum of service needs (e.g., think Partners or BI Deac with single payer contracts and the ability to provide all services except for that offered by competing oligopolies in a geographic area). 2) The parallel - while competing 3rd party insurers are truly inflationary, equally problematic is the decision in the 70/80's to encourage competition by giving free-standing alternatives to the local and regional hospitals ... competing oligopolies, controlling all that single payer revenue would never sub-contract with free-standing Surgi-centers, labs, radiology centers, MRIs and perhaps many of the super SNF sub-acute units in nursing homes (albeit, that is less problematic). In sum, while we should eliminate competing insurers, most of the financial savings will occur on the 'supply side' of service delivery. Together, proactive efforts on both fronts )if pursued 10 years ago) would have left us with a societal health care delivery bill that would be 20 % to 30% less than the bill now being paid.

You neglected to mention the costs the insurance industry forces on providers. Hospitals have entire departments dedicated to obtaining pre-approval, billing, claim denial appeals etc. Every physician's office also have staff dedicated to the above. It is unfortunate that your recommendations will be ignored by a governor and legislature who place the continued survival of the health insurance industry above the welfare of MA residents.

1) Don't tell me about the overhead in a cherry-picked place like Ontario. What is the overhead for Medicare and Medicaid? Why are both programs going bankrupt? Ontario is a fantasy. Tell me what we're likely to achieve in the US. 2) One function of billing individuals (in ANY business) is to detect and eliminate fraud committed by management. Medicare and Medicaid already have fraud problems. How will your system avoid them? 3) The "medical arms race" drives invention and innovation. I don't want to end it. 4) How do "right size" the physician work force? Central planning? Some bureaucrat decides how many doctors we need, what type, and where they should go? No thanks. 5) Drug companies charge Americans more to make up for getting less from Canadians. If we pay less to, will we get cheaper drugs, or just a bankrupt pharmaceutical industry and no drugs? 6) A hospital CEO makes more than the President because the President's salary is kept artificially low for political reasons. You don't understand economics or politics, do you?

the previous blogger asks the Globe writers "You don't understand economics or politics, do you?". Unfortunately they not only DO, they DON'T CARE. They have an AGENDA, which is like Elizabeth Warren's and Barack Obama's "If you are successful, you didn't build that on your own". This is a call to nail those RICH DOCTORS, by basically asking them to provide free healthcare.----Notice that the MA legislature and the Globe, when claiming that new legislation is needed to restrain health care costs, they mention that their plans are approved by hospitals, insurers, and anonomyous "health care advocates". ----But NONE of them asks DOCTORS what they think of this.-----The Globe is advocating a MA version of the HHS Kathleen Sibelius, who will DICTATE health care.---------- See yesterday's editorial from the WSJ "Coming to a state near you"---- http://online.wsj.com/article/SB10000872396390443343704577553172506961212.html?KEYWORDS=coming+to+a+state+near+you----------------- And See today's editorial from the WSJ "RomneyCare 2.0"------------ http://online.wsj.com/article/SB10000872396390443343704577553172506961212.html?KEYWORDS=coming+to+a+state+near+you