Lynn you seem to think that whatever a hospital spends, its costs, ought to be paid for. Maybe you need to reconsider...why do we need as many hospitals that we have, if many are failing perhaps the "free" market ought to just let them go...so say good-bye to all those Steward facilities (Lynn wouldn't mind, they aren't members of her association). Good riddance to little old Holyoke, it's falling down anyway. And same for Noble, Harrington and anyone without a deep pocket godfather. The result, significant costs are removed from the system and occupancy rates go up everyone else. What's not to like there?

Reducing payment to any health care provider results in cost shifting. Somehow it can not get through legislators and some of the public's head that delivering services has a fairly fixed cost. If someone pays less for a particular treatment the shortfall will be made up elsewhere. Eliminating services does not eliminate the people who have to administer them. The real savings is in reforming the structure of insurance price setting and the negotiations between insurer and provider. Without uniform pricing and all encompassing risk pools of the well, sick, and very sick this is not true insurance. Insurers cherry pick healthier populations rather than cover all comers. If everyone was in under similar circumstances and similar payouts the bureaucracy would shrink and providers could streamline their billing departments. Time and time again it has been pointed out that the savings would be $400 billion nationwide. Medicare runs with a less than 5% overhead while private insurers operate with 11 to 30% costs. Having central rules would be boon to our capitalistic system by adding the savings to places in the economy that could sorely use it for boosting incomes and creating and preserving positions. The jobs lost in the insurance industry would be made up by other employers who have significantly lower health insurance costs. There would be strong incentive to hire and expand the economy.