Listen to the doctors! They are on the front lines & know what works. There is no need for some huge new program as the facts are right in front of us, but it seems no one wants to see them. There are many large institutions that have only salaried physicians. Mayo Clinic, Cleveland Clinic, Kaiser-Permanente, the armed services (including the VA), to name a few. All have at least as good an outcome record as anyone, some a lot better. All also have a lower cost per patient than any fee for service practice. The physicians are paid by performance (outcome) not by how many tests and procedures they order & perform. Only a physician can practice medicine and order all of these procedures. It is estimated that 30% of all medical procedures are not necessary. I am a retired physician and I believe that it is much closer to 50% that is not necessary. I have seen the way it works in real life- put the physicians on a salary and per patient costs will drop 40-50% almost immediately. There are many additional issues involved, but there will be no meaningful cost reduction under the existing fee for service system.

Steve S